Americans Have Worries About Future Health Insurance Coverage, Report Says

Thirty-six percent of Americans who have health coverage through the Affordable Care Act (ACA) and 27% of those with Medicaid are pessimistic they will be able to keep their future coverage, according to a new Commonwealth Fund survey of 2410 adults.

Nearly half cite actions by the Trump administration or Congress to undermine the ACA as the main source of their worry.

The nationally representative survey of adults ages 19-64 also found that regardless of political affiliation, most believed all Americans should have the right to affordable healthcare. Those agreeing with that sentiment included 99% of Democrats, 92% of independent voters, and 82% of Republicans.

The survey was conducted between November 2 and December 27, 2017.

The Commonwealth Fund said 11.8 million people selected plans through the ACA marketplaces, about 3.7% fewer than 2016. In 2017, the Trump administration cut the budgets for the marketing and outreach efforts that encourage enrollment and shortened the enrollment period.

“This year’s enrollment numbers are impressive considering the uncertainty that surrounded the law most of the year, but we found that some people are concerned about being able to keep their coverage in the future,” said The Commonwealth Fund’s Sara Collins, lead author of the study.

Only 9% of those with employer coverage are not confident about the future of their health insurance.

Other findings of the survey include:

• At the end of 2017, 14% of adults were uninsured, the same as 6 months earlier. That is below the 20% uninsured rate seen just prior to the ACA’s first open enrollment period. Uninsured rates are highest among low-income adults, Latinos, the unemployed, employees of small firms, and residents of states that have yet to expand Medicaid.
• Most of the public is aware of the availability of ACA marketplace coverage, but lack of awareness is higher among uninsured adults.
• About 47% of uninsured adults were aware of the ACA plans but did not intend to purchase; when asked why, most cited affordability (71%). Other reasons included not thinking they would be eligible, thinking health insurance was not needed, thinking the ACA would be repealed, and thinking it was no longer required to have health insurance.

The Commonwealth Fund said Medicaid expansion is the most obvious means for expanding coverage nationwide, and suggested that signs of support from both the Trump administration as well as Congress would go far towards reassuring the public about their healthcare coverage. “Such a shift also would provide a more stable regulatory environment for insurers participating in both the marketplaces and Medicaid,” the report said.

Reference

Collins SR, Gunja MZ, Doty MM, Bhupal HK. Americans’ views on health insurance at the end of a turbulent year. The Commonwealth Fund issue brief. The Commonwealth Fund website. commonwealthfund.org/publications/issue-briefs/2018/mar/americans-views-health-insurance-turbulent-year. Published March 1, 2018. Accessed March 1, 2018.