There have been many, many reports detailing people’s personal experiences with the insurance exchanged. Although certainly no one has been pitching them as a great success, still – depending on whom you read – they have been an abject failure at improving the landscape with some qualified successes. But these are anecdotes. And, as always, when data are available, we will use those to describe the current state of affairs. The Commonwealth Fund has just provided us with just that:
On October 1, the Affordable Care Act’s health insurance marketplaces were opened for business. To learn what Americans experienced when shopping for a health plan during the marketplaces’ first month of operation, the Commonwealth Fund Affordable Care Act Tracking Survey interviewed a nationally representative sample of adults who are potentially eligible for the law’s new coverage options: those who are either uninsured or purchasing individual coverage on their own. Social Science Research Solutions conducted the telephone survey of 682 adults ages 19 to 64 from October 9 through October 27, 2013.The first thing they found was that only 60% of those who were eligible for new plans or Medicaid on the exchanges were actually aware of this fact. That means two in five Americans who were eligible didn’t know it. This would be reason for despair if it wasn’t a big improvement over the one-third of eligible Americans who were aware earlier this year. Only 17% of those who were eligible visited the exchanges in October, the first month they were open. Only 20% of them were between the ages of 19 and 29, or in the “young invincible” bracket that insurers desire. Again, all of this would be quite concerning if we didn’t know that the exchanges had been such a disaster in the first month. Few of those visiting seem likely to have had a good experience. That said, still, 20% of those who visited reported enrolling in a plan. That’s some success, at least. Only 37% of people who didn’t get a plan reported technical difficulties preventing them from doing so. More concerning, however, are the 48% of people who reported not enrolling because they weren’t sure they could afford it. That’s a huge problem for the administration. If that many people are finding plan unaffordable, then the whole law may be for naught. It’s unclear, though, why they feel this way. It’s possible that technical problems are preventing people from seeing the subsidized premiums, which for most would be much less. It’s possible that they’re seeing the wrong numbers, period. About 3 in 10 reported not being able to find out if they qualified for subsidies or Medicaid. But it’s concerning that so many report cost still being an issue. Further, some said that deductibles and co-pays were too high (42%), and some said networks were too narrow (21%). There is some good news for the administration. About 58% report being somewhat likely or very likely to go back to the exchange before March 31, 2014 to get more information and shop for a plan. It’s likely that number will go up with time. But there are still too many people who are frustrated or just not knowledgeable about how the ACA works. There’s still so much work to be done. –Aaron