website stumped the millennials

Study reveals where designers erred

Share with others:

Print Email Read Later

Mil­len­ni­als who strug­gled to sign up for health in­sur­ance on have some sim­ple ad­vice for the Obama ad­min­is­tra­tion: Make the web­site more like Yelp or Tur­boTax.

Pres­i­dent Barack Obama fa­mously told doubt­ers that they could use the gov­ern­ment’s health in­sur­ance site to pick a health plan “the same way you shop for a plane ticket on Kayak, same way you shop for a TV on Am­a­zon.” Speak­ing at a com­mu­nity col­lege in Mary­land last fall, he prom­ised that the pro­cess was “real sim­ple.”

That turned out not to be the case, of course. A study pub­lished Mon­day by An­nals of In­ter­nal Med­i­cine lays out some of the spe­cific ways that — a cen­ter­piece of the Pa­tient Pro­tec­tion and Af­ford­able Care Act — went wrong.

A team of doc­tors, law­yers, health econ­o­mists and health pol­icy ex­perts from the Univer­sity of Penn­syl­va­nia re­cruited 33 vol­un­teers and ob­served them as they strug­gled to sign up for health in­sur­ance on the highly touted web­site. These vol­un­teers should have been in pretty good shape: With ages rang­ing from 19 to 30, they were all mem­bers of a Web-savvy gen­er­a­tion. In ad­di­tion, the study de­scribed the young adults as “highly ed­u­cated.”

But when they got to, they ran into prob­lems. Some of them had an­tic­i­pated that they could type in their pref­er­ences — what ser­vices they wanted to have cov­ered, how much they wanted to spend on pre­mi­ums, how much flex­i­bil­ity they want in pick­ing their doc­tors — and get a list of op­tions that met their cri­te­ria. (It could have been the health in­sur­ance equiv­a­lent of us­ing Yelp to find a su­shi bar near a cer­tain city that has out­door seat­ing and takes res­er­va­tions.)

In­stead, the vol­un­teers had trou­ble match­ing their pref­er­ences with ac­tual plans, ac­cord­ing to the study. The re­search team said this was partly be­cause of the “over­whelm­ing” amount of in­for­ma­tion the web­site dis­played.

As one of the vol­un­teers told the study au­thors: “I would love a tool where it’s, like, is it im­por­tant that you have den­tal cov­er­age? Check this box. Do you want men­tal health cov­er­age? Check this box. ... [A]nd then have it gen­er­ate: These are the plans that most closely meet your needs.”

Another hur­dle was vo­cab­u­lary. Plenty of terms on were “in­ad­e­quately ex­plained,” as the study au­thors put it. What is the dif­fer­ence be­tween a PPO, an HMO and an HSA? How is a de­duct­ible dif­fer­ent than a co-pay? When site us­ers ran into these con­fus­ing terms, they got stuck.?

Barack Obama


You have 2 remaining free articles this month

Try unlimited digital access

If you are an existing subscriber,
link your account for free access. Start here

You’ve reached the limit of free articles this month.

To continue unlimited reading

If you are an existing subscriber,
link your account for free access. Start here