Anyone wondering why Obamacare is having a hard time meeting its enrollment projections, even after the problems with HealthCare.gov have mostly been fixed, will want to look at a survey released today by Bankrate.
The headline number from the telephone survey of more than 3,000 people is that 34 percent of respondents without insurance say they plan to stay that way, even after being told that the new law requires them to get covered or pay a penalty. What's more interesting is who's saying that:
- It's not just the young. Of the 1,249 respondents without insurance, people age 18 to 29 were in fact the least likely to say they will remain uninsured, with just 28 percent making that claim. Among those 50 to 64, the figure was 33 percent; for those 30 to 49, 39 percent said they would stay uninsured.
- Gender matters. When the pollsters asked the uninsured whether they planned to stay that way, despite the individual mandate, 37 percent of men said yes, compared with 29 percent of women.
- There's no correlation with education. You might have thought people with more years of school would be better attuned to the risks — physical, emotional, familial, financial, professional — of going without health insurance. But the survey found that one-third of every group, from high school dropouts to people with graduate degrees, say they'll remain uninsured.
- The decision to stay uninsured isn't about party (though reasons for staying uninsured very much are). Among the uninsured, Republicans were more likely than Democrats to say they'll stay that way — but only slightly, 29 percent to 22 percent. The big difference was for uninsured independents, 41 percent of whom said they won't get insurance.
Even more interesting than who will stay uninsured is why.
- Twila Brase's campaign seems to be working. In August, I wrote about the effort by Brase, who runs a group called Citizens' Council for Health Freedom, to persuade people to undermine the law by refusing to sign up, even if it meant sacrificing their own well-being. Sure enough, 50 percent of Republicans who aren't getting insurance say it's because they don't like Obamacare. Just 5 percent of Democrats and 16 percent of independents said the same thing.
- But that campaign is only working on men. Almost one-quarter of men without insurance who say they'll stay that way said it's because they oppose the Affordable Care Act. Just 8 percent of women said the same thing. (It's not clear from the survey what the big drivers were for women who say they'll stay uninsured. Forty-one percent cited cost, the same share as men; an additional 29 percent cited "some other reason," a category that wasn't broken down.)
- It's not the young who worry most about cost. A little more than one-third of those 18 to 29 said they would stay uninsured because coverage is too expensive. For those 50 to 64, 39 percent cited cost; for the 30 to 49 group, the share was almost half.
- But the young really do think they're invincible. Almost one-third of those 18 to 29 who said they won't get insurance said it's because they don't need it. Just 6 percent of those 30 to 49 said they same, and 11 percent of those 50 to 64.
- The Obama administration is doing a terrible job of publicizing the law's subsidies. The people most likely to say they won't get insurance because it's too expensive were those earning $30,000 to $50,000 a year — those who probably stand to benefit the most from financial assistance. Sure enough, one- third of respondents in that category didn't know about the subsidies.
- But Republicans aren't helping. Republicans were more than twice as likely as Democrats — 42 percent to 20 percent — to say there are no tax credits available under Obamacare to make insurance more affordable. It's hard not to think the party's constant denunciation of the law is clouding Republicans' understanding of what help the law actually contains.
There's only so much of this that the administration can address. People who say they're not getting insurance because they don't like the law probably won't change their minds because Democrats ask them to. And people who still think they don't need insurance, after four years of everyone talking about Obamacare, might be hard to convince otherwise.
But the survey shows there's a big group of people who are worried about cost, yet whose income makes them eligible to benefit from subsidies. Democrats need to work harder to reach those people — especially if they're Republicans.
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