Recent reforms to regulated U.S. health insurance markets -- such as the Patient Protection and Affordable Care Act (ACA) of 2010 state exchanges and Medicare Part D -- are motivated by a presumption that well-informed and active consumers will play a key role in supporting vigorous insurer competition. However, recent evidence suggests that it is difficult for many consumers to make fully informed and effective choices in these markets. The poor choices that result can lead to large financial losses for consumers, as well as for the federal and state governments who subsidize their insurance purchases.
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