AFFORDABLE CARE ACT Tracking Survey

Tracking Americans’ Experiences in the Health Insurance Marketplaces

The Affordable Care Act's health insurance marketplaces have been open for business since October 1, 2013. The Commonwealth Fund's Affordable Care Act Tracking Surveys measure public awareness of the new marketplaces and what Americans are experiencing as they shop for health plans. The latest survey was conducted December 11–29, 2013.

Latest Results
Awareness
63%
Three of five adults who are potentially eligible for the reform law's health coverage options are aware of the new marketplaces.
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use & experience
24%
One-quarter of potentially eligible adults had visited a health insurance marketplace by the end of December, up from 17 percent in October.
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enrollment
38%
Two of five adults who visited the marketplaces said they applied for health insurance.
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Explore Survey

Awareness

63%
Potentially eligible adults who are aware of health insurance marketplaces
56%
Potentially eligible adults who are aware of financial assistance to pay for health insurance
54%
Potentially eligible adults who are aware of Medicaid expansion under the health reform law

Are Americans Aware of the Health Insurance Marketplaces?

A majority of adults who are potentially eligible for the health reform law's new insurance options are aware of the marketplaces open in each state and the availability of financial assistance to pay for health plans.

Awareness of the health insurance marketplaces

Six of 10 American adults who are potentially eligible for the health reform law's insurance options are aware of the new marketplaces where they can shop for health plans, about the same percentage as in October.

Percent aware of marketplaces, Summer 2013–December 2013 see details

Adults ages 19–64 who are uninsured or have individual coverage

*Analysis of The Commonwealth Fund Health Insurance Marketplace Survey, 2013, conducted July 15–September 8, 2013.


Awareness of financial assistance to pay for health insurance

More than half of potentially eligible adults are aware that financial assistance for health insurance is available under the Affordable Care Act, about the same percentage reported in October.

Percent aware of financial assistance, Summer 2013–December 2013 see details

Adults ages 19–64 who are uninsured or have individual coverage

*Analysis of The Commonwealth Fund Health Insurance Marketplace Survey, 2013, conducted July 15–September 8, 2013.


Awareness of Medicaid expansion

Similar numbers of respondents in October and December knew that the health reform law makes Medicaid available to more Americans.

Percent aware of Medicaid expansion, October 2013–December 2013 see details

Adults ages 19–64 who are uninsured or have individual coverage

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Use & experience

24%
Potentially eligible adults who visited the marketplaces to shop for a health plan
69%
Marketplace visitors who rate their experience as fair or poor
 
29%
Repeat marketplace visitors who report an improved experience between their first and last visits

Are Americans Using the Health Insurance Marketplaces?

Nearly one-quarter of potentially eligible adults have visited the marketplaces, up from 17 percent in October. A majority of visitors said they were in good health.

Use of health insurance marketplaces by potentially eligible adults rose from October to December.

Percent who visited marketplace, October 2013–December 2013 see details

Adults ages 19–64 who are uninsured or have individual coverage


How Easy Is It for People to Use the Marketplaces?

People's ability to compare health plan benefits and premiums improved from October to December, but finding an affordable plan that meets their needs continued to be a challenge.

Three of five adults (59%) who visited the marketplaces tried to find out if they were eligible for financial help to pay for their health plans or Medicaid. Of those who tried to find if they were eligible, half said it was somewhat or very easy to find out.

How easy or difficult was it to... (percent) see details

Adults ages 19–64 who are uninsured or have individual coverage and went to marketplace

* Only asked of respondents who tried to find out if they were either eligible for financial assistance to help pay for their plan, or if they were eligible for Medicaid (59% in December)

Segments may not sum to indicated total because of rounding; bars may not sum to 100 because of "don't know responses" or refusal to respond


How Do Visitors Rate the Marketplaces?

Assessment of the marketplace experience remains low.

There was little change since October in the overall assessment of the marketplaces. Despite improvements in the ability to compare plans and benefits, seven of 10 adults who have visited the marketplaces still rate their experience as fair or poor.

Rating experience with the marketplace, October 2013–December 2013 (percent) see details

Adults ages 19–64 who are uninsured or have individual coverage and went to marketplace

Segments may not sum to indicated total because of rounding; bars may not sum to 100 because of "don't know responses" or refusal to respond


How Are People Accessing the Marketplaces?

Most visit the insurance marketplaces online. Many repeat visitors report improvements.

The Internet is the most common way of accessing the health insurance marketplaces. Nearly four of 10 marketplace visitors received personal assistance, such as by phone, online chat, or through an in-person navigator. Visiting the marketplaces more than once is common. Of those who visited more than once, three of 10 said their experience improved between their first and last visits.

How adults visited the marketplaces see details
 

Adults ages 19–64 who are uninsured or have individual coverage and went to marketplace

*Respondents could report visiting the marketplaces in more than one way.

Percent who received personal assistance see details

Adults ages 19–64 who are uninsured or have individual coverage and went to marketplace

Percent visiting marketplaces more than once see details

Adults ages 19–64 who are uninsured or have individual coverage and went to marketplace

Change in experience using the
marketplace
see details

Adults ages 19–64 who are uninsured or have individual coverage and went to marketplace more than once

Bars may not sum to 100 percent because of "don't know" responses or refusal to respond

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Enrollment

38%
Of those who visited the marketplaces, percent who applied for health insurance.
59%
Of those who have not yet enrolled, percent who are somewhat or very likely to shop for coverage before the March 31 deadline

Are Americans Enrolling in Affordable Care Act Health Plans?

Nearly two of five adults who visited the marketplaces said they applied for health insurance.

Of those who visited the marketplaces, percent who applied for health insurance.

Percent applying for coverage,
December 2013
see details
38%
Adults ages 19–64 who are uninsured or have individual coverage and went to marketplace

Are Americans Likely to Visit Before the Deadline?

People who want health insurance through the marketplaces next year have until March 31, 2014, to enroll in a plan. A majority of adults who are potentially eligible for the new coverage options but have not yet enrolled said they will likely try to do so by the deadline.

Likelihood of shopping for insurance before the enrollment deadline

Fifty-nine percent of potentially eligible adults who either had not yet visited the marketplaces or had visited but not applied for or enrolled in a health plan said they were very or somewhat likely to go to the marketplace by the end of the March to enroll in a plan or find out if they are eligible for financial help.

Likelihood of going to/going back to marketplace by March 31, 2014 see details

Adults ages 19–64 who are uninsured or have individual coverage and who have not gone to marketplace, or went to marketplace but did not apply or did not enroll

*Respondents with individual market coverage who said they had received an offer from their insurance carrier to renew their plan for 2014 and said they planned to keep their policies were excluded from this analysis.

Segments may not sum to indicated total because of rounding; bars may not sum to 100 because of "don't know" responses or refusal to respond.

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Special topics

Cancellation Letters and Renewal Options

In 2013, many people with individual market coverage and many small businesses were informed by their insurance carriers that their health plans did not meet the more comprehensive benefit requirements that go into effect this year under the Affordable Care Act. Consequently, they had to select a new health plan, whether through the insurer or through the marketplaces. Among adults in the survey who had health insurance that they purchased in the individual insurance market, 22 percent said they had received a cancellation letter from their insurance company informing them that their health plan would not continue in 2014.

A few states decided early on to allow insurance companies to let people with individual market coverage renew their health plans in 2013, ahead of the new insurance market reforms, even if the plans were not compliant with the law's new standards. The difficult rollout of the federal marketplaces also prompted the Obama administration to make a similar allowance, out of concern that some people with cancelled policies might not be able to find a new plan in time for coverage beginning in January. In the survey, 60 percent of adults with individual coverage said that their insurance carriers had offered them the option of renewing their plans through 2014. Of those who were offered the opportunity to renew their policies, 82 percent said they planned to keep their current plan.

Percent who received a health plan cancellation letter from their insurance company (December 2013)
22%
Adults ages 19–64 who have individual coverage
Percent who were offered the option of renewing their plan through 2014 (December 2013)
60%
Adults ages 19–64 who have individual coverage
Percent who are planning to keep their current plan (December 2013) see details
82%
Adults ages 19–64 who have individual coverage and were offered option to renew plan
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