Thanks to the Affordable Care Act, millions of people have gotten health insurance. But according to a recent survey from the University of Connecticut, lots of those people may not actually know what their plans cover.

Since the ACA came into effect seven years ago, thousands of residents in Connecticut enrolled for health insurance. But according to Access Health CT, the state's digital healthcare marketplace, lots of those people weren't taking full advantage of the benefits of their plans or were surprised at the cost of medical bills they received.

Researchers at the Health Disparities Institute at the University of Connecticut surveyed more than 500 Connecticut residents who had gotten insurance through Access Health CT. The results, recently released by the University of Connecticut, revealed startlingly low comprehension.

On the 13-question survey, the average person got 62 percent correct. For example, though most understood the word "premium" (80 percent), the majority were unable to calculate how much they would owe out-of-pocket on a given hospital bill (66 percent).

There's reason to think that there is similar confusion at the national scale — a 2014 survey of more than 1,000 nationwide by the Kaiser Family Foundation found comparable results.

This might be more important as Republicans put forward their latest rumored plan to replace the ACA. Their previous bill, the now-defunct American Health Care Act, contained a provision to cut the requirement that every plan available to Americans cover 10 essential health benefits, which was required by the ACA. If the new bill contains a similar provision, Americans need to be able to understand the language of these plans before signing on the dotted line.

"If you don't understand your health insurance, it can cost you in terms of health and in terms of money — you would feel it in your flesh and in your wallet," Victor Villagra, a professor of medicine at the University of Connecticut and one of the authors of the report, told Vocativ.

Ultimately, the researchers hope that health insurers can start to make the language in their plans more accessible, which benefit the providers themselves by increasing customer loyalty, Villagra says. But short of that, they have a few temporary solutions, such as education campaigns among the most vulnerable populations. They also recommend that people in need could access in-person support in the form of "insurance coaches." Those in-person interactions were essential for recruiting more patients for the ACA, so they could be fairly easily deployed to help educate patients nationwide, too, Villagra says.

He and his collaborators are preparing a few manuscripts based on the findings of their survey to submit to peer-reviewed journals, and plan to further investigate how the ACA has affected wellbeing overall.

"The most important message I would have for policy makers in Washington is that health insurance literacy is important and needs policy attention," Villagra says.

This article originally appeared at No one understands health insurance, even their own.