October 4, 2013

Most of the uninsured plan to get coverage soon, but not necessarily because of the law


A majority of Americans without health insurance say they will obtain it in the next six months, but only 26% say it is because of the health law’s requirement.

Traffic remained heavy on the first week that new online health insurances exchanges were open – there were 4.7 million unique visitors to healthcare.gov in its first 24 hours – and many consumers still had to contend with lengthy waits or a variety of technical problems.

The law, officially known as the Affordable Care Act, contains an individual mandate that requires Americans and anyone they claim as dependents to obtain health insurance coverage in 2014 or pay a penalty.  A Pew Research Center survey in September found that 63% of those who do not have health insurance say they plan to get it within the next six months.

However, only about a quarter (26%) of the uninsured said they would be getting insurance because of the law’s requirement. A third said they were planning to get insurance anyway. Almost a third (32%) said they were not planning to purchase insurance.

The survey found that uninsured Americans were less likely than the insured to be aware of the mandate. About six-in-ten (61%) of those who do not have health insurance knew that the law requires the uninsured to get insurance. That compares with 71% of those who have health insurance.

Just half of the uninsured (50%) are aware that low-income residents in their state will be eligible for federal subsidies.

Category: Daily Number

Topics: Health Care

  1. Photo of Bruce Drake

    is a senior editor at Pew Research Center.

1 Comment

  1. Paul Mullen4 years ago

    I am surprised that it is as many as a quarter of the uninsured who are getting coverage “due to the mandate”. Most studies find that almost everyone wants health insurance: most of the uninsured are uninsured because they either can’t afford it, or have been rejected because of pre-existing conditions.

    It would have been helpful to have put this remark into perspective by showing some of the other reasons why the uninsured may now get insurance, including other effects of the ACA.

    First, according to NHIS, about 20% of uninsured at the time of survey had been uninsured for less than a year, presumably because of job changes etc. Most these people probably expect to find a job with insurance within 6 months.

    Then there are the many with pre-existing conditions which have prevented them from getting affordable insurance. Most of these, like me, are self-employed or work for small businesses that do not offer a group policy, so are keenly looking forward to January 1st 2014.

    Expanded Medicaid (even though it has only been implemented by the States that least need it) will still make a significant reduction in the uninsured.

    Many studies have shown that affordability has been the biggest single barrier to people getting health insurance. ACA will make premiums for older adults and the sick much more affordable (though this means that premiums for healthy young males will increase).

    Premium Tax Credits will make insurance affordable for many low income individuals and families.

    Excluded from the mandate are undocumented immigrants, those below FPL in states which are not expanding Medicaid, and anyone for whom premiums are deemed “unaffordable” by ACA. What proportion of your 32% not planning to get health insurance fall into these categories?

    So, how many uninsured would wish to remain uninsured if it were not for the mandate? Consider how many decline employer-offered insurance (excluding those who decline because they have other coverage)? Those who decline insurance include young people who see no need for insurance because they are not presently sick, those who have the money but would rather spend the premium on something like a car payment, those offered employer coverage which they cannot afford, or those that are so poor that even the subsidized premiums (plus out of pocket payments) are unaffordable.

    Surely data exist to take a pretty good stab at all these numbers. It would be nice to place your 26% into context. Anyway if 50% of the uninsured surveyed were unaware that they might be eligible for subsidies and 39% were not aware of the mandate, there must be considerable uncertainty over what that 26% were thinking when they answered the way they did. Did those surveyed really understand their choices?