Of Americans potentially eligible for coverage under the Affordable Care Act, 17% visited the new health insurance marketplaces to buy coverage via mail, Internet, phone or in person, according to a new Commonwealth Fund survey that tracked peoples experiences with the marketplaces from the Oct. 1 launch through Oct. 27.
Of 682 people surveyed, 60% were aware of the marketplaces, and 53% were aware that financial help may be available to them. The level of awareness is an increase from about a third who were found to be aware of the marketplaces in a Commonwealth Fund survey conducted earlier this year.
About one in five adults (21%) who visited the health insurance marketplaces said they enrolled in a health plan. Those who did not enroll said they were not sure they could afford a plan (48%), were still deciding on a plan (46%) and/or had technical difficulties with the website (37%).
According to the survey brief, Americans Experiences in the Health Insurance Marketplaces: Results from the First Month, 58% of those who potentially are eligible for coverage but who have not yet enrolled say they are likely to try to enroll or find out about financial help by March 31, 2014, the end of the open enrollment period.
People without insurance, with individual market coverage or who said they had a plan through the marketplace were interviewed for the survey.
While it is disappointing that so many people have had difficulty accessing the online marketplace, the survey results show that awareness of the marketplaces has grown this fall, and those who initially struggled appear determined to try again, Sara Collins, PhD, the surveys lead researcher and Commonwealth Fund vice president for healthcare coverage and access, said in a news release.
Marketplace shoppers and experiences
The survey found that 21% of marketplace visitors were young adults ages 19 to 29. About half (52%) of those who visited were between ages 30 and 49. In addition, marketplace shoppers were in good health, with 73% describing their health as excellent, very good or good, and only 25% as fair or poor.
Majorities of those who went to the marketplace to shop for coverage had some difficulty using them:
70% of adults who visited the marketplaces ranked their experiences as fair or poor; 27% said they had good or excellent experiences.
56% said it was impossible, very difficult or somewhat difficult to find a plan with the coverage they needed, while 38% said it was very easy or somewhat easy to do so.
61% said it was impossible, very difficult or somewhat difficult to find a plan they could afford, compared with 30% who said it was very easy or somewhat easy to find an affordable plan.
Majorities of those surveyed had a hard time comparing insurance plans, saying it was impossible, very difficult or somewhat difficult to compare benefits offered (58%), premium costs (52%) and potential out-of-pocket costs (51%).
The initial rollout of the health insurance marketplaces has been challenging, but as the website problems are addressed we expect peoples experiences to improve, Commonwealth Fund President David Blumenthal, MD, said in the news release.
We cannot lose sight of the fact that millions of Americans are going to gain health insurance coverage under the law. However, it is crucial that the federal marketplaces are open and functioning well to be sure those gains are fully realized and that users are able to understand the costs and benefits of the products they are being offered.
Additional survey findings:
47% of adults who went to the marketplaces tried to find out whether they were eligible for financial help paying their premiums.
73% of people surveyed either somewhat or strongly in favor of making Medicaid available to more residents in their state, including majorities of those who identify as Democrats (85%), independents (72%) and Republicans (54%).
42% of those surveyed have a somewhat or very favorable opinion of the Affordable Care Acts new health insurance options, while 38% have a somewhat or very unfavorable view.