New Survey by Enroll America Provides Insights into ACA Implementation

By Cathy Hope, Georgetown University Center for Children and Families

A new PerryUndem survey commissioned by Enroll America and funded by the Robert Wood Johnson Foundation and the California Endowment contributes new information to the discussion about the Affordable Care Act. It’s a fairly extensive survey and I encourage you to read it in full if you have time.

What I found most interesting was the positive response to questions about coverage and access to care for those who have enrolled.  According to the survey, the newly enrolled are four times more likely to say they are happy with their coverage than unhappy. Only 9% had trouble getting the care they needed and only 13% said they feel there are not enough providers in their network, according to the survey results.

Another interesting finding involved Medicaid enrollees.  Only half of the Medicaid enrolless surveyed thought they would qualify for the program when they started looking for coverage.

The survey also reaffirmed what children’s health care advocates know, securing coverage for family members is a major motivating factor for those signing up for coverage.  Also, mothers played an important role in young adult enrollment with 19% of those between ages 18 and 29 saying mom “helped them enroll.”

The survey also shed light on some of the barriers to enrollment faced by Latinos including significant knowledge gaps on most Affordable Care Act topics.

Based on the survey findings, Enroll America made the following recommendations to prepare for the next round of enrollment:

1. Recognize that most uninsured individuals want affordable health coverage. The survey suggests this is true and that individuals are willing to put time and effort into enrolling. They want insurance.

2. Understand that the law and fine (and how it is increasing) motivated many to enroll.Talking more explicitly about the mandate and the increasing fine may encourage more people to enroll next time. However, this will not be enough. Being able to see a doctor and avoid big medical bills were also important motivators and should be part of the conversation.

3. Address affordability perceptions/misperceptions. The belief that insurance is not affordable kept many from even looking for coverage. This is the barrier that must be addressed. Part of the issue may be the low awareness that financial help was available to low- and moderate-income individuals. Continuing to raise awareness about the tax subsidy may be important. 

4. Keep educating. There were many knowledge gaps about key aspects of the Affordable Care Act – and about insurance – that still need to be addressed. Those who enrolled knew more; knowledge may be a factor in enrollment.

5. Use the “news” to educate. For better or worse, “news” is where most survey respondents get their information on this topic – particularly local TV news programs and online sources. It may be important to consider the role of these sources in relaying important information about the law and enrollment to the remaining uninsured. Advertising may also be an effective tool – those who saw ads knew more facts about the law and enrollment. 

6. Provide Latinos with more details and enrollment help. They were more likely than others to find enrolling confusing and to question whether they were eligible or not. They also seem to value in-person enrollment assistance more than others. 

7. Activate moms (and other family members and friends) to enroll young adults. Moms played an important role in enrollment for young adults. Also important is talking about the mandate and the increasing fine with this age group.

8. Improve the enrollment process. While enrolling was easy for many, it was not for others. Many of those who did not successfully enroll dealt with website problems, confusion, and could not find answers to questions. Perhaps educating this population about free in-person enrollment assistance could help – people who enrolled this way were more likely to find the process “easy.”

Editor’s Note: This post originally appeared on Georgetown University’s Center for Children and Families Say Ahhh! Blog. It has been slightly modified for publication on CHIRblog.

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The opinions expressed here are solely those of the individual blog post authors and do not represent the views of Georgetown University, the Center on Health Insurance Reforms, any organization that the author is affiliated with, or the opinions of any other author who publishes on this blog.