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New health insurance marketplaces signing up few uninsured Americans, two surveys find
By Amy Goldstein, Published: March 6
The new health insurance marketplaces appear to be making little headway in signing up Americans who lack insurance, the Affordable Care Act’s central goal, according to a pair of new surveys.
Only one in 10 uninsured people who qualify for private plans through the new marketplaces enrolled as of last month, one of the surveys shows. The other found that about half of uninsured adults have looked for information on the online exchanges or planned to look.
The snapshots from the surveys released Thursday provide preliminary answers to what has been one of the biggest mysteries since HealthCare.gov and separate state marketplaces opened last fall: Are they attracting their prime audience?
The findings emerge as the Obama administration has been revising a series of rules that define how the 2010 law works in practice. According to a variety of health-policy experts who support and oppose the law, the changes are in response to consumer hesitancy and political opposition that linger — at least, in the early going — as the law’s major provisions have taken effect.
The rule changes have postponed or relaxed aspects of the law, sometimes to adjust for technical problems, other times to push into the future controversies that have arisen from specific groups of consumers or parts of the health-care industry.
This week, administration officials said that people could keep for three years health plans whose benefits do not meet the law’s standards. Last week, they said the government would pay for people in certain states to collect federal subsidies for insurance policies outside the exchanges. Two weeks before that, they gave medium-size and large employers two additional years before they must offer coverage to their full-time workers.
The surveys offer no evidence that the rule changes contribute to the insurance marketplaces’ relatively low popularity among the nation’s uninsured. One of the surveys, by the consulting firm McKinsey & Co., shows that among people who are uninsured and do not intend to get a health plan through one of the exchanges, the biggest factor is that they believe they cannot afford it.
The McKinsey survey shows that of people who had signed up for coverage through the marketplaces by last month, about one-fourth described themselves as having been without insurance for most of the past year. That 27 percent, while low, compares with 11 percent a month earlier.
The survey also attempted to measure what has been another fuzzy matter: how many actually have the insurance for which they signed up. Under federal rules, coverage begins only if someone has started to pay their monthly insurance premiums. Just over half of uninsured people said they had started to pay, compared with nearly nine in 10 of those signing up on the exchanges who said they were simply switching from one health plan to another.
The second survey, by researchers at the Urban Institute and based on slightly older data from December, shows that awareness of the new marketplaces is fairly widespread but that those with a lower income and those who are uninsured are less likely to know about this avenue to health coverage than other people.
The surveys are not a perfect way of showing what is happening in the insurance exchanges. But they begin to fill in blanks that both advocates and opponents of the 2010 health-care law agree are critical to understand.
“If there is one point to the law, it is to lower the number of uninsured,†said Larry Levitt, a senior vice president at the Kaiser Family Foundation, a health-policy organization. “Ultimately, that has to happen for the law to be judged a success.â€
With just over three weeks remaining in a six-month sign-up period, the question of how many uninsured people are gaining coverage is eluding both Obama administration officials and most of the private health plans being sold through the new marketplaces.
By Amy Goldstein, Published: March 6
The new health insurance marketplaces appear to be making little headway in signing up Americans who lack insurance, the Affordable Care Act’s central goal, according to a pair of new surveys.
Only one in 10 uninsured people who qualify for private plans through the new marketplaces enrolled as of last month, one of the surveys shows. The other found that about half of uninsured adults have looked for information on the online exchanges or planned to look.
The snapshots from the surveys released Thursday provide preliminary answers to what has been one of the biggest mysteries since HealthCare.gov and separate state marketplaces opened last fall: Are they attracting their prime audience?
The findings emerge as the Obama administration has been revising a series of rules that define how the 2010 law works in practice. According to a variety of health-policy experts who support and oppose the law, the changes are in response to consumer hesitancy and political opposition that linger — at least, in the early going — as the law’s major provisions have taken effect.
The rule changes have postponed or relaxed aspects of the law, sometimes to adjust for technical problems, other times to push into the future controversies that have arisen from specific groups of consumers or parts of the health-care industry.
This week, administration officials said that people could keep for three years health plans whose benefits do not meet the law’s standards. Last week, they said the government would pay for people in certain states to collect federal subsidies for insurance policies outside the exchanges. Two weeks before that, they gave medium-size and large employers two additional years before they must offer coverage to their full-time workers.
The surveys offer no evidence that the rule changes contribute to the insurance marketplaces’ relatively low popularity among the nation’s uninsured. One of the surveys, by the consulting firm McKinsey & Co., shows that among people who are uninsured and do not intend to get a health plan through one of the exchanges, the biggest factor is that they believe they cannot afford it.
The McKinsey survey shows that of people who had signed up for coverage through the marketplaces by last month, about one-fourth described themselves as having been without insurance for most of the past year. That 27 percent, while low, compares with 11 percent a month earlier.
The survey also attempted to measure what has been another fuzzy matter: how many actually have the insurance for which they signed up. Under federal rules, coverage begins only if someone has started to pay their monthly insurance premiums. Just over half of uninsured people said they had started to pay, compared with nearly nine in 10 of those signing up on the exchanges who said they were simply switching from one health plan to another.
The second survey, by researchers at the Urban Institute and based on slightly older data from December, shows that awareness of the new marketplaces is fairly widespread but that those with a lower income and those who are uninsured are less likely to know about this avenue to health coverage than other people.
The surveys are not a perfect way of showing what is happening in the insurance exchanges. But they begin to fill in blanks that both advocates and opponents of the 2010 health-care law agree are critical to understand.
“If there is one point to the law, it is to lower the number of uninsured,†said Larry Levitt, a senior vice president at the Kaiser Family Foundation, a health-policy organization. “Ultimately, that has to happen for the law to be judged a success.â€
With just over three weeks remaining in a six-month sign-up period, the question of how many uninsured people are gaining coverage is eluding both Obama administration officials and most of the private health plans being sold through the new marketplaces.