Exchange of Information: Getting the Word out on Health Insurance Exchanges

The newly formed health insurance exchanges open their doors to the public October 1, amidst threats of a government shut down. Although it may seem that news about “Obamacare” is everywhere, a recent study by the Commonwealth Fund released September 30 found many of those who may truly benefit from the health insurance exchanges do not know their options. According to the individuals surveyed, just two in five adults are actually aware of it and what that means for them. Only 32 percent of the uninsured knew about the exchanges, and just 31 percent of the uninsured were aware government subsidies are available to reduce insurance costs for many low- and middle-income people, according to the report. Out of those people who might be eligible for the exchanges, three of five said they were likely to take advantage of them.  

The Commonwealth survey also found broad support for state expansion of the Medicaid program, even in states that have not yet decided to expand their programs. While the Commonwealth Fund noted that outreach and education are critical to ensuring that those eligible for the new coverage options will enroll, their survey results suggest that eligible Americans will likely take advantage of the law’s insurance reforms in the months and years to come. So, the question is, how does one get the word out? The Federal government has a website, titled which explains a lot about the new exchanges and coverage options. The website includes answers to questions from “What is the health insurance marketplace” to “How can I get an estimate of costs and savings on Marketplace health insurance?” It even has answers to questions for small businesses, so that they can obtain information on employee coverage. Individuals can also sign up to get email updates on the latest news and changes within the exchanges. People will have between October 1, 2013, and March 31, 2014, to enroll in plans through the marketplaces. State marketplaces will provide a menu of available options and individuals may enroll online, by phone, by mail, or in person. Health insurance coverage and subsidies will begin on January 1, 2014.

But not everyone knows about the website, or that they have choices. The Commonwealth Survey found that the people who are most likely to benefit from the marketplaces are the least aware of their options. Only 32 percent of those who were uninsured for any time over the prior 12 months are aware of the marketplaces compared with 43 percent of those who were insured all year. And only 40 percent of people surveyed were aware that financial assistance is available to help pay for health plans purchased through those marketplaces; the people in the most need were the most unaware of the available financial assistance. The study found that just under one-third (32 percent) of adults with incomes under 250 percent of the federal poverty level ($28,725 for an individual and $58,875 for a family of four) are aware compared with 47 percent of those with higher incomes.

Medicaid expansion. Health insurance marketplaces will also help people find out whether they are eligible for federal financial assistance to pay for their plans or if they are eligible for coverage under PPACA’s Medicaid expansion. The survey indicated widespread support for the law’s provision to expand Medicaid to everyone who earns less than 138 percent of the federal poverty level ($15,856 for an individual and $32,499 for a family of four).  In 2012, the Supreme Court ruled that states may choose whether to participate in the expansion. Until now only 25 states and the District of Columbia have decided to expand their programs.

The Commonwealth Survey found that overall, more than two-thirds (68%) of adults surveyed are strongly or somewhat in favor of making Medicaid available to more residents in their state. Few adults actually knew whether their state was participating in the expansion, but more than two-thirds (68%) of those who correctly identified their state as expanding the program said they strongly or somewhat favored their state’s decision. Among those adults who correctly identified their state as not yet expanding Medicaid, only 38 percent strongly or somewhat favored their state’s decision.