Friday the revised forms were approved and sent to the insurance commissioners for approval. The labels will then go to federal officials – perhaps by the end of June -- who will issue the regulations on the use and distribution of the forms.
Consumers Union used an intensive consumer-focus-group testing called "cognitive interviewing," where researchers encourage participants to express every reaction they have to the product being tested, with prompting from an interviewer. The testers were 26 to 64 years old, and either had no insurance or bought their own policies in the individual market. (Anonymity was guaranteed, which is why participants' names cannot be published.)
One woman, who appeared to be in her early thirties, said she and her husband have no insurance and go to a free clinic for medical care. The forms puzzled her, until some numbers grabbed her attention: "Showing what the plan is paying and what I'm paying, that's a big eye-catcher for me," she said. "A lot people think they are paying for the majority of the cost."
The testing targeted the "coverage facts labels." The labels say that the information can help consumers compare plans by showing how much they would pay for procedures based the national average costs. A beneficiary's actual costs might be different, based on the doctor's advice, what providers charge, how much the policy pays, among other factors. That didn't go over well with some testers.
"The word 'might' ruins everything," one young man says. "It's kind of sketchy."
The woman who needed an ice cream break tells Kleimann that she understands the purpose of the coverage facts labels: "Even though they may not be real numbers, if the treatment is the same, this tells me which plan will save me money," she says. "I am in the population at risk for breast cancer, so this would help me."
But like some participants, she suggests adding other medical treatment examples for the coverage facts labels, something an average family would experience. "I'm much more likely to fall in my driveway than be diagnosed with diabetes."
Premiums, deductibles and other numbers intimidate another participant, a man in his 20s, wearing shorts and flip-flops. He had to turn his baseball cap around so it wouldn't hide his face from the video camera recording the sessions. "I'd have to have a calculator or ask someone from NASA to do the math," he says.
Finally, at the end of each session, Kleimann asked the crucial question: which plan would you buy? All but two participants are able to make a decision, and one man says that he now feels confident that he knows what questions to ask when it comes time to buy a real health plan.
But for the two others, the new forms are no substitute for the all-purpose expert in their lives, no matter what the health law says.
"I'd have to ask my mom," says the woman who liked seeing what she would have to pay.
The young man who needed a calculator, also needs good advice: "I'd probably call my mom and ask her."
Kaiser Health News is an editorially independent news service and a program of the Kaiser Family Foundation, a nonpartisan healthcare policy research organization. Neither Kaiser Health News nor the foundation is affiliated with Kaiser Permanente.