review of national findings: why did some people enroll and not others?

© 2013 Enroll America | EnrollAmerica.org

Review of National Findings: Why Did Some People Enroll and Not Others?

June 10, 2014


Agenda

Welcome & Introductions Ambar Calvillo National Deputy Director of Women’s Engagement, Enroll America

Key Findings Overview Anne Filipic President, Enroll America

The Affordable Care Act’s First Open Enrollment Period: Why Did Some People Enroll and Not Others?

Tresa Undem , PerryUndem Research & Communication

Looking Forward: Recommendations

Jessica Barba Brown Communications Director, Enroll America

Q&A

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Agenda







Q&A

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© 2013 Enroll America | EnrollAmerica.org 4

Anne Filipic

President Enroll America

Key Findings Overview

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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.

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.

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Agenda







Q&A

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SURVEY

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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

ENROLLED: MOTIVATIONS

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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

ENROLLED: MOTIVATIONS

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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

ENROLLED: MODE OF ENROLLMENT

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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%

ENROLLED: EASE OF PROCESS

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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%

ENROLLED: CHOOSING A PLAN

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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

ENROLLED: AFFORDABILITY

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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

ENROLLED: AFFORDABILITY

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Very confident

40%

Somewhat confident

34%

Not too confident

16%

Not at all confident

9%

REF 1%

How confident are you that you will be able to afford your premium payment each month?

N = 480 enrolled in private plan

74% confident

ENROLLED: VIEWS TOWARD PLAN

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41% happy 11% unhappy 31% too early to tell

Overall

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

ENROLLED: PLANS TO GET CARE

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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)

ENROLLED: KNOWLEDGE

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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%

STILL UNINSURED: KNOWLEDGE GAPS

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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


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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…


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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

STILL UNINSURED: THE ENGAGED

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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


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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


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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


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Will you get insurance next year if you are still uninsured?

N = 345 looked for insurance

Yes 57% No

12%

Not sure 31%

STILL UNINSURED: THE DISENGAGED

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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.

STILL UNINSURED: THE DISENGAGED

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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.

STILL UNINSURED: FUTURE INTENTIONS

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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

STILL UNINSURED: MOTIVATORS

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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


Agenda







Q&A

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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.

Looking Forward: Continued

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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.


Agenda







Q&A

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review of national findings: why did some people enroll and not others?

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