In addition, the mostly Republican states that defaulted to the federal exchange tend to have higher rates of individuals without insurance. Some 33 percent of the nation’s uninsured population lives in states running their own exchanges, while 68 percent live in states that defaulted to the federal exchange or set up a partnership.
Almost 90 percent of assister programs surveyed reported that most or nearly all of the people they helped were uninsured. More than 40 percent said that most and or nearly all of the people they helped did not have Internet access.
In the end, it wasn’t the broken website that was the top reason people sought help from an assister – it was a lack of understanding of the law. About 65 percent of the program said that most or nearly all consumers had online difficulties. But more than 85 percent said that most or nearly all had a limited understanding of the ACA and needed help understanding their plan choices. And three-quarters said that most or nearly all needed help understanding basic health insurance terms.
“How can you explain coverage options to someone who doesn’t know what a deductible is?” asks Pollitz. “It’s just a much longer conversation,” which might help explain why most of the programs reported that assistance required one to two hours per client. “And those same people, at least some of them, are starting to come back with post-enrollment problems,” Pollitz adds.
The need for help selecting the right plan is not likely to disappear in the coming years. “It’s a fundamental need people are probably going to have for the foreseeable future,” says Pollitz, especially as consumers experience a change in their family size or employment.
In the end, about 8 million Americans signed up for a plan on the health insurance marketplaces in the first year. Others enrolled in Medicaid or CHIP plans, and some of those who received help from assisters did not enroll in coverage at all.
The survey also found that federally qualified health centers and nongovernmental funds played a surprisingly important role in enrollment. Of the 4,400 different assister programs, 70 percent were supported either by the federal safety net clinic program or were privately funded.
Tue, Jul 15 2014