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Survey: Health Insurance Enrollment In California More Complex Than Anticipated

Newly insured Californians felt relieved after signing up for health coverage but encountered numerous obstacles with technology and communication during the enrollment process, according to a report released Monday by the California HealthCare Foundation.

Surveyed in interviews and focus groups, consumers said they had trouble getting through to the call center, choosing a health plan and calculating their income. They also had problems with the online chat program, and many were surprised by the amount of documentation required to enroll, according to the report.

The problems were worse for Medi-Cal applicants than for those seeking private coverage through the health insurance exchange, the report said.

For their part, enrollment counselors said they did not have enough training and preparation.

Today marks the final enrollment deadline for consumers who had difficulty signing up for private insurance through the state’s health insurance exchange, or Covered California. The exchange gave consumers a two-week grace period to complete applications they had begun by March 31.

Already, about 3 million people have enrolled in coverage in California since October under the health law, including about 2 million in Medi-Cal and more than a million in Covered California.

The survey took place in February and included people who enrolled between Oct. 1 and Jan. 31. Most consumers were motivated to sign up for health insurance for financial security, but others did so because it is the law or to avoid a fine. Family and friends played a significant role in encouraging people to sign up.

The process, however, was confusing for many, according to the report. Some people didn’t realize that Medi-Cal had been expanded under the law to include childless adults or that they could receive tax credits by purchasing plans through Covered California.

“I think we oversold simplicity,” said Frank Mecca, executive director of the County Welfare Directors Association of California. “As it turns out, it is not as simple as we thought.”

The knowledge gaps about insurance remain even after enrollment, said Michael Perry, a partner at PerryUndem Research/Communication, which conducted the survey. “There are a lot of people out there who just don’t know how it works.”

Covered California is figuring out what to do differently, said Sarah Soto-Taylor, deputy director of community relations. The next open enrollment period, which begins in late fall, will be “as complex if not more” so,  she said. “We need to brace ourselves for that challenge and see what we can do better,” she said.