Five years later, ACA is still a mystery to many

It has been more than five years since the Patient Protection and Affordable Care Act (take your pick whether to call it PPACA, ACA or ObamaCare) was passed in May 2010 and public exchanges are wrapping up their third year of operation, yet one-third of consumers are still clueless concerning the law.

Never heard of it!

As of October 2015, 6% of US adults have never heard of the Affordable Care Act or ObamaCare and 27% know nothing about it other than its name.  Only 19% say they “know a lot about it” while 4% foolishly believe they “know almost everything in it” according to the most recent DSS Health Care Engagement Index Survey.  Even among the most Engaged health care consumers, 5% have never heard of the ACA and 13% only know its name.  Years of news stories, political rhetoric, community outreach efforts and health plan marketing / advertising expenditures have had little impact as these percentages have not changed appreciably since 2013.

Still can’t afford coverage!

The uninsured rate has certainly declined significantly the last two years, but “affordability” is still a barrier for many consumers.  The percentage of people who say they have postponed seeking care because of costs or had a problem paying a medical bill has trended upwards since 2013 while the percentage receiving flu shots, having a colorectal screening or receiving a physical exam has not changed despite these services being free under the ACA.  Consumers’ perceived “value” of health plans relative to the benefits received and premium paid has declined since 2013.  Rising premiums, ever higher deductibles and consumers’ lack of motivation to understand health care policy issues seem to be constraining the marketplace.

I worry more than ever about medical costs!

Furthermore, 12% reported that their health plan does not pay for care their doctor said was needed on a regular basis.  Only 63% say they never have an issue with their plan paying for care their doctor says is needed.  Similarly, 13% of consumers said they regularly have to pay out-of-pocket for services they thought would be covered by their plan while only 55% never have to do so.  The magnitude of medical expenses are a worry for many, with 16% always or usually delay visiting a doctor because of worries about costs while another 24% sometimes feel this way.  Even prescription costs create concerns with 10% always or usually delaying filling a prescription and 20% sometimes delaying the filling of a prescription due to costs.

Too much trouble to change plans!

With greater choices than ever before (new entrants, co-ops, both private and public exchanges), you would hope that consumers would carefully shop for a new health plan like they for their next TV or smartphone – but the opposite is true.  When faced with a 20% increase in premium, people in 2015 are likely to say they would simply pay the price increase rather than go to the trouble of changing health plans (37% in Q4 2013 vs. 44% in Q3 2015). When consumer do make a health plan choice, they spend about the same amount of time in 2015 that they did in 2013 with just over half the market spending less than one hour on one of the biggest financial decisions they will face all year.

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