Many uninsured still unaware about Obamacare
health care

View photo


One in three Americans who lack health coverage plan to remain uninsured, citing cost as their chief obstacle, according to Bankrate's latest Health Insurance Pulse survey.

Fewer than a third (30 percent) of the uninsured realize that federal tax credits available through the new Obamacare health exchanges can make health insurance affordable to lower-income individuals and families.

In a telephone survey of uninsured adults drawn from a nationally representative sample of more than 3,000 Americans, one-third (34 percent) said they intend to continue without health coverage. When asked why, 41 percent said health insurance is too expensive, 17 percent cited opposition to the Affordable Care Act, and 13 percent said they're healthy and don't need coverage.

Just over half (56 percent) of the uninsured said they plan to obtain health coverage.

'Not giving it a whole lot of attention'

If a late January Pulse survey demonstrated how familiar the overall population is with health reform penalties and deadlines that won't affect most Americans, this first survey directed specifically at uninsured adults suggests that efforts to reach those most in need of affordable coverage may have fallen short.

"It's hard to generalize, but for some of these folks, it's a case of, 'I'm in pretty good health, I don't think about these things, I know I can't afford it now,'" says Michael Morrisey, professor of health economics at the University of Alabama at Birmingham School of Public Health. "I think it's just rolling past them, and they're not giving it a whole lot of attention."

Deborah Chollet, a health insurance research leader at Mathematica Policy Research in Washington, D.C., agrees.

"They may or may not have looked for insurance, they may or may not have talked to somebody who has insurance, but I'm guessing the overriding reason is that it's just not a priority for them," she says.

The following question was posed to a national sample of uninsured Americans:

View gallery


As far as you know, are there tax credits available through the Affordable Care Act to reduce the monthly price of health insurance?

Source: Health Insurance Pulse survey, March 17, 2014.


  • 42 percent of people who identify themselves as Republicans say there are no tax credits, compared with 20 percent of Democrats and 33 percent of independents.
  • Only 5 percent of Americans earning $75,000 per year or more knew about the tax credits, versus 30 percent of those making less than $30,000.
  • 35 percent of people in both the West and South say the tax credits don't exist, compared with 25 percent in the Northeast and just 13 percent in the Midwest.

The following question was posed to uninsured Americans in the survey who indicated they planned to remain that way, despite potential penalties under the Affordable Care Act:

View gallery


Which is the main reason you will not sign up for health insurance this year?

Source: Health Insurance Pulse survey, March 17, 2014.


  • 22 percent of men who won't obtain health insurance cite opposition to the Affordable Care Act, compared with just 8 percent of women who plan to remain uninsured.
  • 31 percent of people ages 18 to 29 who won't obtain insurance say they're healthy and don't need it, versus just 6 percent of respondents in the 30-49 age group.
  • 50 percent of Republicans who plan to stay uninsured say the main reason is that they don't like Obamacare, but only 5 percent of Democrats in that group say the same thing.

Messages missing the poor

Chollet suspects that Obamacare multimedia advertising campaigns, which have largely targeted the key "young invincibles" between ages 18 and 30, may have missed another group in need.

"Low-income, young families may have been overlooked. They're probably not spending a lot of time watching television, they never read a newspaper, and if they listen to radio, it's probably music in the car," she says.

"In communities of color, people might hear about (Obamacare) in church, but for people who are not attached to a church, I don't know how they get the information."

Too much carrot, not enough stick

Outreach efforts that emphasize Obamacare's positive tax subsidies rather than the punitive tax penalty for not having insurance may have failed to prompt action, says Sabrina Corlette, research professor at Georgetown University's Health Policy Institute.

"They found in Massachusetts, with "RomneyCare," that the individual mandate penalty absolutely motivated a lot of people to purchase insurance," she says. "The Obama administration understandably tried to emphasize the positive, but people need to understand that the mandate is not insignificant -- they could be hit with a big tax bill if they don't buy coverage."

But Morrisey says the more favorable message about the subsidies may have fallen flat with the uninsured as well.

"Someone who makes so little money that they haven't had to file taxes in the past might say, 'How is a tax credit going to help me? I don't even think about tax things because I don't have to file,'" he says.

Many are in the dark about the deadline

Also in the survey, fewer than half (48 percent) of the uninsured could correctly name March 31 as the deadline for obtaining health insurance to avoid the penalty.

"What people need to understand is that the door really closes on March 31," Corlette cautions. "It they don't sign up before then, they're out of luck until Nov. 15 unless they have one of the special enrollment situations, which happen if you lose your job or get a divorce."

Between now and March 31, "the administration needs to really amp up those marketing and outreach campaigns and meet people where they're at," she says. "It's got to be all about marketing and outreach now."

Role of states' Medicaid decisions?

One big unknown in the survey results is how many of the uninsured who plan to stay that way might qualify for Medicaid -- except that their state has chosen not to expand the program.

"If you're in one of the 24 states that did not expand their Medicaid program and you have income below 100 percent of the federal poverty line, you are not going to receive Medicaid and you're not eligible for the subsidies," says Morrisey.

"So it's not at all surprising that they're going to say it's too expensive and they're going to remain uninsured," he continues. "I'm guessing that a third of that 34 percent who will remain uninsured are in that group."

Bankrate's Health Insurance Pulse survey was conducted between Feb. 20 and March 9 by Princeton Survey Research Associates International with a nationally representative sample of 3,005 adults living in the continental United States. The questions were addressed specifically to the 299 respondents who identified themselves as uninsured. The margin of sampling error on their responses is plus or minus 6.1 percentage points.

More From



View Comments (6192)

Recommended for You

  • Obama to GOP: 'Stop just hating all the time'

    KANSAS CITY, Mo. (AP) — Pointing the finger at Republicans for congressional inaction, President Barack Obama chided lawmakers Wednesday for spending the waning days before their month-long summer break trying to sue him rather than addressing economic issues that could boost the middle class.

    Associated Press

    Argentina's stock market is tanking after the...

    Business Insider
  • Are You A Heart Attack Risk?

    Discover Your Risk of a Heart Attack in Just Minutes with Dr. Crandalls Free Online Test. Its Easy to Do and Could Save Your Life!

  • Airbus adamant no room for more talks in cancelled Japan jet deal

    Airbus on Thursday said its decision to cancel a $2.2 billion jet order from Skymark Airlines was final, rejecting the Japanese carrier's suggestion that talks were still ongoing. The European aircraft maker said this week it had informed Skymark that its purchase of six A380 superjumbos "has been…

  • In San Francisco real estate, $1M won't buy much

    SAN FRANCISCO (AP) — San Francisco Association of Realtors President Betty Taisch has two words of advice for those who want to live here and think $1 million will buy them their dream house: Think again.

    Associated Press
  • Play

    Why Do Millennials Prefer Cash to Investing Money?

    In the last year, the S&P 500 delivered 17% and cash investments delivered 1%. Which would you rather have? In a Bankrate study, millennials said they'd rather have the cash. The Mutual Fund Store's Senior Vice President of Investments Andy Smith joins Simon Constable on the News Hub to discuss.…

    WSJ Live
  • Tesla posts 2Q loss, prepares Nevada factory site

    PALO ALTO, Calif. (AP) — Electric car maker Tesla Motors widened its loss in the second quarter as it prepared for the launch of a new SUV and started work on a massive new battery plant.

    Associated Press
  • Asia stocks dip on Dow drop, China data cuts loss

    Most Asian stock markets dipped on Friday following a big sell-off on Wall Street but losses were limited by optimistic reports on China's economy. KEEPING SCORE: Japan's benchmark Nikkei 225 index dropped ...

    Associated Press15 mins ago
  • US warns against traveling to Ebola-hit countries

    NEW YORK (AP) — U.S. health officials on Thursday warned Americans not to travel to the three West African countries hit by an outbreak of Ebola.

    Associated Press
  • Monstrous Preworkout Mix

    This preworkout mix will put trainers out of a job!

  • 4 Unusual Savings Strategies That Really Work

    It's just one of those facts of life: Saving money can be really hard. If you're trying to save and not getting ahead, it might be time to try one of these easy, everyday savings habits that will help you tighten your finances.

    U.S.News & World Report LP
  • What SunPower Earnings Mean for First Solar and SolarCity

    After markets close Thursday, solar panel maker SunPower will report second-quarter results. Competitors First Solar and SolarCity are scheduled to report results next week.

    24/7 Wall St.
  • Wisconsin Supreme Court upholds 2011 union law

    MADISON, Wis. (AP) — The fight over Wisconsin Gov. Scott Walker's signature policy achievement, a law effectively ending collective bargaining for most public employees, ended Thursday with the state Supreme Court declaring it to be constitutional.

    Associated Press
  • Sanctions will damage Russia if not lifted quickly

    MOSCOW (AP) — U.S. and European sanctions against Russia's energy and finance sectors are strong enough to cause deep, long-lasting damage within months unless Moscow persuades the West to repeal them by withdrawing support for Ukrainian insurgents.

    Associated Press
  • Adidas shares plunge 13% after Russia warning

    Adidas shares tanked more than 13 percent after it cut its profit targets for 2014, warning "tensions" in Russia would hit its bottom line.

  • Play

    Tesla's Earnings: What to Watch For

    Electric-car maker Tesla is scheduled to be released after the bell Thursday, and Mike Ramsey joins MoneyBeat with Paul Vigna to preview the results.

    WSJ Live
  • Reverse Mortgage: How it Works (Age 62 Plus)

    Educate yourself! Understand how a reverse mortgage works. Learn more now.

  • Why You Should Prepare for the Next Bear Market Now

    The stock market is going gangbusters these days, with the S&P 500 close to surpassing 2,000 points. While the index may never fall back to that level, bear markets will one day hit us hard again. It's a good idea to develop a plan for the next bear market now, while your asset values aren't free…

    U.S.News & World Report LP
  • Bank of America ordered to pay $1.27 billion for 'Hustle' fraud

    By Jonathan Stempel NEW YORK (Reuters) - A federal judge on Wednesday ordered Bank of America Corp to pay a $1.27 billion penalty for fraud over shoddy mortgages sold by the former Countrywide Financial Corp. U.S. District Judge Jed Rakoff in Manhattan ruled after a jury last October found the…

  • Panasonic, Tesla to build giant battery plant in US

    Japanese electronics giant Panasonic and US electric vehicle maker Tesla Motors said Thursday they will jointly build and operate a huge lithium ion battery plant known as the Gigafactory. Under the deal, Tesla will run the operations at the proposed US-based plant, while its Japanese partner will…

  • 5 Little-Known Ways to Boost Your Retirement Savings

    Saving for retirement is no easy task. Fortunately, we have several tools and strategies that can help us reach our retirement goals. Maintain your asset allocation. When you begin investing you typically select an asset allocation that suits your risk tolerance and investment goals.

    U.S.News & World Report LP
  • Alcatel-Lucent cuts losses but shares slump

    Telecommunication equipment group Alcatel-Lucent said Thursday it cut net losses by more than half in the second quarter as it battles to rebuild after years of setbacks. Alcatel-Lucent said its quarterly net loss was 298 million euros ($399 million), down from 885 million euros for the same period…

  • 3D Systems Shares Are Cratering

    Shares in 3D Systems were down more than 12% in...

    Business Insider
  • Tycoon Worth $62.9 Billion Shares Money Secret

    This billionaire investing wizard has a dead-simple system for making money you can start using today.

    AdChoicesThe Motley FoolSponsored