Health insurance marketplaces signing up few uninsured Americans, surveys say

[alp227]

Source: Washington Post

The new health insurance marketplaces appear to be making little headway so far in signing up Americans who lack health insurance, the Affordable Care Act’s central goal.

A pair of surveys released on Thursday suggest that just one in 10 uninsured people who qualify for private health plans through the new marketplace have signed up for one — and that about half of uninsured adults has looked for information on the online exchanges or plans to look.

Taken together, the snapshots shown by the surveys 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?

One of the surveys, by the consulting firm McKinsey & Co., shows that, of people who had signed up for coverage through the marketplaces by last month, just one-fourth described themselves as having been without insurance for most of the past year.

Read more: http://www.washingtonpost.com/national/health-science/health-insurance-marketplaces-signing-up-few-uninsured-americans-surveys-say/2014/03/06/cdae3152-a54d-11e3-84d4-e59b1709222c_story.html

[sinkingfeeling]

1. Maybe it's because the 'media' has done nothing but blast the ACA and some

of the states have denied any assistance to people or advertising.

[loudsue]

2. That is so true. And the government has NOT done enough to help people

understand the truth. I'm sick of the fucking media...in every single respect. Not just on this issue.

[Hoyt]

3. "1 in 10," is better than what was before. And people are no longer getting booted because they

get sick. People will wise up, and legislation will be improved.

[pnwmom]

4. This may be because some people who were offered new, better policies from their insurer

decided to take them, rather than go onto the exchange. (Sicker people were often offered cheaper policies by their own insurers, because they didn't have to pay more for a preexisting condition). If they didn't qualify for a subsidy anyway, this could make sense. Under the ACA, people could -- for the first time -- buy insurance directly from insurers and have the same protections as on the exchanges -- they couldn't be charged more because of preexisting conditions, they wouldn't be subject to annual limits, and they couldn't be dropped if they got sick. So if they were happy with their previous insurer and could afford the policy, they stayed with it.

I think it also depends on the definition of "lacks" insurance. My son was one who didn't technically lack insurance, because he was paying for an extremely expensive COBRA policy that had another year before it ran out. The young (unrelated) college student living with us didn't lack insurance, because we were paying for it (now she qualifies for Medicaid). Other young people became eligible to stay on their parents plans two years ago, so I doubt they're being included either.

But why aren't Medicaid recipients included as part of the "prime audience"? They should be, because single adults were not previously eligible for Medicaid, and the income limits were raised. The ACA was a major expansion.

[YOHABLO]

5. These surveys hold no weight .. I'm through with the crap they disseminate.

[eggplant]

14. +1

[ebbie15644]

6. My thoughts are that people simply can't afford another bill, period!

[mac56]

7. Till they get sick

[ForgoTheConsequence]

11. And then they still can't afford it.....

So they go without care OR they use the emergency room.


Then we're back to square one.

[Rosa Luxemburg]

23. or they die and then they don't need insurance

[frwrfpos]

26. thats the plan

force them to buy high deductible insurance they cant use or die.

this is what passes as reform in this country

[area51]

27. +1 n/t

[ebbie15644]

12. In the states that didn't expand medicaid people are living paycheck to paycheck and

with heating costs and everything else, simply can't afford it. My niece has a child and can't afford childcare for her. The baby is 18 months and and she gets different people each day she works to watch this child. She makes too much for medicaid, tell me how she affords another bill.

[Keefer]

19. I don't mean to be picky,

but it isn't just people in "red states" who are living paycheck to paycheck. Not everyone is living the high life.

[Bandit]

17. Then they will get insurance and can't be turned down.

That is the catch. They can't be turned down for pre-existing conditions. IMO a young healthy person would be stupid to buy insurance until they need it. Another one of the MAJOR flaws in this new Law.

[jamzrockz]

24. Not so fast

If you do not buy insurance during the open window then you will face discrimination just like before ACA when buying insurance and on top of that you will pay the penalty. So no, you cannot just wait till you get sick to buy insurance, if it was like that then everybody who wants to save money will just wait till they get ill before buying coverage.

[Bandit]

28. if it was like that then everybody who wants to save money will just wait till they get ill

Ding ding ding. That seems to be what the entire article is about. People not buying now but waiting.. The penalty is under a hundred dollars and has no enforcement at all. You don't even have to pay the penalty if you don't want to. There is no enforcement mechanism in place in the Law.

[Myrina]

31. "Insurance" that only covers +/- 60% and has a $6000 annual deductible

is really nothing more than giving away money you don't have to give away.

[Autumn]

25. The current enrollment ends in March, the next one is in November.

So it's get it now or wait.

[albino65]

8. The states are a large part of it

They consistently put up obstacles to the ACA like forbidding ombudsmen to provide information to people who might benefit from the program. It's all bullshit.

[magical thyme]

9. I will be looking into it this weekend.

First, I was waiting for the s/w bugs to be ironed out. I worked in high tech for 20 years, including several in systems integration, so I expected bugs.

Second, I'm in no particular hurry. I'm healthy and have been without insurance most of my adult life. When I did have insurance (Harvard Health -- see some of the feedback Will Pitt posted in his health insurance rant today) I got seriously ill and the insurance company refused to run any tests and left me to die. My dentist saved my life (I was likely septic). I learned from that experience that they take your premiums and ditch you if you need them. So I'm not a fan of ACA, which I see as a boondoggle for the health insurance racket.

Third, I finally have had some days off, but been so exhausted from the last several years that I spent most of those days doing nothing. I get minimal chores done...even the dogs have mostly gone without walks (they get free time outside in in the morning and evening)...and I sit and stare at the computer and rest. Just mentally fried. Just BEING, instead of doing.

I am finally rested to the point that today, while I don't feel bored, I at least don't recoil at the thought of doing. I walked the dogs. And I roasted some eggplant and will bake some moussaka this evening.

So I expect finally this weekend to have the wherewithal to look at the exchange. I will do whatever is cheapest or free. When I ran the calculator, it showed me as qualifying for a fully subsidized bronze plan. If that turns out to be reality and it's not too much work to deal with an insurance scammer, I will sign up. Otherwise, frankly, I'll pay the fine. Either way, I expect if I get sick I will pay for any care out of pocket. I already expect any insurance to be a scam because that is how health care insurance companies make a profit. They take your premium and then refuse to pay for any health care.

Consider the possibility that some uninsured have been so busy struggling to get through day to day since around 2008 or so that we simply don't have luxury time to spend on the health insurance racket. My paycheck may not show it, but my time has value too and I'm effing sick to death of scammers wasting it.

[trublu992]

10. If the Dems weren't sooooo afraid we might have a democracy

[frazzled]

13. Read down the article: it's because they weren't asked

Inside the Department of Health and Human Services, staff analysts who have been producing monthly enrollment updates are confronted with a major hindrance to examining the question of people’s prior insurance status: the wording of the HealthCare.gov applications themselves.

The paper versions of applications, used by a small fraction of people who are signing up contain a multiple-choice question asking whether people in a household currently have insurance. “No” is one of the boxes people can check

However, the online application, used by most people to enroll, asks whether people want to apply for coverage but does not give them a place to indicate whether they have insurance now or have had it in the past. As a result, HHS analysts have no way of assessing how many of the online enrollees were uninsured in the past.

In addition, note what it says about the two surveys: one says 25% were previously uninsured (not 1 in 10), while the other survey was taken back in December, when enrollment numbers were still low!

One of the surveys, by the consulting firm McKinsey & Co., shows that, of people who had signed up for coverage through the marketplaces by last month, just one-fourth described themselves as having been without insurance for most of the past year.

...

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 lower-income Americans and those who are uninsured are less likely to know about this new avenue to health coverage than other people.

[SunSeeker]

18. OFFS, that is not a poll. Thanks for catching that! nt

[quadrature]

15. enrollment starts again on November15....

there is no need to rush to sign up.

[The Stranger]

16. Wait - we just saw a news article about how it had signed up X million and was on track.

[Puzzledtraveller]

20. As a caseworker you would be surprised at how many unininsured are even aware of the law

What information they do have is usually incorrect. Some of them who do show up to apply will ask, "is this that Obama thing?" I get the question from all people, black, white. The next common question is usually about getting fined for not having it. Many of my clients do not know what the basic terminology is when selecting and considering healthcare, such as providers, cop-pays, deductibles, HMO's, PPO's, etc.

[jzodda]

21. I live from paycheck to paycheck

I work mostly in Temp jobs. They pay well but the hours vary from week to week and month to month.

The healthcare site wants me to accurate give my income but I have no idea what it will be next month so I just had to guess.

The subsidy (in NY) that I got from the application was about $50 a month.

The cheapest silver plan is like $325 a month. Its hard for me to add another bill to my unpredictable situation. I will do it by the deadline but I have waited to avoid another bill.

Why you might wonder do I worry since I said the temp job pays well? My Student Loans ARE KILLING ME. I pay over $1000.00 a month with no end in sight to my over $100k student loan bill.

[humbled_opinion]

22. Exactly...

Typical scenario OK I am living paycheck to paycheck....Never had health insurance after my parents policy didn't cover me I just never go to the doctor. I do understand the risk so I loved it when the ACA was passed. I go to sign up for the ACA and I qualify for subsidizes to help me pay for health insurance this is wonderful news but the not so good news is that it is still going to cost me something. I simply cannot afford the $200 after subsidy per month. Never had insurance before don't see why I need to shell out $200 per month now. You want to call the fine thats coming a shared responsibility payment so who is going to help me share the responsibility of my rent, my food, my car, my car insurance, my clothes, etc... Someone needs to do the math.... I guess the government forgot that in order for me to cover that extra cost somehow I have to get a pay raise and that just isn't in the cards right now..... I understand that Democrats are fighting furiously for a minimum wage increase but I already make a little over the $10.10 they are arguing for. So where am I getting that extra $200.00 per month? Oh and that comes with a hefty $6,000 deductible to so in fact I will have to spend the equivelant of $700.00 per month before it becomes financially sensible.... Sure there is risk I have lived with that risk for the last 7 years, I will wait till I make more money.

[juajen]

30. When minimum wage is increased, people who were making over the

minimum, will also get increases, or it will appear that they are getting a reduction in their wage. In other words, everyone's pay should be raised. That's why they are fighting so hard to keep it from happening.

Picture a highschooler making minimum now. He gets raised to 10.10, which is still too low. His Mom, who has been working hard for ten years and is already making 10.00 an hour will be raised proportionately, and so on.

Yep, the kicker is that someone attempting to just pay the interest on their student loans, will then have to pay more, as most are income based. It's typical that when you get a raise, someone else comes along and takes it, akin to SS. When we get a raise, it typically goes to Medicare, not us. That didn't happen to me this time, but did to my sister, who has supplemental insurance and the premium was raised and took away her ss raise.

[christx30]

32. And if you get the insurance

and you don't get sick, you are wasting that $200 per month. That happened to me last year. I spent a bunch of money on insurance premiums last year. Never saw the inside of a doctor's office or emergency room. So that money is gone forever. Wish I hadn't given that donation to BCBS.

[happyslug]

29. I know at least two uninsured who will pay the fine, for it is cheaper.

And I generally do NOT discuss health Insurance. The problem is Congress did not want the fine for not paying to be to high, least it be used to attack the whole program, but also not so low as paying the fine be a viable option. The problem is the fine is TO LOW, so it is a viable option.

That you HAVE to buy insurance is the underlying problem with ACA. The only way to FORCE the uninsured to buy insurance is to set up some sort of "punishment" if they do not. That punishment is a fine collected by the IRS when you file your income tax.

In 2014, the penalty will be the greater of 1.0% of taxable income or $95 per adult and $47.50 per child (up to $285 per family).
In 2015, the penalty will be the greater of 2.0% of taxable income or $325 per adult and $162.50 per child (up to $975 per family).
In 2016, the penalty will be at the greater of 2.5% of taxable income or $695 per adult and $347.50 per child (up to $$2,085 per family).
After 2016, the penalty will be increased annually by the increase to the cost-of-living.

https://www.ehealthinsurance.com/affordable-care-act/faqs/how-much-are-the-tax-penalties-for-not-having-health-insurance-and-when-do-they-apply

Thus NOT to have health insurance in 2014 will cost you no more then $285. In 2015 $975. In 2016 $2,085. Notice the MAX amount, a 2.5% fine only affects those FAMILIES earning less then $83,400. If you are earning less, then the 2.5% fine is the key. Median Income is just under $50,000 so the 2.5% of $50,000 is just $1250. Thus it is CHEAPER to pay the fine if the insurance exceeds $173.75 at the max income level. If the premium is more then $104.17 per month at $50,000 a year it is also cheaper to pay the fine then to buy insurance.

Notice, highest fine is for 2016, in 2014, the fine is ONLY $285 (or $23.75 per month). This appears to be the biggest hurtle, people opting for the cheapest insurance option under the ACA and that is to pay the fine for NOT having health insurance.

For singles, or families without children the fine is even lower. $95 in 2014, $325 in 2015 and $695 in 2016 (Families without children would be double these numbers).

Thus, if you are single living alone and have income over $27,800, it may be more cost effective to pay the fine then buy insurance. Under $27,800 the fine actually DROPS, for then the 2.5% fine in 2016 applies not the max fine of $695.

Thus the problem with ACA, the fine for NOT having insurance is to low. On the other hand, a higher fine MAY imply the fine would be used to pay for insurance, something the authors of the ACA did NOT what for that would be a back door to single payer. Thus the fine was kept low so it would be lower then any real insurance, so no court could rule that the fine implied government provided insurance (i.e. Variation of Social Security, pay the TAX, you get Social Security). As I said the fine is LOW so that no court hopefully would rule the paying of the fine implied Insurance Coverage by the Federal Government.

This was pointed out during the debate on the ACA, but because the solution to it was single payer it was ignored. Now, it appears to be becoming fact and again the reason for it is being ignored for to address it is to show the fine is to low and a higher fine may imply a single payer option, or worse the fine collected if added to Medicare may be enough to do single payer. Thus the fines will stay low and it will remain economically better for many people to pay the fine rather then get health Insurance.