California enrolled 1.4 million people in new private health insurance plans during the first open enrollment period under the Affordable Care Act (ACA). In February, as state officials were administering the sign-up campaign, research supported by the California Health Care Foundation (CHCF) was conducted to study the experiences of consumers attempting to enroll online at www.CoveredCA.com.
CHCF commissioned gotomedia, a San Francisco-based user interface research and design firm, to observe and interview a diverse group of Californians applying from computers in their own homes. Researchers observed consumers as they explored the site, created accounts, entered household and income data, and compared health plan options.
While consumers initially found the site welcoming, they struggled to understand what questions meant, where they were in the process, and how their options fit within a bigger context. As a result, the accuracy of consumer responses and their ability to complete the process suffered. Study findings point to clear and actionable ways to minimize some of these errors.
A summary of the research findings is available under Document Downloads.
Videos of Users on the Covered California Website
The videos below, two of which are included in the summary report, highlight some of the challenges faced by the study participants as they used Covered California's website to enroll in health coverage.
Confusing Eligibility Results and Next Steps: Many users were not sure what they qualified for. Those eligible for Medi-Cal were disappointed at not being able to complete the enrollment process online.
Understanding Questions: Some participants resorted to guessing and online searching when they didn't understand questions and when definitions and help were not available or were inadequate.
Steps and Sequences: Some participants were uncertain where to start on the site and about next steps as they progressed through the process.
Entering Simple Data: Some users struggled to enter simple data, such as phone numbers, in the format required by the online system.