Health care affordability is a top-three issue for nearly 80% of likely voters in next week’s midterm elections. At the same time they go to the polls, they will have an opportunity to select their insurance plan for the coming year as open enrollment begins on November 1.
A large majority are not looking forward to it, new eHealth research found. In fact, more than half of survey respondents said choosing a health plan is as bad as, or worse than, doing their federal taxes. Nearly 6 in 10 consider open enrollment season stressful. Despite the best efforts by employers and brokers to explain their options, almost three-quarters said they have kept the same health plan for multiple years just to avoid the trouble of conducting research.
“Health benefits open enrollment is a stressful time for many Americans, given the complexity of reviewing, understanding and selecting the right insurance plan based on individual needs and preferences,” eHealth CEO Derrick Duke said.
More than 8 in 10 Americans believe the U.S. health insurance system is intentionally designed to be confusing. Forty-six percent of insured Americans have skipped or delayed medical care because of uncertainty about their coverage, and 58% have done so because of concerns about out-of-pocket costs.
At the same time, artificial intelligence is beginning to change the way consumers research health plans and access care. Nearly half of Americans have used an AI tool to review their health insurance options. Four in 10 said it will be a decade or longer before an AI tool can replace a doctor for medical advice, including 30% who said it never will be the case.
Although 22% said AI already can replace doctors for medical advice, two-thirds of Americans who have done so admit the guidance they received sometimes has been incorrect. More than 8 in 10 would support a law that requires a human to review any medical claim denied by an AI tool.
Survey respondents also have strong feelings about both Affordable Care Act and employer-sponsored plans:
- Seven in 10 ACA plan enrollees worry that they won’t be able to find affordable coverage for 2027, and more than one-third said their current plan is unaffordable for them.
- Thirty-seven percent of ACA plan enrollees said their government premium subsidies were reduced from 2025 to 2026.
- Forty-three percent of all Americans said they are familiar with Custom Health Options and Individual Care Expense (CHOICE) Arrangements (formerly ICHRA).
- Three-quarters of people with employer-based coverage wish their employers offered a broader selection of health insurance plans from which to choose.
“This report highlights the need for improved consumer education and support,” Duke said, “as making informed coverage decisions can improve access to quality care, contribute to wellbeing and protect consumers from unexpected medical costs.”