Mastering the Alphabet Soup: Health Literacy in Colorado

It was October 15, and my colleagues and I at the Colorado Health Institute received the dreaded annual email:

“As I promised, here is the update about our health insurance open enrollment,” it began.

As you can imagine, we were giddy with excitement.

Tim Dunbar, our director of finance and administration, explained the rules of open enrollment to an office of health policy wonks. He detailed the distinctions between our new plan options. He even included a bold-faced “So what do you need to do?” section for us.

I studiously mined the attachments, doing my due diligence as a health policy professional, in order to weigh my options.

“Bring it on, convoluted coverage information, you’ve got nothing on me,” I said to myself.

I proceeded with confidence. And then I reached the plan comparisons. Stuck, I phoned a coworker. And then another. Eventually we cracked the code, but it took a small village of health policy professionals.

It was eye-opening.

If choosing between two employer-sponsored plans tripped up me and my fellow experts, people who think about this every day, imagine the difficulty for someone coming off a long spell of being uninsured or someone who has never had coverage.

That’s why the concept of “health literacy” is becoming so important.

Here we’re really talking about health insurance literacy – things like how to compare plans, understand provider networks and correctly interpret bills – but health literacy is even broader than that. Ultimately it all boils down to whether someone is prepared to make informed health care decisions. 

With about half a million Coloradans new to the insurance rolls since implementation of the Affordable Care Act, there is a growing commitment among insurance providers, consumer advocates and policymakers to boost health literacy.

The first step: measuring the status quo.

Who needs the most support when it comes to understanding health care? Who understands their coverage enough to make educated decisions about how and when to get care? If they lose coverage or switch plans, do they have the tools to select the plan that’s right for them?

Our new report, “Mastering the Alphabet Soup: Health Literacy in Colorado,” shows that the newly insured aren’t the only ones who could benefit from Health Insurance 101. Data from the 2015 Colorado Health Access Survey (CHAS) suggest that even those who already had coverage could use a refresher course on four basic health insurance terms: premium, deductible, copayment and co-insurance.

These findings suggest that health literacy efforts should be broad and inclusive — a “universal precaution” approach, as some experts call it.

But there is still a place for targeted health literacy education. Some demographic factors such as high levels of education, high incomes and English language proficiency are closely related to confidence with health insurance terminology.

The four health insurance terms on the CHAS are fundamental to understanding health insurance plans. But health literacy is just step one. Knowing how to navigate an increasingly complex health system is an even bigger challenge. Data from the CHAS show that there is room for improvement in this arena as well.

The report, released today, delves into the data and talks about the work being done to boost health literacy. Read the full report here.

Are you having a little health literacy déjà vu? That’s because CHI’s director of health coverage and access, Jeff Bontrager, just published an insight on health literacy as part of the Mapping Data A to Z series. Read Jeff’s health literacy Insight here.

Natalie Triedman is a policy analyst at CHI.