What you don’t know can’t help you (save money)

Financial assistance is finally making health insurance affordable for millions of uninsured, but only for those who know about it

  • By
  • healthinsurance.org contributor
  • October 29, 2014

Open enrollment is right around the corner. It starts on November 15, but 89 percent of uninsured Americans don’t know that. Two-thirds of the uninsured population knows little or nothing about the exchanges, and more than half of the uninsured don’t know that income-based financial assistance is available in the exchanges.

Access to healthcare is an necessity. And as healthcare has become increasingly expensive over the past generation, having health insurance is essential in order to secure realistic access to healthcare. Very few among us have the sort of resources necessary to entirely self-insure against any potential medical crisis. And yet 13.4 percent of Americans are still without health insurance.

If you don’t have health insurance, now’s the time to start learning about the Affordable Care Act, the exchange, the subsidies that are available to lower premiums and reduce out-of-pocket costs, and the tax penalties that will be assessed on people who don’t have health insurance and are not exempt from the requirement to maintain coverage.

And if you have friends or family members who are uninsured, you may find that they simply don’t know about the opportunity for coverage that the ACA offers. Now’s the time to learn!

What the uninsured stand to gain from the law

A study released in September by Transamerica Center for Health Studies paints a relatively clear picture of the uninsured population. They are overwhelmingly a group that will benefit significantly from the ACA’s provisions, but only if they know about the options available to them.

Across the uninsured population surveyed by Transamerica, several points stand out:

  • 42 percent said they could afford to pay $100/month for health insurance. It’s notable that this is higher than the average after-subsidy premium ($82) paid by the millions of exchange enrollees who got premium subsidies during the first open enrollment.
  • The median household income for uninsured Americans is $37,300. The median household income for the general population is $67,000, so the uninsured tend to have considerably less income than the general population. $37,300 is less than the upper limit to receive subsidies even for a household of one. (That limit is $46,680). For households with more people, higher incomes qualify for subsidies: a family of four can get subsidies with an income of up to $95,400.

    It would thus appear that the majority of the uninsured population is eligible for subsidies to offset the cost of purchasing health insurance (or else have options available that cost a very small percentage of their income, even without subsidies). If you know people who are uninsured, make sure they know this!

  • 44 percent of the uninsured are in the 18-34 age range. 33 percent of the general population is in this age bracket, so the “young invincibles” are heavily represented among the uninsured. And they’re the group that is especially needed in the new risk pools, to help stabilize premiums long-term.
  • 31 percent of the uninsured are Latino. Among the general population, 17 percent are Latino. The exchanges are ramping up efforts to provide outreach and enrollment assistance that’s specifically aimed at the Latino population.

Many reasons to enroll right now

For folks who have yet to enroll in an ACA-compliant plan, there’s a long list of reasons why they shouldn’t wait any longer. (I’ve listed them all in The Insider’s Guide to Obamacare’s Open Enrollment.) But don’t wait too long; open enrollment ends on February 15. After that, you won’t be able to get coverage at all for 2015 unless you have a qualifying event (birth, marriage, loss of other coverage, etc.).

And if you want your policy to take effect January 1, you’ll need to apply by December 15 in almost all states. (Maryland, Massachusetts, Rhode Island and Washington state are the exceptions, but their deadlines are just a few days later in December.)

If you or someone you know is uninsured, a few minutes of shopping in the exchange could be tremendously beneficial. We have many clients who are paying less than $50 a month for their new ACA-compliant coverage – in some cases, just 50 cents a month. That could be you too, but you won’t know unless you check it out.

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