The webinar reviewed our national survey of consumers who enrolled in health coverage during the first open enrollment period, as well as consumers who did not sign up and remain uninsured. The prominent health care research firm PerryUndem conducted the survey with Enroll America in April 2014 to identify the factors that drove consumers to get covered, compare characteristics of those who enrolled and those who didn’t, and better understand the consumer experience during the enrollment process. On the webinar, we discussed the results in detail and answered questions about the new findings.
5. Key Findings Overview
5
1. There
was
a
HIGH
demand
for
health
insurance
during
the
ACA’s
first
enrollment
period.
2. Those
who
enrolled
knew
more
informa@on
about
the
ACA.
3. Individuals
enrolled
for
many
reasons,
par@cularly
because
of
the
mandate
(“it’s
the
law”)
and
the
fine.
4. 69%
of
the
newly
enrolled
thought
the
enrollment
process
was
“easy”.
5. 74%
of
the
newly
enrolled
felt
confident
that
they
could
afford
their
premiums.
6. Key Findings Continued
6. Healthy
people
enrolled:
the
newly
enrolled
were
more
likely
to
report
their
health
as
“very
good”
than
those
who
did
not
enroll
(32%
to
26%).
7. Most
of
those
who
did
not
enroll
(61%)
wanted
coverage.
8. Affordability
concerns
kept
many
from
enrolling:
the
top
reason
why
some
people
did
not
enroll
was
the
percep@on
that
they
were
unable
to
afford
insurance.
9. La@nos
and
young
adults
(age
18-‐29)
lagged
behind
in
knowledge
but
wanted
coverage.
10. 84%
of
those
who
did
not
enroll
were
open
to
enrolling
in
the
future.
6
9. SURVEY
9
ENROLLED
STILL UNINSURED
N = 671 adults 18 to 64
Enrolled in private insurance or Medicaid during open enrollment
Margin of sampling error: + 5.2 percentage points
N = 853 adults 18 to 64
Uninsured at time of survey (4/10-28/14)
Margin of sampling error: + 3.8 percentage points
Conducted April 10 to 28, 2014
10. ENROLLED: MOTIVATIONS
10
7%
8%
13%
15%
19%
19%
23%
23%
24%
26%
30%
34%
35%
36%
Family and friends
I was already in medical debt
I wanted dental care
I got a tax subsidy/financial help
I have a chronic condition
I could afford a plan
I wanted insurance for my family
I qualified for Medicaid
To get my medications
I was worried about getting sick
I was worried about big medical bills
I didn't want to pay the fine
To go to my doctor
It's the law
Were any of these reasons you decided to sign up for health insurance?
41%
Of 18 to 29 year olds
say the fine was a
motivator
11. ENROLLED: MOTIVATIONS
11
Yes
60%
No
19%
I'm not sure
21%
If the law did not require you to have insurance,
would you still have signed up?
69% of 45 to 64 year olds
48% of 18 to 29 year olds
31% of 45 to 64 year olds
51% of 18 to 29 year olds
12. ENROLLED: MODE OF ENROLLMENT
12
9%
14%
18%
20%
52%
Other
Paper application
In person
By phone
Online on my own
Did you sign up for insurance….
White: 57%
Latinos: 30%
White: 12%
Latinos: 34%
13. ENROLLED: EASE OF PROCESS
13
How easy or hard was it to do the following when you applied for health
insurance? Base N = 264 enrolled online and through Marketplace
When applying for health insurance… Easy Hard
Prove your identity 77% 16%
Figure out your income 72% 19%
Create a user account with a password 79% 17%
Find out how much the plans would cost you 73% 20%
Compare different health insurance plans and costs 67% 24%
Choose a health plan 62% 31%
Figure out next steps once you completed the application 58% 31%
Find out what the plans would cover 57% 35%
Find answers to your questions 51% 41%
Find out what doctors are covered by the plans 51% 37%
Find out how the financial assistance/tax credit worked 53% 29%
Get the documents you were required to scan, fax or mail in 47% 23%
14. ENROLLED: CHOOSING A PLAN
14
9%
2%
4%
5%
7%
25%
48%
Other
I liked the doctors that were
covered
I knew the health insurance
company
I just guessed
I had a plan like this before
It was the least expensive
It had the best coverage for what
I could afford
Why did you choose [the plan you did]?
N = 480 enrolled in private plan
15. ENROLLED: AFFORDABILITY
15
More than
expected,
31% Less than
expected,
25%
About the
same as I
expected,
28%
Not sure,
15%
Would you say your monthly premium is…
N = 480 enrolled in private plan
53%
met or exceeded
expectations on
affordability
17. ENROLLED: VIEWS TOWARD PLAN
17
41% happy 11% unhappy 31% too early to tellOverall
Enough doctors and providers
to choose from?
56% yes
13% no
30% not sure
Have you had any problems using your
insurance to get the health care you need?
9% yes
42% no
49% haven’t tried to use it
18. ENROLLED: PLANS TO GET CARE
18
Looking ahead the next few months, do you plan on…
9%
3%
1%
5%
4%
6%
16%
21%
18%
33%
6%
2%
4%
5%
6%
23%
28%
31%
32%
58%
Other
Paying for medcial equipment
Having surgery
Getting birth control
Getting mental health care
Seeing a specialist
Getting a woman's annual exam
Getting dental care
Paying for a prescription
Getting a check-up
Enrolled
Uninsured
Men (63% vs. 53% women)
Latinos (69% vs. 51% white)
19. ENROLLED: KNOWLEDGE
19
Do you feel like you have enough
information about the new health
care law and how it affects you?
Yes
41%
No
34%
I'm not
sure
24%
If your income goes up during the
year, do you have to pay money
back at tax time?
N = 480 enrolled in private plan
Yes
22%
No
23%
I'm not
sure
54%
Ref.
1%
20. STILL UNINSURED: KNOWLEDGE GAPS
20
Percent Has Heard of/Knows about…
* Allowed March & April 2014 as accurate responses
5%
16%
19%
23%
26%
29%
42%
60%
69%
7%
31%
36%
44%
56%
35%
51%
77%
85%
Second enrollment period
Medicaid expansion
Life-changing events
exceptions
In-person help available
Financial help/subsidies
Brand new plans
Enrollment deadline*
Mandate
The website
www.healthcare.gov
Enrolled
Uninsured
22. STILL UNINSURED: KNOWLEDGE GAPS
22
20%
24%
36%
42%
41%
41%
58%
67%
Plans must set limits on out-of-pocket costs
Plans must cover preventive care for free
Children can stay on parent's plan up to age
26
Plans can't deny based on pre-existing
conditions
Enrolled Uninsured
Percent Knows…
23. STILL UNINSURED: KNOWLEDGE GAPS
23
Percent Knows What Each Term Means
47%
48%
48%
56%
63%
69%
70%
71%
76%
80%
"Open enrollment"
"Premium"
"Out-of-pocket
maximum"
"Deductible"
"Co-pay"
Enrolled
Uninsured
24. STILL UNINSURED: THE ENGAGED
24
1 in 3 went to their online
marketplace – an average of 4.7 times.
They are more likely to be…
• Older (45 to 64)
• White, non-Hispanic
• More educated
25. STILL UNINSURED: THE ENGAGED
25
22%
38%
41%
51%
51%
56%
65%
See what doctors would be covered by
each plan
See what financial assistance/tax credit
you would get
See if you qualified for Medicaid
See what the plans would cover
Compare different health plans
Start an application
See how much plans would cost you
Were you able to…
N = 345 looked for insurance
% Yes
26. STILL UNINSURED: THE ENGAGED
26
1%
1%
2%
3%
4%
5%
7%
8%
8%
13%
17%
19%
21%
26%
27%
39%
Worried about immigration problems
Not enough info in my language
Could not get help in my language
Don't need insurance
Haven't had time
The law will probably change
Waiting for insurance through a job
Didn't want to give out personal information
Thought I had more time to apply
Don't want Obamacare
Not sure I was eligible
Could not get my questions answered
Could not figure out plans' costs
It was too confusing
Website problems
The costs aren't worth it
Main reason
• Costs aren’t worth it, 26%
• Website problems, 12%
• Too confusing, 7%
• Don’t want Obamacare, 7%
• Could not figure out costs, 6%
• Not sure if eligible, 6%
• Waiting for insurance. 4%
Why didn’t you sign up for health insurance?
N = 345 looked for insurance
27. STILL UNINSURED: THE ENGAGED
27
Will you get insurance next year if you are
still uninsured?
N = 345 looked for insurance
Yes
57%No
12%
Not sure
31%
28. STILL UNINSURED: THE DISENGAGED
28
Who are the disengaged?
• Been uninsured for 1+ year (82%)
• Under 139% FPL (52%)
• In the South (51%)
• FFE (69%)
• High school or less (68%)
• Not working (51%)
• 18 to 34 (49%)
• Latino (42%)
• Do not access internet at home (41%)
• Excellent/very good health (40%)
63%
of the still
uninsured
never tried
looking for
insurance.
29. STILL UNINSURED: THE DISENGAGED
29
What are the most important reasons why you didn’t look for insurance?
N = 494 didn’t look for insurance
4%
7%
9%
11%
15%
18%
20%
48%
Website was broken
I heard bad stories in the news
I don't need insurance
I am waiting to get insurance through a
job
It was too confusing
I didn't think I was eligible
I don't want Obamacare
I can't afford insurance
79%
do not know
about financial
help /subsidies.
30. STILL UNINSURED: FUTURE INTENTIONS
30
Yes
57%No
12%
Not sure
31%
Among the Engaged
Will you get insurance next year
if you are still uninsured?
Yes
35%
No
16%
Not sure
49%
Among the Disengaged
31. STILL UNINSURED: MOTIVATORS
31
1%
2%
3%
3%
4%
6%
7%
9%
10%
11%
11%
13%
14%
I can get financial help/a subsidy
I qualify for Medicaid
I cannot get health insurance through my job
To get my medications
I want dental care
I have an ongoing health conditon
I am worried about having large medical bills
I am worried about getting sick
I want my family to have health insurance
It is the law
I can afford a plan
To go to the doctor
I don't want to pay the fine
What is the main reason you would sign up for
health insurance next year?
Engaged: Afford a plan, go
to doctor, want family to
have health insurance
Disengaged: Don’t want to
pay fine, it’s the law, go to
the doctor
33. Looking Forward: Recommendations
33
1. Recognize
that
most
uninsured
individuals
want
affordable
health
coverage.
2. Understand
that
the
law
and
fine
(and
how
it
is
increasing)
mo@vated
many
to
enroll.
3. Address
affordability
percep@ons/mispercep@ons.
4. Keep
educa@ng:
there
were
many
knowledge
gaps
about
key
aspects
of
the
Affordable
Care
Act
–
and
about
insurance
–
that
s@ll
need
to
be
addressed.
34. Looking Forward: Continued
34
5. Use
the
“news”
to
educate.
6. Provide
La@nos
with
more
details
and
more
(direct)
enrollment
help.
7. Ac@vate
moms
(and
other
family
members
and
friends)
to
enroll
young
adults,
and
inform
this
demographic
of
the
mandate/fine.
8. Improve
the
enrollment
process.