2027 Individual and Family Plan Member Experience Study

Overview

Our 2027 Individual and Family Plan Member Experience Study shows how consumers are adjusting to the new pricing reality in the ACA market. It examines what higher premiums have meant for their loyalty and their priorities in a plan. It also tracks whether perceptions of ACA carriers have shifted.

For the first time, it dedicates a meaningful portion to the CHOICE consumer experience.

Together, these findings can help carriers identify opportunities to strengthen retention, improve the member experience, and refine their positioning as consumer expectations, coverage costs, and care-seeking behaviors continue to change.

*Local Market Add-On – Available for this study!

Our local market oversample studies show how consumers in specific service areas uniquely behave compared to the national data, providing plan managers with deeper insight for nuanced product, marketing, and sales needs

What's Inside the Study

Enrollment trends. Shows how IFP enrollment has trended over time.

Pre-open enrollment experiences. Examines the experiences consumers have in the run-up to open enrollment, and how those experiences influence key performance indicators.

Carrier brand perceptions. Measures how consumers perceive various carrier brands, and how those perceptions shape consideration.
The role of agents and brokers. Examines what agents and brokers contribute in an era of more premium-based plans and higher premiums overall.

What’s New

The defining moment. Takes a closer look at the single most influential event members recall since the start of the year: the type of experience, how it was resolved, and how it shaped their view of their insurer.
AI impact. Adds a new section on how consumers use AI tools to search for care and insurance, and to explore health conditions and medication interactions.
Care moving outside the carrier. Shows where care is moving away from the carrier and health system to unaffiliated entities such as independent telehealth providers, and how much share of wallet carriers retain versus those outside players.

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Explore Last Year’s Insights

2025 Individual and Family Plan Member Experience SIP

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Insights from the 2025 Report:

Provider Access Is One of the Strongest Drivers of Loyalty
Access to care remains a significant challenge for many IFP members. About one-third report dissatisfaction with their access to providers and medical services, while members who can consistently schedule appointments when needed are far more likely to rate their plans positively. Maintaining access to a PCP is especially important, as members with an established primary care provider report stronger satisfaction, loyalty, and overall plan ratings.

Affordability and Cost Transparency Continue to Challenge Members
Less than half of IFP members feel confident in their ability to afford their current plan premiums going forward, and many struggle with understanding healthcare costs. While premium increases negatively impact satisfaction, the bigger issue is consumers’ perception of affordability. Members consistently identified personalized cost estimates as one of the most valuable ways insurers could help them better understand and manage healthcare expenses.