Halfway through the first enrollment period for health insurance exchanges, the majority of Americans potentially eligible for coverage have not yet visited one of the marketplaces.
About one quarter of Americans who may be potentially eligible for coverage under the Affordable Care Act had visited one of the exchanges by the end of December, according to the Commonwealth Fund.
About 41 percent of those visitors were the highly sought after young adults, aged 19-34, a substantial majority (77%) of whom were reported as healthy, the report released Jan. 9 also noted.
But 59 percent of those in the survey sample who hadn't yet visited an exchange or applied for coverage anticipated that they would enroll in a plan by the March 31 deadline.
The first Commonwealth survey taken in October showed that 17 percent of potentially eligible individuals had visited an exchange during the first month of enrollment.
The IT problems that initially crippled the rollout on the federal Healthcare.gov portal and many of the state exchanges likely played a role in participation. By the end of December, with many repairs deployed, about 1 million had signed up for private health plans on Healthcare.gov and another 1 million signed up in the 14 states, along with the District of Columbia, that run their own marketplaces. An estimated 3.9 million adults have enrolled in Medicaid.
"Adults who are potentially eligible to buy health insurance through the marketplaces are demonstrating their determination to gain health insurance this year," said survey lead author Sara Collins, who is also Commonwealth Fund's vice president for healthcare coverage and access, in a news release.
The report noted that consumers' ability to compare benefits and premiums improved between October and December, but many reported difficulties in plan selection.
Just over one-third (36%) of adults who visited the exchanges said that it was very or somewhat easy to find a plan with the type of coverage they needed, while 37 percent reported that it was somewhat or very easy to find a plan that they could afford. About 38 percent found it very or somewhat easy to compare plans by their potential out-of-pocket costs from deductibles and copays.
The findings show progress toward solving the initial website problems and demonstrate that "those issues have not dampened people's determination to get affordable, comprehensive coverage," said David Blumenthal, MD, Commonwealth Fund president.
Among those who already had individual coverage, 22 percent reported that they had received a cancellation letter from their insurer in 2013.
Getting the word out to people who are potentially eligible for coverage about their options remains a challenge. "The level of awareness of the marketplaces and financial assistance…was stubbornly stable across the two surveys" between October and December, the report said. "Awareness is lowest among those people who stand to benefit the most," those with incomes under 250 percent of poverty and eligible for significant subsidies, the report noted.