Lack Of Information And Misinformation Suppressing Enrollment In Insurance Plans

Recent polls are showing some of the obstacles to extending coverage among the uninsured. A study published Monday by the National Academy of Sciences showed that a substantial number of consumers lack basic knowledge of how insurance works which would be necessary to intelligently purchase coverage. A new Kaiser Health Tracking Poll shows lack of knowledge of the deadline for obtaining coverage and widespread belief in many of the false claims being spread by opponents of the Affordable Care Act.

Many are unaware of next week’s deadline to obtain coverage and avoid potential tax penalties:

A third of those who lack coverage as of mid-March are unaware that the law requires nearly all Americans to have health insurance or pay a fine. When it comes to the specifics, four in ten of the uninsured (39 percent) are aware that the deadline to sign up for coverage is at the end of March, leaving about six in ten unaware of the March deadline.

When reminded of the mandate and the deadline, half of those without coverage as of mid-March say they think they will remain uninsured, while four in ten expect to obtain coverage and one in ten are unsure.

Many plan to not obtain coverage due to cost concerns, unaware of financial assistance available:

While some report trying to get coverage from new options available under the ACA, large shares of the uninsured remain unaware of two of the law’s key provisions that could help them get coverage. About half the uninsured are unaware that the ACA gives states the option of expanding their Medicaid programs, and more than four in ten don’t know that it provides financial help to low- and moderate-income individuals to help them purchase coverage.

The Kaiser poll showed a reduction in the gap between those who see the law unfavorably as opposed to favorably. While more now have a favorable opinion than previously, the majority continue to have an unfavorable opinion. Much of the opposition is based upon misinformation spread by opponents:

“It’s too expensive for regular people.”
“it’s costing too much money. It’s supposed to help people with low incomes and it’s not.”
“Because it’s a financial hardship on the U.S.”

The first two are based upon lack of knowledge of the assistance available which does make coverage more affordable. The third has been shown by the recent non-partisan report from the Congressional Budget Office to be false. Among its other benefits, the Affordable Care Act will reduce the deficit, reduce unemployment, and help stimulate the economy by freeing people from the insurance trap, enabling more people to work for and start small businesses

Opposition also includes a belief that the individual mandate is unconstitutional despite a Supreme Court ruling upholding the law. Some expressed the false belief that the ACA gives government more control over personal health care choices, echoing further scare stories from the right wing as to what the law does.

Despite unfavorable views about the law, a majority still would prefer to see improvement to the law as opposed to repeal or a Republican alternative:

Perhaps reflecting this sense that the debate has gone on long enough, more of the public would like to see Congress keep the law in place and work to improve it (49 percent) or keep it as is (10 percent) rather than repeal it and replace it with a Republican-sponsored alternative (11 percent) or repeal it outright (18 percent).

The poll found that many aspects of the law are popular, even if many people are unaware of these and other benefits:

As previous Kaiser tracking polls have found, many of the ACA’s major provisions continue to be quite popular, including across party lines. For example, large shares of Americans – including at least seven in ten overall and at least six in ten Democrats, Republicans, and independents – have a favorable view of the fact that the law allows young adults to stay on their parents’ insurance plans up to age 26, closes the Medicare “doughnut hole” for prescription drug coverage, provides subsidies to low- and moderate-income Americans to help them purchase coverage, eliminates cost-sharing for preventive services, gives states the option of expanding Medicaid, and prohibits insurance companies from denying coverage based on pre-existing conditions. Nearly as many (including a majority across parties) have a favorable view of the “medical loss ratio” provision that requires insurance companies to give their customers a rebate if they spend too little money on services and too much on administration and profits. Somewhat more divisive is the law’s Medicare payroll tax on earnings for upper-income Americans, which is viewed favorably by about three-quarters of Democrats and just over half of independents, but just a third of Republicans.

The individual mandate remains highly unpopular. Anticipation of this is one of the reasons I opposed the individual mandate prior to passage of the Affordable Care Act, preferring an alternate system to provide incentives to purchase coverage and penalize those who try to game the system by waiting until sick to purchase insurance.

Much of the opposition to the ACA is based upon beliefs about the law which are untrue:

Misperceptions also persist about things the ACA does not actually do. For example, nearly half the public (46 percent) think the law allows undocumented immigrants to receive financial help from the government to buy health insurance, and another two in ten (22 percent) are unsure whether it does. A third of the public (34 percent, including 32 percent of seniors) believe the law establishes a government panel to make decisions about end-of-life care for people on Medicare, with another quarter saying they are unsure (23 percent of the public, 25 percent of seniors).

Unfortunately both lack of information and intentional misinformation being spread by opponents of the Affordable Care Act is likely to cause a substantial number of people to go without coverage this year. The deadline is fast approaching for purchasing coverage on the exchanges. There is no deadline for those who qualify for coverage due to Medicaid expansion, but Republicans in many states are also denying this benefit to residents of their states even though the federal government picks up almost all of the cost.

Cross posted at The Moderate Voice

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