Policy-Relevant Analysis: Insurance Is Local
In the article, Gollust and her co-authors examine whether geographic regions with higher rates of uninsurance spent more time researching ACA market plans and health insurance coverage generally. Gollust’s research offers a unique perspective on insurance-related information seeking patterns because it looks at local-level variation in ACA-related search patterns. This perspective is particularly informative because information about insurance enrollment in private, Medicaid, and marketplace plans is by its nature local, given the primary role of the state in decision-making about Medicaid and insurance market regulation.
A Unique Data Source: Google Trends
The authors merged data from Google Trends with metro-area-level and state-level characteristics to examine factors associated with health insurance-related Google searches in the most populous U.S. metro areas during the first open enrollment period under the Affordable Care Act, or ACA (October 2013 through March 2014). Google Trends is a publically available internet search tool that captures temporal and geographic variation in Google searches (which account for more than 80% of all internet searches) for various search terms.
Each metro area was matched with is corresponding designated market area (DMA). Metro-area-level and state-level characteristics came from a variety of other data sources, including the Census Bureau’s Small Area Health Insurance Estimates, the American Community Survey, the Bureau of Labor Statistics, county-level vote data, Kaiser Family Foundation Data, and data from the Robert Wood Johnson Foundation.
Key Finding: Areas with High Uninsurance Are More Likely to Search Online for Coverage Information
Dr. Gollust and her team found that internet searches for health insurance terms vary greatly across the country, with areas of high pre-ACA rates of uninsurance more likely to search in higher volumes for the key terms “Obamacare” and “health insurance.” This finding is adjusted for sociodemographic, political, and insurance market characteristics.
Why These Findings Matter
Gollust’s results indicate that Google searches are an important way in which people gain information about health insurance coverage, especially in areas with greater need for coverage. Understanding how the uninsured are likely to research coverage options under the ACA can guide future outreach efforts by health advocates and policymakers, particularly as they move beyond initial broad outreach strategies to more targeted approaches tailored to specific audiences, including audiences that are more precisely geographically defined than in the past. The next step in research, writes Gollust and her team, is to examine whether and how internet searching relates to actual insurance enrollment.