A look into PPACA’s enrolleesNews added by Benefits Pro on June 20, 2014

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By Kathryn Mayer

Nearly six in 10 enrollees on the exchanges under the Patient Protection and Affordable Care Act had been uninsured before obtaining coverage, according to a new poll from the Kaiser Family Foundation.

Most of this group say they’d been without coverage for at least two years, and seven in 10 (72 percent) say they decided to buy their own health insurance because of PPACA.

The new report, out Thursday from the nonpartisan foundation, helps gauge the effects PPACA’s had on the uninsured.

Though there’s been “considerable debate” over how many people signing up for coverage in the new exchanges were uninsured, Foundation President and CEO Drew Altman said the survey “reveals that the majority of people who enrolled in the new exchanges were previously uninsured.”

Some critics of the law have argued most of those who purchased the new plans had insurance already.

The nation’s uninsured rate is at a new low, with Gallup putting it at 13.4 percent.

The survey aims to provide a first look at the national demographic and health profile of people who enrolled in PPACA-compliant plans, including those who bought such coverage outside the exchanges. About two thirds of the non-group market is now in PPACA-compliant plans. Kaiser Family surveyed 742 adults in April and early May.

While a large majority (82 percent) of those in compliant plans says they’re in excellent, very good or good health, an even larger majority of those who remain in non-compliant plans say the same about their health (93 percent).

“This means that people in compliant plans are somewhat more likely than those in non-compliant plans to report being in fair or poor health (17 percent vs. 6 percent), which was expected as the law required insurers to accept all enrollees, regardless of their health,” Kaiser reported. “The effect of this on premiums is still uncertain, however, since many insurers anticipated a sicker-than-average mix of enrollees when they set their premiums for this year.”
Roughly half of those who bought a plan that met the PPACA’s rules said they got help enrolling from brokers, navigators or family members.

Read: Consumers want broker help with PPACA

The survey also looked at enrollees’ opinions on their new plans. Similar to previous reports, there are sharp differences between those who say the law has hurt them and those who say the law has helped them.

Specifically, Kaiser found:
  • 71 percent rate their coverage as excellent or good overall, and more than half (55 percent) say it’s an excellent or good value for what they pay for it, while 39 percent rate the value as “only fair” or “poor.”
  • 43 percent say it is difficult to afford their monthly premiums.
  • 34 percent of enrollees say they’ve benefited from PPACA, mostly due to lower costs and expanded access to care and insurance.
  • 29 percent say the law has negatively affected them, with most citing increased costs as the reason why. Other reasons cited for disliking the law was the individual mandate, cuts to benefits or choices, and policy cancellations.
The survey also examined the experiences of those enrollees who switched plans — either because their previous policy was canceled because of new PPACA requirements, or people who switched for other reasons.

Previous reports have found that coverage under PPACA plans are more expensive, though Kaiser only found this to be partially true. Those who switched plans are about as likely to report that they are paying less for their new plan than their old one (46 percent) as they are to say they are paying more (39 percent). Kaiser said that’s likely to be due to available subsidies under the law.

The survey also found that plan switchers indicate that their deductibles and level of coverage are similar to what they had in their previous plans. They are as likely to say their new plan's deductible is lower than their old one as they are to say it is higher (31 percent in each case). About the same shares say their new plan covers more (31 percent) as less (25 percent) services, and that their new plan offers more (29 percent) rather than less (26 percent) financial protections.

More new enrollees said they have less choice when it comes to primary care doctors (32 percent vs. 10 percent) and specialists (24 percent vs. 11 percent).

Originally published on BenefitsPro.com
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