reaching consumers in the third open enrollment period: who are they and what do they need to hear?

© 2015 Enroll America and Get Covered America EnrollAmerica.org | GetCoveredAmerica.org

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Reaching Consumers in OE3: Who Are They and What Do They Need to Hear? Takeaways From Two RWJF Studies

© 2015 Enroll America and Get Covered America EnrollAmerica.org | GetCoveredAmerica.org 2

Agenda

1.   Introduction 2.   The Uninsured 3.   Marketplace Enrollees 4.   What It All Means 5.   Messaging Resources 6.   Q&A 7.   Wrap-Up


Introduction

Mike Perry Co-Founder PerryUndem Research and Communication

Alison Betty Partner GMMB

Jessica Barba Brown National Director of Communications Enroll America


Introduction

The Robert Wood Johnson Foundation commissioned PerryUndem to conduct two national surveys of uninsured individuals and individuals who purchased a qualified health plan (QHP) through HealthCare.gov or their state marketplace. PerryUndem worked closely with GMMB to develop the questionnaires and analyze the results. We are drawing on these two studies for this presentation today.


The Uninsured •  Survey fielded May 5-7, 2015 •  National survey of N=1,270 adults ages

18-64, N=469 Latinos •  All survey respondents were uninsured at

time of survey •  To view the full study, go to:

http://www.rwjf.org/en/library/research/2015/06/understanding-the-uninsured-now.html

Marketplace Enrollees •  Survey fielded August 11-21, 2015 •  National survey of N=1,012 adults ages

18-64 •  All survey respondents had purchased a

qualified health plan (QHP) through HealthCare.gov or their state marketplace

•  To view the full study, go to:http://www.rwjf.org/en/library/research/2015/10/marketplace-enrollees.html

The Studies


THE UNINSURED Section One


Experiencing Many Challenges and Transitions

Only one-quarter say they are doing well financially.

Thinking about your finances, how would you say things are going for you these

days? Use the scale below (0-10). n=1270

Many are experiencing change. More than half of the uninsured (52%) have

experienced a life change in the last 12 months: 21% Became unemployed. 18% Moved homes. 17% Changed jobs. 16% Experienced the death of a loved one. 4% Started school. 3% Started a business. 3% Had a child.

31% have an ongoing medical condition

Not doing well (0-4)

43%

Doing well (6-10) 26%

Doing okay (5) 31%

REF 1%

Money is tight. 58% have $100 or less left over every month after paying bills.


!56%

Optimistic (6-10)

!60%

Doing Better (+1 to +5)!

!

1% REF

But, They Are Cautiously Optimistic

Thinking about the next year, how optimistic are you that life is going to get better and easier? Use

the 0-10 scale. n=1270

Most believe life will get better soon.

When you think of your finances a year from now, do you expect to be doing about the same, better, or worse than you are now? Use a scale

of +5 (better), 0 (same) , -5 (worse). n=1270

Most also expect to be in better financial shape in a year.

20% Not Sure (5) !

23% Not Optimistic (0-4)!!

1% REF

28% Doing the Same !(0)

11% Doing Worse (-5 to -1)!


Most Are Getting Care Without Insurance

16%

21%

21%

32%

34%

Preventive test/screening

Emergency care

Check-up

Doctor visit when sick

Prescriptions

Have you had any of the following since you have been uninsured? n=1270

54% of the uninsured have had at least one of these medical services since being uninsured.


Most Feel They Can Manage the Costs

42%

48%

52%

53%

56%

Preventive test/screening

Emergency care

Check-up

Prescription

Doctor visit when sick

How confident are you that you could get the following care and manage the costs without health insurance? n=1270

Very/somewhat confident

46% think it is “easy” to get prescriptions without insurance.


Four in Ten Went to the Marketplace

Yes 41%

No 47%

Not sure 10%

REF 2%

HealthCare.gov/state marketplace is a place for people to find affordable health insurance. Have you ever looked into the new

health plans available through HealthCare.gov/ state marketplace? n=1270


Cost Is the Main Reason They Have Not Signed Up

Which of the following statements best describes why you have not purchased health insurance on your own since becoming uninsured? n=1270

6%

6%

9%

9%

61%

Getting insurance is not something I really think about.

I can get the care I need without health insurance.

I expect to have insurance soon through a job or through a spouse’s job.

Purchasing a plan on my own does not seem worth it financially.

I can’t afford health insurance.

59% of those individuals who “can’t afford” insurance do not understand or have not heard of the tax credit.


They Consider More Than Just the Premium

59%"

47%"43%" 41%" 39%"

30%" 29%"22%"

19%"

Premium Out-of-pocket costs

Deductible Copayments Benefits covered

Penalty/fine ER costs Tax credit Doctors in network

[If has looked for insurance before]: Thinking about the last time you looked for health insurance on your own, which of the following things did you consider before deciding not to purchase a

plan? n=829

When asked to choose the two most important considerations before deciding NOT to purchase a plan, they respond: premium (57%) and

the deductible (24%).


Six in Ten Are Confused or Have Not Heard About Tax Credits

As you may know, many people are able to get a tax credit to help purchase an insurance plan through HealthCare.gov/state marketplace. How much do you

understand about how these tax credits work? Or have you not heard about these tax credits before? n=1270

!

39%

Understand

A lot 15%/Some 24%

34% Don’t Understand

Not Much 20%/Anything 14%

25% Never Heard of

1% REF


They Want One-On-One Help

If you were to look into buying health insurance for yourself (outside of a job) in the future, how important would it be for you to be able to talk with someone one-on-one to help you understand your options? n=1270

71%

Important Very = 39%; Somewhat = 32%

26% Not Important Not too =16%; Not at all = 10%

2% REF


Some Say the Increasing Fine May Get Them to Enroll

The penalty or fine for not having health insurance increases to $395 or 2% of your income (whichever is higher) in 2015. Then in 2016, it

increases to $695 or 2.5% of your income (whichever is higher). Would these increased penalties or fines make you more likely to get

insurance in the future, less likely to get insurance, or do they not make a difference for you? n=1270

Those more likely to get insurance due to the increasing

fine: 39% Spanish-speaking Latinos 33% Having insurance “very” important 33% Uninsured less than two years 34% 400+% FPL 32% English-speaking Latinos

More likely to get

insurance 26%

Less likely to get

insurance 6%

No difference 42%

Not sure 24% REF

2%


More Than Half Say They Will Go to the Marketplace

Very likely 19%

Somewhat likely 37%

Not too likely 21%

Not at all likely 21%

REF 1%

How likely would you be to look into the health plans available through HealthCare.gov/state marketplace in the

future? n=1270

•  Having insurance “very” important (34%) •  Spanish-speaking Latinos (31%) •  Previously looked into marketplace (25%) •  Those who paid a tax penalty (24%)

Who is “very likely” to go in the future:


Four in Ten Believe They Will Get Insurance Within 12 Months

How confident are you that you will have health insurance in the next 12 months?

n=1270 More than one-quarter see themselves purchasing their own plan.

Those most likely to think they will get insurance by purchasing it on their own: •  Self-employed (42%) •  >400% FPL (36%) •  College+ educated (33%) •  40-49 year olds (32%) •  Looked into marketplace (32%)

If you get health insurance again, how do you think you will get it?

n=1270

Very confident

16% Somewhat confident

25%

Not too confident

17% Not at all confident

30%

REF 12%

1%

4%

12%

25%

25%

30%

REF

Medicare

Medicaid

Not sure

Purchase plan on own

Your/spouse's job


MARKETPLACE ENROLLEES Section Two


They Have an “Insurance Mindset”

Having insurance is very important to the currently enrolled—96% say having health insurance is either very important (73%) or somewhat important (23%). In addition, more than 8 in 10 say insurance is a “must have” that they will figure out how to pay for.

For some people, health insurance is something they feel they just need to have and they will figure out a way to pay for it. For others, health insurance is something they will only pay for if they feel like they

are doing okay financially. Which is closer to the way you think about insurance?

N=831

Insurance is something I need/will figure out how to pay.

Only pay for it if doing OK financially.

83%

17%


Life Is Going Better for Current Enrollees

Thinking about your life in general, how would you say things are going? Scale: 0 (life is really difficult) to 10 (life is going really well)

57%

28%

15%

43% 38%

19%

Life going well (6-10) Life just so-so (5) Life is difficult (0-4)

Currently Enrolled N=831 Uninsured QHP Eligibles N=548


Current Enrollees Have More Stability

Have you experienced any of the following in the past 12 months?

13% 11% 10% 9% 5% 5% 4%

60%

22% 18% 18%

13%

2% 1% 5%

48%

Changed jobs Became unemployed

Moved Death of a loved one

Started school Birth of a child Started a business

None of the above



Current Enrollees Are Doing Better Financially

Thinking about your finances, how would you say things are going for you these days? Scale: 0-10

45%

29% 26%

35% 31% 32%

Going well (6-10) Going so-so (5) Not going well (0-4)



Current Enrollees Value Insurance Much More

Given everything in your life these days, how important is it to you to have health insurance?

73%

23%

3% 0% 1%

35% 36%

19%

9% 2%

Very important Somewhat important Not too important Not at all Important REF



Protection From Medical Bills and the Fine/Law Are Top Motivators

30%

26%

12%

8% 7% 6% 5% 4% 2%

Protection from medical

bills

Fine/law Preventive care

Getting older See Dr when sick

Chronic condition

For family Other None of these

Please think back to when you first signed up for a health insurance plan through HealthCare.gov/state marketplace. What was the main reason you wanted health

insurance? N=831


Many Experiencing a Health Care Need Before Enrolling

13%

18%

28%

29%

50%

Some other important medical event

Heart attack or stroke

Diagnosis of serious illness

An accident that led to the ER

Chronic medical condition

Thinking back to the time before you signed up for a health insurance plan through HealthCare.gov/state marketplace…As far as you can remember, had you or anyone close to you experienced any of

the following? N=831


They Weighed Many Factors When Deciding to Purchase a Plan

Here is a list of things someone might consider when deciding whether to purchase a health insurance plan or to go without insurance. Thinking back to when you were

deciding whether to sign up for a plan, which of the following things did you consider? N=831

73%"

57%" 57%" 56%"52%"

42%"36%" 35%"

26%"

Premium Out-of-pocket costs

Benefits Deductible Co-payments Drs in network Tax credit ER costs Penalty/fine


Most Feel They Chose the Best Plan for Them

How confident were you that you chose the best plan for you at the time? N=831

Very confident 30%

Somewhat confident

49%

Not too confident 14%

Not at all confident 7%

REF 1%


Most Enrolled Online and Many Received Help

Who gave them help: (N=457)

1%"

3%"

11%"

13%"

35%"

54%"

Employer

Someone else

Trained community member

Friend/family member

Agent/broker

Customer Rep from HC.gov/SM

When they enrolled for the first time: (n=831)

Oct 2013 – Mar 2014 38%

Nov 2014 – Feb 2015 28%

Apr 2014 – Oct 2014 12%

After Feb 2015

15%

The main way they enrolled: (n=831)

Online 69%

Phone 16%

In-person 9%

Paper

2%

Getting help: More than half had enrollment help the first time they applied (54%). Those most likely to get help:

•  50-64 years old (66%); •  Latinos (66%); •  those with high school or less (63%); •  and women (62%).

Four in 10 (40%) used a tool/calculator online to help them figure out what their premium would be before enrolling. Of

those who used a tool/calculator, 87% say it was

helpful (43% very; 44% somewhat).


They Are Satisfied With Their Marketplace Plans

They are also satisfied with the doctors and services covered by their plan.

Overall, how satisfied are you with your current plan through HealthCare.gov/state

Marketplace? N=831

How satisfied are you with the doctors and services your current plan covers?

N=831

Very satisfied

29% Somewhat satisfied

45%

Not too satisfied

17%

Not at all satisfied

9%

Very satisfied

38%

Somewhat satisfied

43%

Not too satisfied

11%

Not at all satisfied

7%


Affording Their Premium Is Hard for Many

When asked about their specific premium amount, half (50%) say they pay $200 or less each month.

PREMIUM AMOUNT

Very easy 18%

Somewhat easy 38%

Somewhat difficult

35%

Very difficult 9%

Given your budget, how easy or difficult is it for you to pay the monthly premium for your

current health insurance plan N=831 Q. How much is the monthly premium you pay for the plan you have through HealthCare.gov/state marketplace? Your best guess is fine. N=831

$0-$50

14%

$51-$100 15%

$101-$200 21%

$201-$400 27%

>$400 22%

REF 2%


They Plan to Stay Insured Through the Marketplace

Also, more than 8 in 10 of those who plan to stay insured say they are likely to continue getting their insurance through the marketplace.

Thinking about 12 months from now, do you expect to continue having health

insurance? N=831

Still thinking about 12 months from now, how likely are you to continue getting your health

insurance through HealthCare.gov/state marketplace?

N=824

Will definitely have

insurance 56%

Will probably have

insurance 35%

Will probably not have insurance

2%

Will definitely not have insurance

1%

Not sure 7%

Very likely 44%

Somewhat likely 40%

Not too likely 8% Not at all

likely 7%


The Tax Credit Is the Main Driver to Stay With the Marketplace

[If plan to stay with marketplace coverage] Why do you think you will continue getting your health insurance through HealthCare.gov/state

marketplace 12 months from now? Choose all that apply. N=709 46%"

34%"

29%"26%" 25%"

5%"8%"

Tax credit Can't find better price anywhere else

Works for me now Convenient Want to stay in my plan

Not sure Other


They Are Sensitive to Premium Increases

Many say they might drop coverage if their premium increases. Enrollees who might consider dropping coverage (N=432) were asked about specific dollar amount increases. The results indicate that 20% might consider dropping coverage if there is a $10 increase per month and 61% might consider dropping if the increase goes up to $50 more per month.

As you may know, the monthly premium amount for insurance plans can change from one year to the

next. If your monthly premium increased during the next open enrollment period, would you consider dropping your plan and living without insurance

instead of paying the increased premium? N=831

18% Yes

!

38% Maybe

44% No


Kept same plan 53%

Changed plans 43%

Not sure 4%

Many Changed Plans During Renewal

Of those current enrollees who renewed, 43% say their plan renewed automatically while 37% say their plan did not renew automatically and 20% are unsure. Slightly more than half kept their original plan when they renewed, but more than 4 in 10 said they changed plans.

{If renewed] Is your current plan the same as the one you had when you

first signed up through HealthCare.gov/state marketplace or did you change

plans? N=455


Half Changed Their Plans to Pay a Lower Premium

[If changed plans] Why did you change plans? Choose all that apply.

N=191

48%"

22%"

16%"14%"

8%"6%" 6%"

3%" 2%" 2%"

Pay lower premium

Old plan not offered

Wanted more services + Drs

Pay lower deductible

No longer qualified for

the plan

Wanted to change insur.

co.

Didn't like old plan

Found more affordable

plan

Wanted to change Dr

network

Other


Most Will Compare Plans Next Open Enrollment

Some people use open enrollment to compare all of their insurance options and make sure they are getting the best plan available for them. They could decide to change plans or renew their current plan

depending on what they learn. Other people renew their current plan without looking into all their options again because they do not have time, they are satisfied with their current plan and want to keep it, or for all kinds of other reasons. During the next open enrollment period, how likely are you to compare all of

your insurance options before making a decision about whether to renew your plan? N=831

Very likely 51% Somewhat likely

29%

Not too likely 13%

Not at all likely 7%


WHAT IT ALL MEANS Section Three


What it Means: Cost is Key

#1

Cost is always priority #1. Educate consumers on the tax credit and remind them that plans and rates change every year.


What it Means: Lives Are Dynamic

People are in transition. They’re dealing with new jobs, new moves, changing finances.


Respect the Choice

•  They’re weighing costs and priorities. •  This is not about telling them what they should do,

but understanding why they’re doing it. •  Filling in information gaps, credibly.


Consumers Split into Three Groups…

PEOPLE WHO

LOOKED

MAKING THE CALCULATION

PEOPLE WHO

DIDN’T

UNAWARE OF FINANCIAL HELP

PEOPLE WHO

SIGNED UP

NEED TO COME BACK AND RE-CHECK


So, We Need to Have a Dialogue

Listen more than we talk. What are their priorities? Understand where they are.

Pushing out messages to the masses is likely wasteful. They need information:

Messages need to connect them with what’s real and relevant for them and their situation.


MESSAGING RESOURCES


Get Covered Communicators Guide


The Five Messages Consumers Need to Hear


On Renewals


Tools on GetCoveredAmerica.org

Get Covered Calculator Get Covered Connector Get Covered Plan Explorer Financial Help In-Person Help New Plans, New Prices


Join the Get Covered Communicators Program

www.EnrollAmerica.org/Communicators -  Weekly email messaging update -  Monthly messaging calls -  Earned media best practices -  Localized messaging

resources -  Social media content


QUESTIONS? We know you have them…


Thank you!

Want to know more? Contact: Mike Perry at [email protected] Alison Betty at [email protected] Jessica Barba Brown at [email protected]

reaching consumers in the third open enrollment period: who are they and what do they need to hear?

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