Most Obamacare enrollees like coverage but not cost, poll suggests

A new survey provides the most detailed glimpse yet of who signed up for the first round of Obamacare. Half of the new enrollees had previously been uninsured.

LM Otero/AP/File
People use a phone bank to sign up for health-care insurance at the business office of Parkland Hospital in Dallas on March 31, 2014, the deadline for signing up for coverage under President Obama's health-care law. A new poll finds that most people who signed up for Obamacare rate their insurance highly, but a substantial number are still struggling with the cost.

Obamcare enrollees are more likely than the rest of America to say they like the coverage that’s being offered through new marketplaces created by the health-care reform law. But many of them also say they’re having trouble affording it.

Those findings from a new poll hint at some of the law’s early successes and also at the challenges it faces as the marketplaces move toward Year 2.

The poll by the Kaiser Family Foundation concludes that half of enrollees in Obamacare had been previously uninsured. That’s a higher number than some other surveys have estimated, and it bolsters the notion that the Affordable Care Act is helping to reduce the ranks of the uninsured – not only by expanding Medicaid for the poor but also by helping people of moderate incomes to buy their own coverage.

Among people who didn’t sign up, though, an oft-cited reason has been the cost of insurance – even after accounting for the ACA’s generous subsidies. The test ahead is whether the law can attract millions more from the ranks of the uninsured to buy coverage for 2015.

“The previously uninsured are one of the groups most likely to believe they have benefited from the ACA, and seven in ten of them say they would not have gotten coverage without the law,” Kaiser analysts wrote in releasing the poll results Thursday. But more than 40 percent of people in Obamacare plans say it’s hard to afford their monthly premiums,

The poll provides what may be the most detailed glimpse yet of the people who signed up for Obamacare: who they are, why they enrolled, and what they like and don’t like about the law.

Key findings:

How happy people are with the law. People in Obamacare plans take a favorable view of the law more often than not, the Kaiser poll found. Almost 6 in 10 of those who enrolled on exchanges – those who generally qualified for subsidies – view the ACA favorably. By contrast, other polls find that only a minority of Americans overall feel that way. For many people, the law has made coverage available or affordable for the first time.

Not all Obamacare users are enamored of the law. A majority of  "plan switchers," people who came into Obamacare after having had other coverage in the prior year, have an unfavorable view of the ACA. Many of them saw old plans canceled, and their costs rise.

Health of enrollees. Some 17 percent of people who shopped for an ACA-compliant health plan report their own health condition as “fair” or “poor,” compared with 6 percent of participants in pre-ACA plans. That there’s a gap is not surprising, since a key goal of the law was to price insurance without reference to a person’s preexisting condition. But the survey offers a gauge of enrollee health status that the Kaiser analysts say has been missing until now.

How many had no insurance before. Of the people who bought Obamacare coverage, half were uninsured before, according to the poll, which was designed as a representative sample of people shopping for insurance individually (the “non-group” market). Some bought directly from an insurer, while most shopped on federal or state-level exchanges set up under Obamacare. Other surveys have offered higher or lower numbers for the previously uninsured.  

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