Optimizing consumer choice in selection of health insurance.

Patients are confronted with an overwhelming number of choices when enrolling in health insurance plans, with marketplace enrollees often having over 100 plan options and Medicare Advantage enrollees having on average 42 plan options. This can fuel confusion, administrative burden, and suboptimal plan selection, which in turn can be costly to the patient, who may face greater cost sharing and thus reduce even necessary health care utilization. This is particularly troubling because most Americans experience low levels of health insurance literacy as well as limited numeracy, making it especially challenging to adjudicate among plan options in this setting of health insurance complexity. Accurately discerning optimal plan choice is especially critical given America's notably high health care costs. While there are a growing number of navigator tools, including through the use of artificial intelligence, they tend to suffer from poor take-up and/or efficacy. Existing funding streams prioritize the assessment of the performance of existing interventions, but patients' challenges navigating health plan selection highlight the need to support research to both design and test new interventions to promote health insurance literacy and, in turn, access to necessary medical care.