Based on a 2010 survey of people who used Massachusetts’ health insurance exchange (“The Connector”) to sign up for a health plan—and who experienced some difficulty with things like understanding and choosing plans—a group of investigators concludes that such exchanges should be designed with users’ experience in mind.

States are now required to create health insurance exchanges under the Affordable Care Act (ACA). These exchanges serve as marketplaces where individuals, families, and small businesses can go to a single website to find, compare, and select health plans. In 2022, 25 million people are expected to purchase health insurance through these exchanges.

The new study, published in the January 2013 Health Affairs, was led by Anna Sinaiko, postdoctoral research fellow in the Department of Health Policy and Management at Harvard School of Public Health (HSPH), and researchers at Harvard Medical School and the Harvard Pilgrim Health Care Institute. The researchers analyzed how a sample of Massachusetts consumers selected their plans. For the majority of those surveyed, the Connector was the only marketplace they used.

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