Uninsured Americans not planning to sign up by today’s deadline for health insurance under the Affordable Care Act (ACA) say they are basing that decision, at least in part, on the cost of coverage. However, most made that decision without visiting an exchange to get a price quote or to see if they were eligible for a subsidy, according to consumer research from nonpartisan market research consultancy Market Strategies International.

The nationwide survey of 2,741 US adults who have been without health insurance for at least six months found that seven in 10 do not intend to enroll prior to the March 31st deadline. Among those not planning to enroll, 176 respondents were further interviewed to understand why. Eighty-one percent listed the cost of coverage as one of the reasons for their decision and 62 percent listed it as the primary reason. The second most common reason, at 55 percent, was disagreement with the ACA’s individual mandate requiring purchase of a qualifying plan, and 28 percent said they were influenced by media coverage of problems with the health care exchanges.

Approximately 85 percent of those for whom the expense of coverage was a factor in their decision were eligible under the law for a subsidized plan that would reduce their costs. Of those who said that affordability was a factor in their decision to not purchase insurance, only 32 percent had actually visited a federal or state exchange website, while 29 percent had done no research whatsoever, not even to the point of discussing the topic with friends or family.

“What we found is that those individuals who were the primary reason behind the ACA and its subsidies—the low-income, uninsured—seem to have made the assumption that health insurance remains unaffordable to them, often without exploring whether a subsidy would help them afford it, and they are acting accordingly,” said Susan McIntyre, managing director of healthcare at Market Strategies International.

McIntyre added, “Even more concerning is that compared with those who intend to enroll prior to the deadline, those forgoing insurance are more likely to be older and have a chronic condition that would benefit from access to health care, including preventive and primary care services that can hold down healthcare costs over time.”

Market Strategies’ healthcare market researchers have decades of experience serving national, regional and single-state health and benefits insurers as well as the nation’s leading hospitals and health systems. The firm’s healthcare industry research includes health insurers and payers, ancillary benefits providers, hospitals and health systems, healthcare providers, government, health technology and health supply chain.

About the Study

Market Strategies International’s Uninsured Intentions study is a quantitative study among currently uninsured consumers. For this study, Market Strategies conducted a web survey between February 20 and March 13, 2014 with a national sample of 2,741 adults drawn from ROI Rocket’s online consumer panel. Qualified respondents were 18-64 years old, health insurance decision-makers for the household, uninsured for at least six months and not Medicaid-eligible. Due to its opt-in nature, this online panel (like most others) does not yield a random probability sample of the target population. As such, it is not possible to compute a margin of error or to statistically quantify the accuracy of projections.

About Market Strategies International

Market Strategies International is a market research consultancy with deep expertise in communications, consumer/retail, energy, financial services, healthcare and technology. Offering custom research services and syndicated research products, the firm provides insight from more than 75 countries, focused in the areas of brand, communications, CX, product development and segmentation. Its syndicated products, known as Cogent Reports, help clients understand the market environment, explore industry trends and evaluate and monitor their brand and products within the competitive landscape.

Founded in 1989, Market Strategies is one of the largest market research firms in the world, with offices in the US, Canada and China. Read Market Strategies’ blog at FreshMR, and follow us on Facebook, Twitter and LinkedIn.


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