The Experience of Texans with healthcare.gov

The Health Reform Monitoring Survey (HRMS)-Texas report is based on the HRMS, a national project that provides timely information on implementation issues under the Affordable Care Act (ACA) and changes in health insurance coverage and related health outcomes. The Baker Institute and the Episcopal Health Foundation are partnering to fund and report on key factors about Texans obtained from an expanded representative sample of Texas residents. They have published five reports in the series:

• "The Experience of Texans with healthcare.gov" (released June 11, 2014)
• "The Affordable Care Act and Hispanics in Texas" (released May 9, 2014)
• "Early Effects of the Affordable Care Act on Health Insurance Coverage in Texas for 2014" (released April 14, 2014)
• "The Affordable Care Act and Texas' 'Young Invincibles'" (released March 31, 2014)
• "Were Texans Satisfied with the Cost of Health Care and Health Insurance Prior to the Affordable Care Act?" (released Feb. 10, 2014)

The Rice University press release on the latest report, "The Experience of Texans with healthcare.gov," follows:

HOUSTON – (June 11, 2014) – Almost all adult Texans were aware of the Affordable Care Act's Health Insurance Marketplace before the open-enrollment period ended March 31, according to a report released today by Rice University's Baker Institute for Public Policy and the Episcopal Health Foundation.  

The report also found that an estimated 2 million Texans looked for information about the Marketplace and found the federal healthcare.gov website generally helpful. Almost half of Texans who visited the site wanted to purchase insurance or check their eligibility for a premium subsidy.

In addition, the report found Texans shopped for Marketplace plans early and often. Those who enrolled tended to begin shopping in the first or last month of the enrollment period or the end of the enrollment period.

The Health Reform Monitoring Survey (HRMS)-Texas report is based on a national project that provides timely information on implementation issues under the Affordable Care Act (ACA) and changes in health insurance coverage and related health outcomes. The Baker Institute and the Episcopal Health Foundation are partnering to fund and report on key factors about Texans obtained from an expanded representative sample of Texas residents. Today's report contains responses from 1,595 Texans in September 2013 and 1,538 in March 2014.

The report is the fifth in a series on the implementation of the ACA in Texas. It was co-authored by Vivian Ho, the chair in health economics at Rice’s Baker Institute, a professor of economics at Rice and a professor of medicine at Baylor College of Medicine, and Elena Marks, the president and CEO of the Episcopal Health Foundation and a health policy scholar at the Baker Institute.

"In our previous report, we estimated that 746,000 Texans purchased insurance through the Marketplace," Ho said. "Given that 2 million Texans looked for coverage through the Marketplace, a strikingly high percentage of them elected to enroll in a health insurance plan."

Opened in October 2013, the Marketplace was designed to enable individuals with low to moderate incomes, including about 2 million uninsured Texans, to purchase subsidized, affordable health plans. The Marketplace in Texas is operated by the federal government and accessed through the healthcare.gov website and affiliated call centers.

"Given media reports regarding the difficulties people encountered with the Marketplace website and call center, we were surprised that 70 percent of respondents who used them viewed them as very or somewhat helpful," Marks said. "It is discouraging that so few respondents obtained advice on the Marketplace from navigators or health care providers. Increasing the number and impact of navigators is essential for additional gains in coverage during the next enrollment period."

The survey was developed by the Urban Institute, conducted by the company GfK and jointly funded by the Robert Wood Johnson Foundation, the Ford Foundation and the Urban Institute.

The analyses and conclusions based on HRMS-Texas are those of the authors and do not represent the views of the Urban Institute, the Robert Wood Johnson Foundation or the Ford Foundation.

Download the report here: