Because prices of existing health insurance plans bought under the Affordable Care Act are changing — and there are many more options on the table this year — the first two weeks of the ACA's second enrollment season were met with a more discerning set of buyers, say representatives from Florida, Illinois, Michigan and Missouri in a teleconference on Wednesday.

In certain states in which enrollment is managed by federally facilitated marketplaces, both new and previously enrolled consumers are exercising increased discretion over last year when selecting plans. Since the number of plans has more than doubled and many of the plans already in place are becoming costlier, prospective enrollees want to shop around. And they're certainly not impulse-buying: Instead of simply selecting plans with the lowest premiums, enrollees often are weighing health-based factors, such as prescription coverage options and doctor availability. 

"A lot of consumers are coming in wanting to know what new options are available to make sure they are meeting their health needs appropriately," said Jodi Ray, project director of Florida Covering Kids & Families. "They are making sure their info is up-to-date in the system, and [because of that] they often find that they get better premiums."

Having trained staff who went through this process last year helps, too. They have faced their own learning curves, and are doing a better job in making potential enrollees aware of their options, said Phillip J. Bergquist, director of health center operations at the Michigan Primary Care Association.

"The assisters have learned so much from previous open enrollment," Bergquist said. "They've learned quite a bit about how to prompt enrollees to think about their needs."

Buyers also should consider that changes in their health or living situations can affect what subsidies they receive. ACA marketplace advocates have made this detail front and center in their "review before you renew" messaging.

"What we learned from various surveys is that the most effective message to get to someone who's already enrolled is to make sure they know about the subsidies," Ray said.