Survey Reveals Confusion in Calif. About ACA Insurance Coverage

Three out of four California residents with modest incomes incorrectly believe that they are not eligible for subsidies to purchase health plans through the state insurance exchange or do not know if they qualify for federal assistance, according to a Kaiser Family Foundation survey, Kaiser Health News reports.

KFF surveyed about 2,000 uninsured state residents from mid-July through the end of August, prior to expanded outreach efforts highlighting the exchanges under the Affordable Care Act (Varney, Kaiser Health News, 9/26).

The survey is part of a KFF project to examine the experiences of 2,000 uninsured California residents with the ACA over the next two years (Bunis, CQ HealthBeat, 9/26).

Confusion Among Undocumented Immigrants

The survey found that 49% of undocumented immigrants living in the state believe that they might qualify for Medi-Cal under a program expansion and 43% expect to purchase a plan through the exchange. Medi-Cal is California's Medicaid program.

However, the ACA prohibits undocumented immigrants from purchasing health coverage through the health insurance exchanges created under the law, and such individuals already are barred from enrolling in Medi-Cal, according to Kaiser Health News.

Other Findings

The survey found that 57% of respondents said that they have little financial security, while 64% said that they have forgone needed medical care because of cost concerns.

According to the survey, 80% of respondents said that they feel they need health insurance, while 57% said that they believe health insurance is worth purchasing.

Reactions

Sonya Vasquez -- policy director for Community Health Councils -- said, "There is a lot of confusion about the messaging in the news and at the federal level," adding, "With the enrollment program, that is going to shift." She said that anxiety over cost concerns "reminds us that we have to push forward on the message that the plans are affordable and [that] some people may not have to pay hardly anything" if they qualify for subsidies.

Michael Cousineau -- a professor of family and preventive medicine at the University of Southern California's Keck School of Medicine -- said findings showing that individuals feel they need coverage "tells me that people do value health [insurance] and will take action to get themselves covered if it's affordable" (Kaiser Health News, 9/26).

Second Phase of Project

For the second phase of the project, KFF will question the original respondents after the ACA's open enrollment ends in March 2014 to find out:

• Whether they signed up for coverage or remained uninsured;
• Who enrolled in Medi-Cal and why; and
• Who used the exchange to shop for insurance and how they would rate that experience.

KFF will interview the respondents two more times to learn more about their other experiences under the law (CQ HealthBeat, 9/26).