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Covering New Hampshire releases survey on those insured through Affordable Care Act, remaining uninsured

An outreach organization is pointing to a recently released survey as an indication that residents who got health insurance through the Affordable Care Act were satisfied with their experience and as a sign of what barriers it will need to overcome to reach those who remain uninsured.

The phone survey reached 850 people who were targeted based on their likelihood of being uninsured, according to a report on the findings. Within that sample, 167 said they were recently insured through the Affordable Care Act and 232 said they were uninsured.

The survey revealed the following about the respondents who were recently insured through the Affordable Care Act, according to the report:

∎ About half, 55 percent, said they were previously uninsured, while 36 percent said they changed insurance plans. When asked why they enrolled through the Affordable Care Act, 38 percent cited affordability, 31 percent said it was because they didn’t have coverage and 19 percent cited the law or a desire to avoid a fine.

∎ Overall, 75 percent enrolled through and 25 percent relied on an in-person assister. Eighty-one percent of respondents said they were satisfied with the enrollment process, 80 percent said they were satisfied with the available plans and 86 percent said the available plans were affordable. Eight percent said they were unsatisfied in each category.

∎ Seventy-eight percent said they were employed. Within that group, 89 percent said they were paid by the hour, 62 percent described their work as “sporadic or shift-based” and 47 percent said they worked in the service industry.

∎ Half are married, and 57 percent reported having no children who live half- or part-time in their household. Twenty percent of respondents were single, while 11 percent were separated, widowed or divorced, and 16 percent were unmarried but living with a partner. About 40 percent reported having at least one child living in their household.

∎ Forty-five percent of respondents were men without college degrees, while 34 percent were women with the same educational status.

Among the uninsured respondents, according to the report:

∎ Most of them, 65 percent, said they did not attempt to enroll through the Affordable Care Act. Of those who did attempt to enroll, 25 percent used and 5 percent worked with an in-person assister.

∎ Those who considered enrolling but didn’t follow through reported concerns about affordability and technical issues – and 72 percent of those who visited said they encountered “moderate” or “major” problems. Ninety percent of those who said they encountered problems with said those problems prevented them from signing up for coverage.

∎ Almost 80 percent said they knew nothing or “only a little” about the Affordable Care Act, and 63 percent said they were “a little” or “not at all” familiar with the fines associated with it. When asked about their disposition toward Obamacare and the health insurance marketplace, more indicated a “cool” (or more unfavorable) feeling than a “warm” (or favorable) one.

∎ Intentions to sign up for health insurance are varied, with 40 percent reporting plans to seek coverage moving forward, 22 percent saying they don’t plan to do so and 38 percent unsure.

∎ Here, only 12 percent said they were unemployed, while 24 percent were employed part time and 38 percent were employed full time. Thirty-two percent indicated that they were retired, a student or in some other unspecified category. Of those employed, 36 percent said they work in the service industry and 67 percent described their work as “sporadic or shift-based.”

∎ Half of the uninsured respondents were men who have not completed college, and 30 percent were women of the same educational status.

Covering New Hampshire, the organization leading outreach efforts for the state’s health insurance marketplace, partnered with Washington-based research firm Myers Research & Strategic Services to conduct the survey.

Jayme Simoes – president of Louis Karno and Co., a communications firm partnering with Covering New Hampshire – said the results provide “a better idea of who didn’t sign up and a little better idea of why.”

Andrew Myers, president of Myers Research & Strategic Service, said the survey seems to indicate that among the newly enrolled, “people were very satisfied with the process and experience in the end.”

Still, New Hampshire Center for Public Policy Studies Executive Director Steve Norton cautioned against reading too much into these findings because of the small sample size and level of precision. (The margin of error was 7.6 percent for the sample of those who enrolled through the Affordable Care Act and 6.4 percent for the uninsured sample, according to the report.)

There’s still much to be explored on the implications of the Affordable Care Act beyond what’s included in this survey, Norton said – most notably its effects on market dynamics, on the insurance rate and, especially, on people’s health.

“That’s not to be critical, we just don’t have enough information,” Norton said. “This is just one piece of information that helps us understand the process of enrollment.”

Given that the survey indicated relatively low levels of dissatisfaction with the enrollment experience through among the newly insured and given that New Hampshire’s Affordable Care Act enrollment exceeded expectations, Norton said it’s important to further probe what contributed to the state’s enrollment figures. For example, Norton said, how engaged were hospitals and insurance brokers in the enrollment process? Additional time and research are needed to fully understand these and other dynamics of the state’s changing health insurance landscape, he said.

Lisa Kaplan Howe, policy director for NH Voices for Health, said the survey’s findings reinforced her assumptions about the characteristics of those who enrolled through the Affordable Care Act. Moving forward, she said, it will be important to focus even more closely on reaching out to those who remain unenrolled.

“I think the biggest challenge is going to be that the low-hanging fruit, so to speak, have been reached,” she said. “Now, it’s trying to find, connect with and educate people who you couldn’t find.”

That group of harder-to-reach uninsured New Hampshire residents could include those who might speak English as a second language or those who might have “tuned out and don’t want to hear about the marketplace,” she said.

It will be important for those seeking to enroll more residents in the year ahead to target their outreach campaigns to reach people during their normal routines – at the grocery store, at schools, on the news – Kaplan Howe said.

“Catching them where they are and getting them information through organizations and individuals they already trust is really proven nationwide to be the best way of reaching people,” Kaplan Howe said.

That’s part of why the Covering New Hampshire survey asked those who were uninsured where they shop for groceries, Simoes said. They found that 33 percent typically go to Wal-Mart, 23 percent go to Market Basket, 17 percent go to Hannaford, 16 percent go elsewhere and 8 percent said they didn’t shop for groceries.

Simoes said Covering New Hampshire will use this and other information gathered in the survey to target future outreach campaigns leading up to the second round of open enrollment later this year.

(Casey McDermott can be reached at 369-3306 or or on Twitter @caseymcdermott.)

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