NCPA - National Center for Policy Analysis

Uninsured Reluctant to Enroll in Coverage

April 8, 2013

The Affordable Care Act ("ObamaCare") sets up health exchanges that expand health insurance access to all Americans. Previous efforts to expand coverage to individuals and families have not proven successful and do not bode well for the future of ObamaCare, says Kaiser Health News.

  • A program in Palm Beach County, Florida, was aimed at the one in five residents that lack health insurance in the county.
  • The program offered subsidized insurance to residents who were above the income cap for Medicaid but could not afford private insurance.
  • The coverage was offered at about $52 a month -- far less than the average cost of a private insurance plan.

Fewer than 500 people signed up for the program, called Vita Health. Organizers attributed the lack of interest to the fact that many of the uninsured believe that they do not need insurance. With less than a third of the expected number of participants, the lackluster enrollment may indicate the coming struggle for ObamaCare.

  • For the federal health exchanges, enrolling young and healthy people is an important aspect in keeping the overall premium costs in those markets to a minimum.
  • If young and healthy people do not sign up for insurance, more sick people will be in the exchanges, which will raise health care costs and premiums.
  • Every American is required to have health insurance by January 1, 2014.

Americans making less than 400 percent of the federal poverty level will have the option to purchase insurance. Persuading many of the uninsured to purchase insurance will be a tough sell, a fact that veterans in previous efforts have already found out.

  • The key, say those with previous experience enrolling the uninsured, is to extend beyond mass advertising and talk with people in their churches, workplaces and neighborhoods.
  • The personal outreach effort is important because many of the uninsured know little about coverage.
  • Focus groups conducted for Vita Health revealed that convincing people they need coverage is a bigger issue than price.

It took Vita Health and another similar program in Jacksonville, Florida, years to reach their enrollment goals. If these challenges exist for ObamaCare enrollment, prices could rise even further.

Source: Phil Galewitz, "Why Uninsured Might Not Flock to Health Law's Marketplaces," Kaiser Health News, March 31, 2013.


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