Despite New Healthcare Options Mandated by the Patient Protection and Affordable Care Act, 42% of U.S. Residents do not know the ACA is the Law of the Land

Jun 26, 13 Despite New Healthcare Options Mandated by the Patient Protection and Affordable Care Act, 42% of U.S. Residents do not know the ACA is the Law of the Land

By Cassandra Bremer, Content Manager and Developer

In just six months, the U.S. federal government will begin fining residents who do not have health insurance as defined under the Affordable Care Act (ACA). Commonly referred to as “Obamacare,” the ACA mandates that the U.S. Department of Health and Human Services (HHS) establishes health insurance exchanges in all 50 states and the District of Columbia by Oct. 1, 2013 to allow ample time for uninsured residents to select and purchase a health care plan before the 2014 deadline. Sixteen states and D.C. 1 are currently establishing state-based exchanges, seven states2 have opted for partnership exchanges with the HHS and 26 states3 have chosen a federally facilitated marketplace. With these new options, the government will fine individuals who fail to secure coverage $95 or one percent of their annual income —whichever is greater. However, according to a Kaiser Family Foundation Poll, 42% of U.S. residents who may be penalized are unaware the ACA is the law.

Despite the Supreme Court upholding the ACA last year, saturated media and continued discussions by the GOP to repeal the law have residents uniformed or misinformed about the ACA. Because of the significantly uninformed population, reaching America’s nearly 84 million uninsured residents will be a unique challenge for federal/local government and health care providers alike. Misunderstanding and misinformation has 58% of America’s uninsured feeling under informed about the law and how it will impact them and their families (65% of which are Hispanic, 48% are black and 45% are white) according to Kaiser. The confusion, coupled with cost concerns, has six in ten uninsured Americans unsure if they will purchase coverage or pay the penalty.

The main concern among America’s uninsured is cost. According to, 60% of uninsured Americans report they do not have coverage because they cannot afford it. Consumers place cost consideration first—even before quality—when purchasing health insurance reports HealthPocket. Some consumers considering paying the penalties rather than buying coverage from the exchange believe that health insurance will be more expansive than current coverage. However, the ACA is designed to provide affordable health care options to all American residents by introducing a competitive marketplace and making it illegal for providers to deny customers based on pre-existing conditions.

Aware of the country’s concerns, President Obama discussed cost and California’s Exchange, also known as a marketplace, in San Jose earlier this month to help inform both the under informed and skeptical populations of the ACA’s effectiveness. “In nearly every state, more than half of all consumers are covered by only two insurers. So there’s no incentive to provide you a lot of choices or to keep costs down. The Affordable Care Act changes that,” he said.

The president highlighted states that are focused on implementing the exchange, such as California, Washington and Oregon, and he said that the exchanges were actually offering Americans higher quality insurance at lower costs due to the competitive marketplace. “The 13 insurance companies that were chosen by Covered California have unveiled premiums that were lower than anybody expected. And those who can’t afford to buy private insurance will get help reducing their out-of-pocket premiums even further with the largest health care tax cut for working families and small businesses in our history. So about 2.6 million Californians—nearly half of whom are Latinos—will qualify for tax credits that will, in some cases, lower their premiums a significant amount,” said President Obama. While the ACA addresses the main fears and concerns expressed by the uninsured, reaching these audiences to convey the message proves to be a unique challenge.

The challenge comes with reaching and educating the robust, diverse uninsured population before the deadline. The government and health care providers must develop targeted outreach to the different uninsured segments because each group has nuances and preferences specific to location, ethnicity, race, age, income and literacy levels. For example, according to Managed Care Weekly Digest, Colorado Hispanics are more comfortable using the term “Obamacare” than the “ACA” or “heath care reform” to discuss the law while media outlets have begun to diminish their use of Obamacare. Additionally, some consumers require extensive health care coverage and health care reform education before they feel they understand the ACA. The government and health care providers will have to implement a variety of outreach techniques for reaching the diverse uninsured American population.

“An alarming number of Americans are unaware of the health care reformations currently underway,” says George L. San Jose , president and chief creative officer at The San Jose Group. “Whether people do not know that the ACA is the law, or they believe myths that they cannot afford it, the government at the state and national levels are moving forward with creating exchanges. But without a clear understanding of the health care options, the uninsured will miss the opportunity to gain coverage before the January deadline.”

With four in ten Americans unaware that the ACA is the law, the government and health care providers focus will turn to educating the uninsured and clearing the confusion surrounding the ACA in order to meet the open registration deadline.


1 Declared State-based Exchange California, Colorado, Connecticut, District of Columbia, Hawaii, Idaho, Kentucky, Maryland, Massachusetts, Minnesota, Nevada, New Mexico, New York, Oregon, Rhode Island, Vermont, Washington 
2 Planning for Partnership Exchange Arkansas, Delaware, Illinois, Iowa, Michigan, New Hampshire, West Virginia
3 Default to Federal Exchange Alabama, Alaska, Arizona, Florida, Georgia, Indiana, Kansas, Louisiana, Maine, Mississippi, Missouri, Montana, Nebraska, New Jersey, North Carolina, North Dakota, Ohio, Oklahoma, Pennsylvania, South Carolina, South Dakota, Tennessee, Texas, Utah, Virginia, Wisconsin, Wyoming

Source: May 2013 Kaiser Family Foundation Report

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