Consumers and the ACA: Lessons Learned

October 3, 2014

Today we’ve got a look at a nationwide survey on health insurance and the ACA conducted by the TransAmerica Center for Health Studies. There are a number of interesting findings across numerous topics including coverage status, health status, and information level. The report compares findings from the July 2014 online survey of over 2,600 individuals to those of the same survey conducted a year before.

The Uninsured

The uninsured rate amongst those surveyed declined from 21% in 2013 to 15%.

Interestingly, those uninsured tend to be higher income than the newly insured – this may imply that lower income individuals found the large subsidies available to them a better deal than those with higher incomes and smaller subsidy amounts. The good news: only 1% of the uninsured say they didn’t purchase insurance because the enrollment process is too difficult. Instead, the majority cite affordability concerns. The bad news: only 57% of the uninsured have heard of the Exchanges. This makes it very clear that continued outreach is necessary.

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The Newly Insured

Individuals who were insured in 2013 but now have coverage obtained it from a variety of sources (see chart below), but a majority is insured through the Exchanges or public health insurance.

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The Continuously Insured

A vast majority of individuals who were previously insured and remain so stated that the ACA has not had an impact on their access to care or quality of services. However, 48% claim that the ACA has increased their premiums, deductibles, and/or out-of-pocket expenses. It is important to note though that 96% of the continuously insured kept the same source of coverage in 2013 and 2014.


A related study of employers showed that the most cited reason for not offering insurance to employees is small firm size (cited twice as much as cost). Despite this, far more employers began to offer insurance or plan to do so than dropped coverage. Unfortunately, only half of businesses eligible to participate in SHOP are aware of its existence.

More interesting tidbits:

  • Only 67% of individuals surveyed and 54% of the uninsured are aware of the individual mandate, although this was the most well-known provision of the ACA
  • 26% of individuals surveyed are unsure what their plans are for obtaining coverage in 2015
  • 75% of individuals are satisfied with their access to health insurance
  • 63% of individuals are interested in receiving care through nurse practitioners to lower costs
  • Employees are more satisfied with their work-based health insurance than they were in 2013

Check out the fascinating surveys here.