Vivian Ho, chair in health economics at the Baker Institute, said, "The long-term success of the Affordable Care Act depends on buying, using and experiencing satisfaction with health insurance.
"The lack of understanding about basic financial coverage provisions of health insurance plans can lead to surprise and frustration," Ho said. "That can undermine efforts to increase coverage."
More than 1.3 million Texans signed up for Obamacare plans for this year on the federally run insurance exchange HealthCare.gov, a 78 percent increase in enrollment in the state since 2014.
Texas has the second-highest number of Obamacare customers in the nation — trailing only Florida. Federal officials have said that eight of the 10 local coverage markets nationwide that saw the strongest enrollment growth this past sign-up season are located in Texas.
Almost half of the people who signed up for Obamacare coverage this year in Texas were new enrollees.
The findings in the EHF and Baker Institute report echo a previous study which found that about 25 percent of Texans with any kind of health coverage lack confidence in their knowledge of health insurance terms.
The report, which looked at confidence levels across people with different kinds of coverage, found that the biggest knowledge gaps were seen among customers of individual plans.
For example, the report found that more than 30 percent of people with individual plans in Texas said they were either "not too confident" or "not confident at all" about their understanding of the term "premium," which is the monthly charge that people must pay to maintain health coverage.