Many U.S. Residents Still Choose To Forgo Health Coverage
Although eight million U.S. residents have enrolled in coverage through the Affordable Care Act's insurance exchanges, a large number of individuals have opted not to sign up for coverage for a variety of reasons, including cost, the New York Times reports.
Some consumers and industry observers say many of those people believe they are better off paying the tax penalty under the law's individual mandate than the potentially higher cost of premiums for coverage through the exchanges.
Many of such individuals do not qualify for the federal subsidies offered through the exchanges or they believe the subsidies are still not enough to make premiums affordable. Meanwhile, some have been discouraged by the online enrollment process or are ideologically opposed to the law and its requirements.
State enrollment counselors also have found that those who have previously been uninsured or have not experienced a major illness in years can be particularly resistant to purchasing health coverage.
In addition, some consumers are still confused about the law, the Times reports. For example, several individuals are unsure whether financial assistance is available to help pay for coverage (Goodnough, New York Times, 4/21).
As a result, more work lies ahead for ACA advocates in convincing millions more people to enroll in coverage in the coming months, the AP/Sacramento Bee reports.
Other Barriers Keep Millions Uncovered
Meanwhile, other barriers have kept tens of millions of other people from obtaining coverage under the ACA. According to the AP/Bee, coverage rates still are low because:
- Undocumented immigrants cannot purchase coverage under the law;
- Many residents live in states that are not expanding Medicaid under the ACA; and
- Some employers have cut back work hours to avoid the law's employer mandate.
The Migration Policy Institute has found that more than 7.5 million undocumented immigrants rely on safety-net clinics and emergency departments because they cannot obtain insurance coverage.
Meanwhile, a December 2013 Kaiser Family Foundation report found that nearly five million low-income, childless adults do not have health coverage. According to the AP/Bee, these adults could gain coverage through expanded Medicaid programs. However, about two dozen states have decided not to expand the program.
Health advocates say that convincing such states to expand Medicaid would help to reduce emergency department and hospitalization costs throughout the health care system (Lin, AP/Sacramento Bee, 4/22).
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