Americans Are in the Dark About Accessing Healthcare Coverage

With the start of healthcare open enrollment for 2019 coverage right around the corner, healthcare executives face some challenges.

“U.S. healthcare executives with skin in the game face significant obstacles in educating Americans about the ACA’s changing landscape, and the importance of choosing a healthcare plan within the open enrollment timeframe,” says Brian O’Connell, analyst at insuranceQuotes.com. “If that scenario doesn’t come to pass, millions of Americans risk going without healthcare until the next open enrollment period, in November of 2019.”

The 2019 open enrollment period is from November 1, 2018, to December 15, 2018.

The its 2019 State of Healthcare and Politics Report from insuranceQuotes.com unveils Americans’ knowledge, views and predictions surrounding the ACA, President Trump’s impact on the law, and the state of healthcare between now and 2020.

This study was conducted for insuranceQuotes.com via telephone by SSRS. Interviews were conducted among a sample of 1,005 respondents from August 14-19, 2018. All data are weighted to represent the adult U.S. population.

According to the report, 41% of Americans say they do not know what healthcare open enrollment is, and 14% say it was cancelled. 

“Clearly, U.S. adults are confused about the ACA and open enrollment-even on the basics,” says O’Connell.

Other survey findings include:

• 38% are unaware that the ACA is still in effect.
• 24% of Americans say they view the ACA less positively after the 2016 election.
• 18% say their view on the ACA have been “more favorable” since the election.

“Make no mistake, quality financial outcomes for healthcare industry companies dependent on the ACA for revenues increasingly rely on an educated public-a scenario that is, to a large extent, on shaky ground as the open enrollment period beckons,” O’Connell says. “No matter which side of the political spectrum survey respondents reside, politics plays a substantial role in consumer optics on the ACA and open enrollment.”

No help from politics

According to O’Connell, U.S. political leaders haven’t helped educate the public, which remains largely in the dark over recent changes in the ACA.
“At the top of that ‘change’ list is the elimination of the individual mandate tax penalty-but not the actual individual mandate-and the Trump Administration’s green-lighting so-called ‘short-term,’, less-expensive healthcare plans for consumers,” he says.

Related: Eleven Things to Know About Healthcare in the Midterm Elections

These executive orders, in place now, could place the ACA at risk, as more healthcare consumers leave the government-run healthcare exchanges and steer their healthcare plan needs into the private sector, according to O’Connell. “U.S. consumers who abandon the exchanges are typically healthier and have higher incomes on average, which places a higher burden on healthcare consumers who remain under the ACA umbrella,” he says.

With confusion the new normal with the ACA, it’s no wonder that 24% of Americans say their views on Obamacare have become less favorable since the 2016 presidential election, compared to 18% who say their views have become more favorable in that time, according to the study.

Top takeaways

According to O’Connell, healthcare executives invested in a better ACA experience for Americans should focus on three key factors highlighted in the insuranceQuotes.com study:

•  Don’t expect much help from Uncle Sam in promoting Obamacare. “The Trump Administration has cut funding for both the advertising and marketing end of the ACA and for the program’s navigators who helped consumers choose the healthcare plans that were best for them,” says O’Connell. “With less public funding for ACA education and customer service, the burden falls on the healthcare industry to get the word out on ACA plans and policies.”
• A political imbalance with the ACA. The ACA seems to be in somewhat of a holding pattern right now, as Republicans and Democrats engage in a political tug of war over federal healthcare policy-and that’s further muddying the waters on the ACA and open enrollment, says O’Connell. According to the study, 39% say that President Trump will make U.S. healthcare worse, compared to 24% who say he will make it better. In addition, 35% of Americans say that Republicans are more responsible for problems with the U.S. healthcare system, compared to 29% who say that Democrats are more responsible, and 16% who say that both parties are equally responsible.
•  Consumer disengagement with the ACA. “U.S. healthcare consumers and employers also share in the ACAs ‘awareness problem’,” says O’Connell. “That’s especially the case when it comes to reviewing and understanding their own healthcare benefit packages, and on the open enrollment period. Citing the study’s data, experts say the employer-based healthcare plan experience is both overly-bureaucratic and less than technology savvy.”

For example, when healthcare consumers actually have questions on their plan policies, employers generally steer them to an appointment with a company benefits specialist who may well require substantial paperwork to get the problem resolved, according to O’Connell. “This is a turn-off to employees, who only want a resolution to the problem, and not more bureaucracy. That only adds to consumer disengagement on the ACA and open enrollment,” he says.

What can healthcare executives do? 

According to O’Connell, based on the issues vexing consumers on the ACA as noted in the study, healthcare decision makers should take the following steps to improve the consumer ACA/open enrollment experience:

• Reduce paperwork and bureaucracy. “As noted above, consumers don’t respond well to an overly complicated response to a basic ACA enrollment and management problem,” he says. “Healthcare executives should advise their corporate clients to keep things simple and direct when responding to an employee ACA query.”
• Help create a system where employers have a “first responders’ mindset when responding to a query. Answer the question right away, reduce the need for documentation (beyond noting the query in the employee’s records), and create a Q&A experience where employees get the health care information they need, streamlined, and with no need for appointments or excessive paperwork.
•  Get tech proficient. “Healthcare companies need to meet corporate clients and health care consumers on the turf where they’re most comfortable. That means improving engagement benefit via information tools online and on their mobile phones,” O’Connell says. “Going digital provides faster and more streamlined access to healthcare plan information and enables health care consumers to be self-sufficient with their plans. That should drive consumer engagement on the ACA significantly upward.”
• Embrace an educator role. “Healthcare executives are the actual experts on all things ACA and open enrollment and should embrace the role,” O’Connell says.

“After all, education is the big issue as consumers face more plan choices and options for themselves and their families as the ACA shifts into higher gear in 2019,” he says. “This should be a year-round campaign that regular engages and educates both employers and health care consumers on a regular basis, with ACA/open enrollment digital alerts, updates, and tips a staple of an educational campaign.”

Encourage participation in company wellness programs and provide workplace incentives (think gift cards, days off, and even cash payouts) for meeting ACA and open enrollment goals, according to O’Connell.

“Make sure that healthcare consumers and employers realize that it’s ultimately up to them to get healthcare insurance right,” O’Connell says. “After all, the best healthcare insurance decisions are made when plan participants are informed and proactive-and that largely depends on the health care sector to steer healthcare consumers in that direction, and sooner rather than later, as the survey study indicates.”