With King v. Burwell ruling coming in favor of Obamacare, the administration can finally focus on filing the remaining gaps in its strategy to have all round health insurance for everyone.
What has been keeping these uninsured away? Here are 5 quick facts that reveal strategic points for Obama administration for this current open enrollment period.
1 – First, Some Facts and Figures
Since Obamacare took the stage, nearly 16.5 million people have gained health insurance coverage. The uninsured rate has dropped to a historic low of 12 percent, and nearly 35 million people remaining uninsured. By 2019, it’s projected that about 26 million people will be without health insurance, provided Obamacare continues to enroll people at the same speed. Even with subsidies in place, the current setup might not be sufficient for enrolling the remaining people.
2 – Key Segment of Remaining Uninsured
Of the remaining uninsured, the demographics are pretty interesting. 30 percent of the uninsured are illegal immigrants who haven’t enrolled in the program for obvious reasons. 5 percent of the uninsured are people who are eligible for Medicaid, but have fallen in a coverage gap due to their state deciding not to expand Medicaid. 20 percent of uninsured are Medicaid eligible, but decided not to enroll. That leaves us with 45 percent uninsured, the crucial segment for Obama administration in this open enrollment.
This 45 percent comprises people who have access to affordable health insurance, either through employer-sponsored health insurance or through Obamacare subsidies, but have still chosen to remain uninsured. This segment is a target for the administration in this OEP.
3- Money is the Prime Reason behind Their Choice to Stay Uninsured
It’s not that these people do not want to enroll for health insurance, they probably do. They do not have any vested political inclinations that are keeping them away from Obamacare, it’s all about the money. For most of these uninsured, paying for health insurance, even after subsidies and other cost saving mechanisms, just does not make sense.
They are already burdened with debt and low income, and they have other priorities to take care of before having health insurance for their family. And they have been to Obamacare marketplaces and researched options, before finally deciding to stay uninsured.
4- They Prefer Penalties over Current Plans on Obamacare Marketplaces
Most of these uninsured have checked out the available plans on www.healthcare.gov or their state marketplaces. They know how much subsidy they would receive, the cost of health plans available in the market and what the deductibles options are available
Given their current state of finances, the potential liability of health insurance premiums are significantly higher than the penalties for going uninsured – so they opt not to enroll and find alternate means of care.
5- Availability of Alternate Methods of Care
For most of these uninsured, a prime reason for being not too concerned about health insurance coverage is the availability of alternate means of care that do not require health insurance. Hospitals and doctors who accept cash, discount drug programs, cheap remedies, and the ever-present option of emergency rooms & charity programs – all these options are making it easier for the uninsured to get care without worrying about health insurance.
These are the reasons why it is essential that the Obama administration targets this 45 percent segment in the coming OEP. Once that’s successfully done, we can move on to the other issues.