The vast majority of people expected to use the Affordable Care Act's marketplaces say they will need help, according to a survey out of the University of Iowa, with a full four out of 10 saying they will need "a lot" of assistance.
The figures come from a study by the University of Iowa's Public Policy Center and College of Health. The study was prepared for the state Department of Public Health.
In addition to the 40 percent who said they would need "a lot" of help, 42 percent acknowledged they would need "some" assistance. By far, they preferred to get that help over the phone or in person, rather than going online.
Thus far, the debut of the Affordable Care Act's exchanges has been marked by a website that's been mostly unusable to millions of Americans.
As a result, relatively few people have been able to get enrolled in coverage, according to analysts and news reports.
Obama administration officials say they are working to fix the site, but it still is having significant troubles.
What the new survey underlines is the importance of in-person assistance for people. And one of the primary authors of the study said he thought the network of in-person assistance in place in Iowa probably is not adequate to handle the load.
The federal government has funded and trained a range of groups and individuals to help. But Peter Damiano, the director of the public policy for the center said Friday, "it's probably not nearly enough to assist folks."
He said paid navigators don't cover the entire state. Twenty-two counties are without them.
The federal government, which is operating Iowa's online marketplace, is tasked with leading the effort at providing assistance. The state decided last year that it would not get involved in that kind of in-person help.
Damiano did say the state's decision to auto-enroll people in the IowaCares program will help.
In addition to saying they would need help, the people taking part in the survey expressed a clear preference to getting assistance over the telephone or in a face-to-face meeting, rather than online through a "chat" or some other means.
Assistance over the phone was cited by 47 percent of respondents, with in-person assistance outside the home by 43 percent. Thirty percent cited an insurance agent. Just 27 percent cited an online chat as an acceptable type of assistance.
The survey of 498 people was conducted before the marketplaces opened Oct. 1. Most of the respondents already had employer-provided insurance, while the others did not have coverage. The latter were considered those most likely to utilize the marketplaces.
David Lind, a health researcher from Des Moines, said it's not surprising that people would say they need help buying insurance, nor that they would gravitate toward help provided by someone in person or over the phone.
"I think it's more comforting than it would be online," Lind said.
Out-of-pocket expenses, services and monthly costs were the most likely areas to be cited by people saying they would need "a lot" of assistance.
The survey also said that people with employer-provided insurance were better informed about the health care law.
Forty-seven percent of those expected to go to the exchanges said they had heard "not much" about the law or weren't sure. That compared with 16 percent who had insurance who said they knew little about the law or weren't sure.