The Impact of Decision Aids on Health Insurance Selection

High-deductible health plans (HDHPs) often offer lower total costs than traditional plans, yet many eligible individuals choose not to enroll. To understand this gap, we study whether a simple decision aid can improve individuals’ comprehension of cost differences and influence their actual enrollment decisions. Leveraging a large-scale field experiment (N = 2,718) conducted during the open enrollment period, we examine whether two decision aids, a short educational video, and a simplified comparison graphic provided in addition to the video, can reduce complexity and enhance individuals’ understanding of health plan trade-offs. The experiment involved real plan choices, with participants deciding between a high-deductible health plan that was generally more cost-effective and a traditional alternative. We find that the decision aids substantially improved individuals’ understanding of plan features and cost differences. However, these improvements led to only modest increases in HDHP enrollment. This suggests that decision aids can help clarify plan differences but may not fully overcome behavioral frictions such as inertia, liquidity concerns, or risk aversion. Preliminary results also point to heterogeneous responses across individuals, motivating ongoing work to identify key characteristics driving variation in treatment effects.