Almost seven in 10 uninsured individuals with pre-existing conditions still don't know if they will purchase health insurance in 2014, according to a report from InsuranceQuotes.com, part of Bankrate Inc.
This despite the Affordable Care Act requirement that insurers offer them coverage at no extra cost regardless of health status and the individual mandate to obtain insurance or pay a fine.
Only 18 percent of uninsured individuals with pre-existing conditions are definitely planning to purchase health insurance – 12 percent before Jan. 1 and 6 percent subsequently. Fourteen percent are planning to remain uninsured, while the others are undecided.
"It's really surprising how few people with pre-existing conditions are planning to purchase health insurance, especially since a key goal of the ACA is to provide affordable health insurance to people with pre-existing conditions," said Laura Adams, senior insurance analyst for InsuranceQuotes.com in a news release Wednesday.
The overwhelming reason, according to 85 percent of those responding, is the lack of education and information – and misinformation – to date about provisions of the ACA, the health insurance exchanges, how much coverage will cost and the law's effect on their personal finances.
Consumers likely will seek more information in the coming months once the health insurance exchanges start selling coverage in the fall, said John Rother, president and CEO of the National Coalition on Health Care, a non-profit advocacy group.
"People tend to get a lot more focused when they have to make a decision," he said in the report. "They will have a lot of choices to make."
According to the survey, 37 percent of those responding have a preexisting condition. Right now, individuals with preexisting conditions can get coverage through group plans offered by employers but often get denied – or charged exorbitant premiums – when they try to buy insurance on the individual market, said Sally McCarty, a healthcare reform expert with the Center on Health Insurance Reforms at the Georgetown University Health Policy Institute, in the report.
Under ACA, "You won't be turned down because of cancer or any illness, and you won't pay more because of your condition," she said. Consumers who buy insurance on the individual market will be pooled by state, much like employees in a group plan. Pooling by state creates a large group, so the high medical bills of one sick person will have much less of an effect on the premiums paid by all group members.
States are just now beginning to publish health plan premiums. Once the exchanges open, more costs will be available so consumers can shop and compare plans.
Before the exchanges open, the federal government, many states and community organizations plan to mount big publicity pushes with TV commercials, billboards and ads to educate consumers. "I just don't think the big push to get the word out has started yet," McCarty said.
Kicking off the publicity campaigns closer to when the exchanges open will help make sure that the information is fresh in the minds of consumers when it's time to start shopping for insurance.
"You want to start early but not too early," McCarty said. The survey of 3,005 individuals in July was conducted by Princeton Survey Research Associates International (PSRAI).