WASHINGTON — With the Affordable Care Act’s first enrollment period in the books, two surveys released Tuesday offer insight into why those still uninsured decided to remain on the sidelines. Hint: It has a lot to do with cost.
The latest monthly Kaiser Health Tracking poll, which has provided some of the most reliable data on the public’s opinion of the ACA during the past four years, found that nearly four in 10 uninsured adults cited affordability as their main reason for skipping health insurance coverage. Twenty-two percent cited employment status (they were unemployed or couldn’t get coverage through their job), while an additional 11 percent said they missed the deadline, and 9 percent said they just didn’t want insurance.
About 45 percent of the uninsured surveyed said they expect to pay the individual-mandate penalty this year, although enforcement is not expected to be stringent this year. Further, the group of people who will trigger the mandate is likely to be small — the Congressional Budget Office has projected that just 2 percent of the total population, or 6 million people, would have to pay the mandate penalty in 2016.
The industry-backed group Enroll America offers further context on the affordability question in a new report analyzing the group’s efforts to increase enrollment. The organization surveyed individuals in urban areas in 10 states where the federal government is running the local ACA insurance marketplace.
Based on conversations with about 1,350 people who attempted to get insurance but ultimately didn’t, Enroll America found that Web issues (37 percent) and affordability (21 percent) ranked as the top two reasons for not enrolling.
Complaints about online problems decreased each month from November 2013 to February 2014, but they didn’t go away entirely. More than half of consumers (56 percent) in November reported technical problems, which decreased to 27 percent in February, according to the Enroll America report.
Meanwhile, the group said, complaints about the lack of affordable health-care options increased each month during the sign-up period (8 percent of complaints in November, compared with 29 percent in February). Enroll America said this could be a reflection of more people advancing to the point in the application process where they had to pick a health plan.
It is likely that the website problems that plagued the rollout this past year will be less of an issue going forward. The affordability question, though, isn’t going away.
