Medicaid consumers and informed decisionmaking.

In 2006, Florida's Medicaid reform required some Medicaid consumers to enroll in health plans that differed in terms of cost-sharing requirements and benefit limitations. In focus groups we found enthusiasm among Medicaid consumers for having choices among health plans; however, enthusiasm did not translate into comparison shopping for health plans. Survey findings suggested that Medicaid consumers had difficulty comprehending Medicaid health-plan comparison information, particularly if they were lower in numeracy or literacy skills. Given the number of plans offered and the numerous ways they differed, our efforts to simplify the comparison chart resulted in slightly higher comprehension, but only among those with higher skill levels. Our study suggests that policymakers should seek to simplify Medicaid Program information and design to encourage informed decisionmaking.