Obamacare May Be Failing the Uninsured

The Fiscal Times

The entire goal of Obamacare was to expand health coverage to the uninsured—but the majority of people who have signed up for Obamacare already had insurance.

That’s according to a new survey from the McKinsey consulting firm, which found that just 27 percent of the 4 million Obamacare enrollees were previously uninsured. That means that the majority of those signing up for Obamacare had previous insurance of some kind—whether they were kicked off their old policies, or they found a better deal on the exchanges. 

Related: Uninsured Are Still Unaware of Obamacare Deadline

While the number of previously uninsured enrollees is low, the survey does not include those who are now eligible for Medicaid. So the number is likely larger since under the expanded Medicaid program the Obama administration estimates that about 9 million people have been deemed eligible.  

The private consulting firm is the first to offer an answer to one of the biggest mysteries surrounding the Obamacare rollout: Is it actually helping to expand coverage to the uninsured? The administration has not been tracking this information, though it’s a key metric in determining whether the law is meeting its goals.

“That's not a data point we are really collecting in any sort of systematic way,” Gary Cohen, a top official at the Centers for Medicare and Medicaid Services (CMS), told an audience at a health policy conference in Washington on Thursday. 

Related: Top 10 Questions Consumers Ask About Obamacare 

The administration has so far provided numbers only for people who have selected plans on the health exchanges. The figures don’t include how many uninsured have received coverage. They also don’t include an estimate of how many enrollees have paid for their policies – a crucial piece of information to assess how the risk pools are actually shaping up. 

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The McKinsey survey found that about 75 percent of enrollees have paid their premiums. That’s similar to previous estimates from insurers who have said about 20 percent have not paid.

In response to the new survey, CMS officials said they’re ramping up their outreach efforts – especially to uninsured individuals – in the final weeks of the open enrollment period, which ends March 31. 

“We are seeing increased interest in marketplace plans across the country as we enter the final weeks of open enrollment,” said CMS in a statement. “Outreach is occurring in every state with a particular emphasis on areas with the highest population of the uninsured using a mix of grassroots activities and advertising.” 

The president himself has been reaching out to the Hispanic community to sign up for health insurance ahead of the deadline, since Hispanics represent 25 percent of the 38 million eligible uninsured. Nearly all of the issues with the Spanish-language exchange websites have been fixed, Obama has said – and he warned that if people waited too long, the system could crash at the end of the month.

The Kaiser Family Foundation has found that awareness of the new law among the uninsured remains particularly low. Some 76 percent of Americans without coverage said they still didn’t know the deadline to sign up for coverage. Moreover, just 12 percent of uninsured respondents said they knew “a lot” about Obamacare, while 24 percent knew “some” information about the law, 36 percent knew “a little,” and 26 percent knew “nothing at all.” 

Other studies have found that people at/or below the poverty line without insurance were less likely to know about the law than others.

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