CHA News Article

Report Examines Experience of Non-Group Health Insurance Enrollees Post-ACA Implementation

A new report from the Kaiser Family Foundation has analyzed the Affordable Care Act’s (ACA) significant impact on those purchasing health insurance in the non-group market, via a survey conducted among individuals who purchased ACA-compliant coverage, whether inside or outside of a marketplace. The survey is the third in a series and was conducted Feb. 9 – March 26, 2016, after the close of the third open enrollment period. It includes individuals who are currently enrolled in non-ACA compliant plans, because the low number of people who remain in those plans is too small to be reported separately. The report details findings from the survey and draws comparisons using data from the first two surveys in the series, which were conducted at the end of the first two enrollment periods.

Key report findings include:

  • Nearly two-thirds of enrollees (64 percent) report being in a marketplace plan, a number similar to that in 2015 (59 percent) and an increase from 2014 (48 percent). Currently, about one in five enrollees (19 percent) report being in an ACA-compliant, non-marketplace plan; 12 percent report having pre-ACA, non-compliant plans.
  • Most individuals with non-group coverage don’t have access to coverage from an employer, either because they are self-employed (31 percent), not employed (28 percent) or their employer does not offer a health plan (21 percent). Among the 18 percent who work for an employer that offers coverage, most are either not eligible to enroll in their employer’s plan (5 percent are not currently eligible and 1 percent are in an eligibility waiting period), or they say it is less expensive to buy their own coverage than to pay the premium for their employer plan (6 percent). Three percent say they’re not happy with the plan their employer offers.
  • A somewhat higher share of non-group enrollees now reports being in plans with high deductibles than did so in 2015. In the current survey, about half (49 percent) of those with ACA-compliant non-group coverage say their plan has an annual individual deductible of at least $1,500 or a family deductible of at least $3,000, up from just over a third (36 percent) last year. Those with marketplace plans are somewhat less likely to report having a high deductible (46 percent, compared with 61 percent of those in ACA-compliant non-marketplace plans), likely because many marketplace enrollees qualify for cost-sharing subsidies that lower their deductible.
  • The majority of enrollees in ACA-compliant non-group plans give their overall coverage a positive rating, with 14 percent calling their plan “excellent” and about half (52 percent) saying it is “good.” However, the share rating their coverage as “not so good” or “poor” is higher in 2016 (31 percent) than it was in the two previous waves of the survey (20 percent in 2014 and 21 percent in 2015). Non-group enrollees have consistently given their plans lower ratings than their counterparts in employer-sponsored plans. However, among those with employer coverage, the share rating their coverage as “not so good” or “poor” is also higher in 2016 than it was in previous years.