There was a significant disparity, however, in outreach efforts depending on whether states opted to run their own insurance marketplaces or defaulted to the federal exchange. In the 16 states and the District of Columbia that operated their own exchanges, 325 people received assistance for every 1,000 uninsured individuals. By contrast, only 162 individuals per 1,000 uninsured received assistance in the 29 states that relied on the federal marketplace.
The remaining five states, which partnered with the federal government in running their exchanges, fell in the middle: 276 individuals received assistance per 1,000 uninsured.
That’s in large part reflective of the fact that there were simply more outreach workers on the ground in states running their own marketplaces. States with their own marketplaces had 8.7 assisters per 10,000 uninsured—or nearly double the number of workers involved in outreach efforts in states that relied on the federal marketplace, according to the Kaiser study.
More than 80% of the outreach programs surveyed by Kaiser reported that most consumers who sought help didn’t understand the Patient Protection and Affordable Care Act or were confused by the coverage choices available to them. In addition, they reported that nearly three quarters of individuals who requested assistance struggled to understand basic insurance concepts such as deductibles or provider networks.
Nearly 90% of outreach programs reported that most of their clients were previously uninsured. In addition, nine out of 10 assister programs indicated that they had already seen clients return to discuss questions or problems with their new insurance coverage. Those issues included not receiving insurance cards or having claims denied.
“The folks that signed up this year mostly aren’t working nine-to-five jobs at a steady salary,” Pollitz said. “They have a lot of volatility in their lives.”
The Internet survey was conducted from April 24 through May 12, shortly after the first open enrollment period concluded. A total of 4,445 outreach programs were invited to participate in the study; 843 programs responded.
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