Most consumers would flunk a test today on the federal Affordable Care Act, a new survey indicates, even though doing the wrong things could cost them bundles of money, add to their tax bills and affect the health care they and their families receive.
But there's still enough time to learn how the law can help or hurt people so that they'll get a passing grade as important provisions of the law take effect later this year.
“We have a big gap to close,” said Laura Adams, senior insurance analyst for InsuranceQuotes.com, which commissioned Princeton Survey Research Associates International to survey 1,006 adults by landline and cellphone about a month ago. The sample had a margin of error of plus or minus 3.6 percentage points.
Among findings made public Thursday, of those surveyed:
• 90 percent didn't know that the new health care marketplaces, also known as insurance exchanges, will open Oct. 1, one of the most important features of the new law. This is where individuals will compare and buy health insurance policies. Tens of millions of previously uninsured Americans are expected to gain access to health insurance.
• 49 percent knew that health plans will have to limit the amount that patients must pay for care each year, and 46 percent knew that plans won't limit yearly total benefits per person.
• 34 percent didn't know that health plans must extend coverage to dependent adults to age 26, a provision that took effect in 2010.
• 40 percent expect the law to have a major impact on their lives, 39 percent a minor impact and 19 percent no impact.
• 28 percent say they are not too knowledgeable about the law, 39 percent say they are somewhat knowledgeable and only 10 percent say they are very knowledgeable.
• 27 percent didn't know that starting next year, the law will ban health plans from denying coverage based on pre-existing health conditions.
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A lack of consumer awareness is understandable, said John Rother, president and CEO of the National Coalition on Health Care in Washington, D.C. “It's a huge law, it deals with something a lot of people don't understand to start with, and it's been polarized in terms of politics.”
Sally McCarty of Georgetown University's Health Policy Institute said advertising, social media and community outreach efforts will push the open enrollment message. “The word will get out.”
Adams, from the insurance website, said it's especially important for consumers to be aware of the Oct. 1 enrollment date because so many people, including those who have health insurance through their employers, will be eligible for subsidies that could reduce their health care costs, or will be subject to penalties if they simply do nothing.
The health care marketplaces will be online sites in each state where people can compare and purchase different health insurance policies and find out whether they qualify for subsidies, Adams said. Tens of millions of Americans are now uninsured.
“We know that the consumers are really lacking information and just clarity in general about the health care reform law,” she said. “We were pretty surprised that 90 percent didn't even know when the insurance exchanges will open.”
Some consumers underestimate the impact of the law and overestimate what they know, she said. “They think they know more about it than they really do.”
For example, people whose employers provide health insurance may assume that the law won't affect them, when actually they might qualify for healthy federal tax credits if they are paying more than 8 percent or 9 percent of their income for health insurance.
Websites like InsuranceQuotes.com are putting information out to consumers, and state and federal government agencies will supply information, too. Insurance companies likewise are gearing up to provide more information to consumers and to businesses that provide coverage for employees.
Simply being aware of dates and general provisions won't be enough, Adams said. People should prepare to visit the marketplaces, making sure they have information on their incomes, current health insurance costs, dependents and other basics so they can compare specific health insurance coverage.
The marketplaces will have people known as navigators to guide consumers through the process, but they will be busy. Adams said people should start visiting the marketplaces as soon as possible because there's bound to be a rush to arrange coverage by Jan. 1.
“I believe the sites will be overwhelmed,” she said. “We don't want people to wait until New Year's Eve to start shopping.”
Although the “open enrollment” period will last through March 31, 2014, people are required to have coverage by Jan. 1 or face penalties. While the first-year penalty for not having insurance is only $95, the amount goes up in 2015 and 2016.
And many people may be surprised to see that they qualify for subsidies, which they could miss if they delay making choices.
Those who don't shop intelligently might choose the wrong coverage and be stuck with it through 2014.
“It's going to be a transition year,” Adams said. “All of this is sort of uncharted territory.”
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