3 peeks inside your health prospects’ brains

Exchange plan buyers generally say they like their coverage, but some are happier than others. Exchange plan buyers generally say they like their coverage, but some are happier than others.

A group that helped plant the seeds that grew up to become the Patient Protection and Affordable Care Act (PPACA) has released a big new batch of consumer survey data.

Analysts at the Commonwealth Fund commissioned a polling firm to interview 4,881 U.S. adults ages 19 to 64 earlier this spring, then compared the results with results from a second survey conducted from April 2014 to June 2014, after the end of the first PPACA open enrollment period, and a third survey conducted from July 2013 to September 2013, before the first open enrollment began. 

The fund analysts use the latest survey results to make the case that working-age adults who have Medicaid coverage or public exchange qualified health plan (QHP) coverage as a result of PPACA generally like their coverage and are getting access to care comparable to what other working-age adults have.

The survey results themselves have no party labels or opinions about PPACA. Whether you love the exchange or live to destroy it, you may be able to use the survey data to support your own health insurance or health-related marketing efforts.

See also: Uninsured rate is also bigger in Texas

For a taste of the information in the survey report, read on. 

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1. The need for health insurance (often) transcends politics.

Few consumers have the financial means and determination to tie major financial decisions to politics.

Even many Americans who feel terror about the state of the U.S. entitlement programs, they may continue to pay Medicare and Social Security payroll taxes, sign up for benefits when the time comes, and hope for the best.

The same is true in the health insurance benefits industry.

Republicans are a little less likely than other Americans to have exchange QHP coverage, but not that much less likely.

Adults who identified themselves as Republicans made up 18 percent of the survey sample, and 14 percent of the survey participants who had exchange QHP coverage.

See also: Satisfaction with government health care work climbs 

2. Higher income consumers may be having more trouble in PPACA World than lower-income consumers.

Earlier surveys have found signs that the kinds of consumers who make obvious prospects for agents and consumers — higher-income consumers — are getting less help from the PPACA system with paying for health coverage than lower-income consumers are, and the Commonwealth Fund survey supports that conclusion.

The PPACA system provides easier access to Medicaid for people with incomes around the federal poverty level (FPL), and rich subsidies for PPACA exchange users with incomes under 250 percent of FPL. The system provides only modest subsidies for QHP buyers with incomes from 250 percent to 400 percent of FPL, and no subsidies at all for people with income over 400 percent of FPL.

Commonwealth Fund found that PPACA programs have helped reduce the number of survey participants who were uninsured from about 21 percent since the summer of 2013 for those with incomes under 100 percent of FPL; by almost 50 percent for adults with incomes from 100 of FPL to 137 percent of FPL; and by 50 percent for adults with incomes from 137 percent to 249 percent of FPL.

In the category for adults with incomes of 250 percent to 399 percent of FPL, the number of uninsured people fell just 25 percent.

Most survey participants with incomes of 400 percent of FPL or higher have health coverage, but the number who are uninsured may have risen 25 percent since the summer of 2013, and about 60 percent since the spring of 2014.

The Commonwealth Fund analysts report that about 5 percent of high-income adults may now lack major medical coverage. That's up from 4 percent in the summer of 2013, and up from 3 percent in the spring of 2014.

See also: How PPACA squeezes moderately high income 60-year-olds 

3. Your real competition may be "deer in the headlights" syndrome.

The Commonwealth Fund analysts found that about 41 percent of the remaining uninsured adults are unaware of the existence of HealthCare.gov, and only about half know that the PPACA system offers premium subsidies.

Just 12 percent of the uninsured adults who failed to visit HealthCare.gov said they had gone someplace else to look for health coverage.

About 60 percent of the non-shopping uninsured adults said they did not think they could afford insurance, and it's possible that many of those adults are correct.

But 39 percent of the non-shopping uninsured adults may be unaware of the new PPACA restrictions on medical underwriting: 39 percent said they did not think they would be eligible for health insurance.

Some of the non-shopping uninsured adults may face no barriers to getting covered than weariness and disorganization: 37 percent said they have not visited HealthCare.gov because they have been too busy.

See also: HR group finds employer PPACA freeze

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