Financial barriers are slowing rate of enrollment in ACA plans

How Many Individuals might Have Marketplace Coverage at the End of 2016?

Department of Health and Human Services, October 15, 2015

Last year, the Secretary of Health and Human Services projected that 9.1 million consumers would be enrolled through the Marketplaces for individual coverage at the end of 2015. We expect that figure to be the starting point for the third open enrollment period.

We project that in 2016 the year-end effectuated enrollment will be 9.4 to 11.4 million. ASPE’s analysis implies that most of the new Marketplace enrollment for 2016 is likely to come from the ranks of the uninsured, with more than three previously uninsured new enrollees for each one new enrollee who previously had off-Marketplace individual coverage.


Health Insurance Marketplace: Uninsured Populations Eligible to Enroll for 2016

By Kenneth Finegold, Kelsey Avery, Bula Ghose, and Caryn Marks
Department of Health and Human Services, October 15, 2015

People who are uninsured often experience financial barriers to coverage and may place other priorities over obtaining health insurance.


  • Only 26 percent of those who are uninsured say that they are doing well financially. Nearly 80 percent have less than $1,000 in savings and about half have less than $100 in savings.
  • More than half of people who are uninsured feel financially insecure and half had difficulty affording basic necessities such as food or housing in the past year.
  • When asked what they would do if they were to become better off financially, many uninsured people say they would pay down their debt, put money into savings, or make home or car repairs before buying health insurance.


Is Obama’s Health Overhaul Losing Steam?

By Ricardo Alonso-Zaldivar
Associated Press, October 15, 2015

The health care law's historic gains in coverage may be leveling off: The Obama administration announced Thursday it expects only a slight overall increase in enrollment next year.

(Health and Human Services Secretary Sylvia M. Burwell) said it's getting harder to sign up the remaining uninsured. They tend to be young, managing very tight household budgets, and often unaware they can qualify for taxpayer-financed assistance with their premiums.

Some people who sign up for a plan don't follow through and pay their first month's premiums. Others drop out because they can't afford even their subsidized premiums.

A new research paper from the administration finds that nearly 60 percent of the uninsured were not aware or did not understand that subsidies are available to help with their premiums. Half had difficulty affording basic necessities. And many have other financial priorities - such as paying down debt or making car repairs - before buying health insurance.

Getting and keeping coverage under Obama's law can be frustrating, especially when it comes to documenting eligibility for benefits. Insurance counselors say they are seeing many people whose subsidies were completely eliminated because of income reporting problems.



By Don McCanne, MD

Out of a population of about 322 million, 32 million US residents remain uninsured. Because of the complex eligibility requirements for various insurance programs under the Affordable Care Act, there are many reasons that so many remain uninsured. Regardless, this latest data from HHS shows that the success in reducing the numbers who are uninsured is leveling off, and one of the most important reasons is that the Affordable Care Act did not make health insurance affordable for far too many of us.

Four-fifths of the uninsured have less than $1,000 in savings. Half have difficulty affording food or housing. Even if they had more money, many would feel obligated to use it to pay down debt, or to repair their homes, or to repair their automobiles that provide them transportation for employment. They still wouldn’t have enough left to purchase health insurance.

Yet when these people turn 65, they can afford Medicare. The program is automatically funded, primarily through the tax system.

If we improved Medicare, funded it completely through progressive taxes, and then provided it to everyone, not only would it be affordable for all of us, none of us would ever have to make a decision on whether our health care dollars needed to be used for food, housing or any other essentials. Medicare would automatically always be there for all of us.