The Affordable Care Act has survived severe challenges; the political battle that began in the early days of the healthcare reform’s legislative history put the law’s constitutionality before the Supreme Court, spawned dozens of attempts in the House of Representatives to repeal the law as a whole or in parts, and was a precipitating factor in October’s shutdown of the federal government.
Now that the cornerstone provision — the individual insurance exchanges — of the Affordable Care Act has been implemented, the nature of the political battles has changed and the survival of the healthcare reform is no longer as precarious as it once was, although the Republican party is considering ways to offer their own solution to America’s healthcare problems. But there are survival battles yet to be fought; namely, the Affordable Care must show that it accomplished its express purpose, as making health coverage accessible to the nation’s millions of uninsured.
Early in the enrollment period, policy experts worried that uninsured Americans were not signing up for policies via the exchanges. That concern was legitimate. Not only did survey results show in the months leading up the to the October 1 marketplace launch that a large percentage of the American population was confused about the law and its implications, research done by Gallup suggest that in November, both confusion and the problems with the healthcare website linking the federally-facilitated marketplaces had discouraged the uninsured from enrolling.
The survey found that only three in 10 uninsured Americans are familiar with the insurance marketplaces created by the healthcare reform law, while just 18 percent of the country’s 48 million uninsured — roughly 8.6 million people — had attempted to visit an exchange website. Just a slightly higher portion, 22 percent, said they plan to get insurance through the exchanges.
At the time, Gallup’s Frank Newport noted that, “The health exchange websites are not only fraught with the technical problems that have led to so much news coverage in recent weeks, but have also generated relatively little interest or use among uninsured Americans — the primary target group for the exchanges.”
Now, according to the January edition of the survey, 53 percent of all uninsured Americans say they plan to get insurance, while 38 percent say they are more likely to pay the fine — which amounts to $95 or 1 percent of income, whichever is greater — that the government will levy for going without qualifying health insurance.
Of those who plan to get health insurance, 56 percent of uninsured Americans say they will do so through a government health insurance exchange. That measure has steadily increased since Gallup began tracking uninsured Americans’ insurance plans last October. Gallup’s Jeffrey M. Jones attributed the increase to the improvements the Department of Health and Human Services made to the federal health website at the end of last year, fixes that were meant to address the software errors and design flaws that caused hours-long wait times, prevented potential customers from creating accounts and completing the 30-step enrollment process, sent insurers the wrong information, and made it difficult for customers to get an accurate cost estimate.
One sign that uninsured Americans are enrolling in insurance polices is that the uninsured rate dropped from 17.3 percent in December to 16.1 percent in early January. Also decreasing is the number of uninsured Americans who are unaware of the federal requirement to have health insurance, a figure that has fallen from 80 percent in December to 72 percent in January.
However, at 23 percent, only a surprisingly low number of uninsured Americans told Gallup they have visited, or have attempted to visit a federally-facilitated website or a state-run exchange. That is only slightly lower than December’s 26 percent. Even among those who say they plan to get insurance through an exchange, few respondents, 21 percent, have visited the website. These numbers suggest that those plan to enroll have not yet taken a specific step toward signing up. Comparatively, 67 percent of those polled claimed to be unfamiliar with the exchanges.
“A small but notable drop in the percentage of Americans who are uninsured in January, the first month new health plans went into effect, is a positive sign the Affordable Care Act is making progress toward its goal of getting more Americans covered. Another positive sign may be the increasing percentage of the remaining pool of the uninsured who are planning to get insurance through the exchanges that were created by the law,” wrote Jones. “Still, both trends represent only modest improvements, and it may get harder to convince the remaining uninsured population to sign up for health insurance in the coming months.”
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