How satisfied are ACA exchange enrollees?

Today, millions of Americans receive their health insurance through the marketplaces mandated by the Patient Protection and Affordable Care Act, but many experts wonder how good this coverage actually is for the people who use it. And after a rough first year, it seems that satisfaction with ACA insurance has improved.

On a scale of 1 to 1,000, the satisfaction rating given to health insurance purchased on the exchanges rose to a reading of 670, up from 615 a year earlier, according to a new survey from J.D. Power. What's notable, though, is that this data is not culled just from people who have had coverage for both years that the marketplaces have been open, but only new enrollees, indicating that a potentially large amount of effort has been expended to make sure people are satisfied with their coverage.

However, among people who re-enrolled (getting coverage for the second straight year), it seems that those people were even happier with their coverage, the report said. In all, those people rated their satisfaction level at 731, and people who automatically re-enrolled in the same plans tended to be more pleased with their coverage than those who did not, with those ratings coming in at 744 and 724, respectively.

What does this mean for the marketplaces?
Altogether, then, the report indicates that satisfaction with all plans among new and old enrollees earned a rating of 696. This is, in actuality, 17 points higher than the 679 given to their health care coverage by all people with health insurance. The survey also found that when it comes to what drives satisfaction, the biggest influencer here is the cost of coverage.

Rick Johnson, senior director of the healthcare practice at J.D. Power, noted this certainly plays a role in people being more satisfied with potentially subsidized coverage purchased through the exchanges.  Another factor may be in the discussion as well, according to the report. When people get health insurance outside the exchanges, they typically do so through their employers; but that often doesn't give them a lot of choice when it comes to picking their plans. The added choice on the exchanges could help people find plans that more closely align with their preferences.

This result should serve as a lesson to health insurers offering coverage both on and off the exchanges. If they can get a better understanding of what drives preferences, they may be able to better tailor their offerings going forward.