Additional outreach about insurance marketplace premium subsidies and expanded eligibility standards for Medicaid is needed to reach the uninsured, a Kaiser Family Foundation study suggests.
Lack of awareness of new coverage options and financial assistance, not difficulties with the application and enrollment process during the 2014 open-enrollment period, was the key reason people remained uncovered, Kaiser found in interviewing 10,000 individuals for its survey.
Many think insurance would be too expensive to obtain and maintain, the study found. This sentiment was held even among those who appear to be currently eligible for subsidies or Medicaid under the Patient Protection and Affordable Care Act.
“These people may have shopped for marketplace coverage and perceive it to be too costly, they may have received incorrect or misinterpreted information on Medicaid coverage, or their eligibility may have changed between the time they sought coverage and completed the survey.”
The findings come as HHS has begun allowing states to impose cost-sharing on people below and above the poverty level as they expand Medicaid coverage. States where individuals must pay part of their premiums include Iowa, Michigan and, most recently, Arkansas, Indiana and Pennsylvania.
Approximately 11 million non-elderly adults were newly insured last year. However, about 30 million people remained uninsured by year’s end (PDF), the report found. More than half of the remaining uninsured population has family income at or below 138% of poverty, the income range for the Medicaid expansion.
Some who attempted to get insurance were incorrectly told they were not eligible or misinterpreted information they were given, Kaiser said.
Even as open enrollment draws to a close, Kaiser is hopeful more outreach work will take place, especially for Medicaid, which has enrollment year round.
Some will be either ineligible either for subsidies or Medicaid, Kaiser noted. These include undocumented immigrants, those living in non-expansion states, or those with incomes above the limit for premium subsidies. In addition, many remaining uninsured are working for companies that will not be required to offer coverage under the ACA because they have fewer than 50 full-time employees.
Those who remained uninsured are more likely than those with coverage to rate their health as fair or poor but less likely to have a diagnosed condition or take a prescription medication on a regular basis, according to the report.
Follow Virgil Dickson on Twitter: @MHvdickson
