New Study Finds a Quarter of ACA Enrollees were Uninsured, and Most are Paying Premiums

Written by: PeopleKeep Team
Originally published on May 8, 2014. Last updated August 14, 2019.

A new study by McKinsey & Company finds that a quarter of enrollees in new ACA individual health plans were previously uninsured, and 87% report paying their first premium.

McKinsey's new study looks at buying behaviors in the individual health insurance market (both on and off the public Marketplaces) at the end of the open enrollment period. Topics include intentions consumers expressed and actions they reported taking during the 2014 open enrollment period, consumers’ awareness of the ACA’s requirements and provisions (including potential subsidies and penalties), and other factors influencing their actions. The most recent consumer survey was conducted between April 7 and April 16, 2014. 

Here's a look at McKinsey's findings:

  • Of all respondents who reported selecting a new qualified health plan (QHP) at the time of the April survey (either on or off the exchanges), 26% reported being previously uninsured.

  • 87% who selected a new 2014 QHP indicated that they had already paid their first premium. Reported payment rates were higher among those previously insured and those aged 30 or older. 

  • Perceived affordability was the reason most often given for not enrolling by both previously insured and previously uninsured respondents. About 90% of all those citing perceived affordability challenges were subsidy-eligible, and among these subsidy-eligible respondents, awareness of the subsidies has remained low.

  • Of those reporting that they remained without coverage after the open enrollment period, 23% indicated they intend to purchase coverage in 2015.

  • Among those who reported having purchased coverage for 2014, 50% indicated that they plan to enroll in 2015.

  • Close to half (48%) of all respondents not planning to enroll in 2015 were unaware of the penalty for lack of coverage. After they were informed about the penalty, the percentage of respondents reporting that they planned to enroll in 2015 rose by 6 points among those currently uninsured (to 29%) and by 5 points among those currently insured (to 55%).



Study and Charts Source: McKinsey & Company

The rate of premium payment the survey found is similar to other recent reports. According to Bloomberg News, as many as 90 percent of WellPoint customers paid their first premium by its due date and Aetna reports payment is in the 80% range. Health Care Service Corp., which operates Blue Cross Blue Shield plans in five states including Texas, said that the premium paid rate is 83%,


Originally published on May 8, 2014. Last updated August 14, 2019.


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