Exchange targets assume they don't qualify for subsidies

The Affordable Care Act is projected to reduce the number of uninsured by 14 million this year; however, barely 40 percent of currently uninsured Americans believe they will have insurance in 2014, according to new survey findings released by the Robert Wood Johnson Foundation (RWJF).

The survey found the target population for health insurance exchanges mistakenly think they don't qualify for exchange subsidies or Medicaid. The uninsured adult exchange target population consists of nonelderly adults without insurance with family incomes above 138 percent of the federal poverty level.

Only 31 percent of Medicaid-eligible uninsured adults think they are eligible while only 35 percent of uninsured adults who qualify for exchange subsidies know so, according to the survey announcement.

"The survey respondents' relative lack of knowledge about the availability of free or subsidized health insurance illustrates the need for increased outreach," Katherine Hempstead, who leads coverage issues at the RWJF, said in the announcement. "People should know that help is available so they can get high-quality, affordable healthcare."

Similarly, a December Enroll America survey found a lack of public knowledge about subsidies was the major deterrent to enrollment in insurance plans available under the ACA, FierceHealthPayer previously reported. That lack of awareness could be to blame for the low turnout of subsidy-eligible exchange consumers, as only 30 percent have signed up for the federal exchange as of Nov. 2.

Moreover, of the exchange target population who have considered or tried purchasing nongroup coverage, the RWJF survey found 62.6 percent cited affordability as the main reason they didn't have coverage. Difficulty purchasing coverage or not knowing how (12.1 percent), insurance company rejection (5.5 percent) and insufficient benefits (4.5 percent) also kept uninsured adults from buying coverage.

Meanwhile, the Centers for Medicare & Medicaid Services just reported that state agencies deemed more than 6.3 million people eligible to enroll in Medicaid or the Children's Health Insurance Program between Oct. 1 and Dec. 31. Of the 2.3 million determinations in December, 1.2 million were in states expanding Medicaid and slightlly more than1 million were in Medicaid expansion opt-out states.

For more:
- here's the RWJF statement and report
- here's the CMS report (.pdf)