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Survey: Higher-income consumers less happy with PPACA plans

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U.S. consumers who dislike their new health coverage may have more money and fewer health problems than consumers who like their new coverage. 

Researchers at the Commonwealth Fund have published data raising that possibility in a summary of results from a recent telephone survey of 4,425 U.S. adults ages 19 to 64 conducted from April 9 through June 2, 2014. The researchers compared those results with results from an earlier telephone survey of 6,132 U.S. adults ages 19 to 64 conducted from July 15, 2013, to Sept. 8, 2013.

The Patient Protection and Affordable Care Act (PPACA) has now expanded adults’ access to Medicaid in many states; created a public health insurance exchange system; created standardized “qualified health plans” (QHPs) that can be sold either through public exchanges or outside exchanges; and imposed many new underwriting and benefits design requirements on ordinary individual and family major medical coverage.

See also: Researchers: Health costs also hit high earners

The percentage of Commonwealth Fund survey participants who said they were completely uninsured dropped to 15 percent in the spring, from 20 percent last fall. A majority of all of the people who had gotten new coverage through the exchanges or Medicaid — 58 percent — said they thought they were better off, and only 9 percent said they were worse off.

Most of the holders of new coverage who said they had tried to get new primary care doctors or see specialists said they got access to care quickly. The researchers found that optimism and satisfaction levels were lower among healthier people and people with higher incomes.

In the income bracket for people with incomes under 250 percent of the federal poverty level (FPL), 82 percent of participants with new coverage obtained through the exchange system said they were satisfied with their new coverage, and 85 percent said they were optimistic about it.

In the income bracket for people with incomes over 250 percent of the FPL, only 65 percent of the people with new coverage were satisfied, and only 66 percent were optimistic.

See also: High-Income Parents Face Coverage Gaps

When the researchers broke out satisfaction statistics by a variety of different demographic factors, such as age and political affiliation, the higher-income participants were more likely to be pessimistic and dissatisfied than people in any other demographic group included in the results.

Sixty-one percent of the holders of new exchange coverage with health problems said they thought they were better off than they were before they had the coverage. Only 54 percent of the healthy new coverage holders said they thought they were better off.

Other survey findings:

  • The people who used the public exchange system to get QHP coverage may be healthier than people who got new Medicaid coverage: 49 percent of the people who signed up for exchange QHP coverage reported said they were healthy. Only 36 percent of the people who signed up for new Medicaid coverage said they were healthy.
  • PPACA may have narrowed a gap in Republican and Democratic health coverage rates. Last summer, 18 percent of Democrats were uninsured, and 11 percent of Republicans were uninsured. In the spring, 11 percent of Republicans were still uninsured, but uninsurance rate among Democrats had fallen to 13 percent. Among independents, the uninsurance rate fell to 14 percent, from 19 percent.


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