Young Adults' Awareness of Insurance Exchanges

Health insurance exchanges, one of the two major mechanisms (along with expanded Medicaid coverage) for uninsured individuals to purchase insurance under Obamacare, are scheduled to become available on October 1. Ezra Klein has described the health care exchanges, which will be offered via the website healthcare.gov, as analogous to Amazon.com, but for purchasing health insurance rather than books. This article provides background information on how the exchanges are designed to work and the kinds of glitches that may arise.

Key to the success of Obamacare is getting people -- particularly in targeted demographics -- to sign up for health insurance using the exchanges. According to Talking Points Memo, the program “needs to get young and healthy people enrolled in coverage to make the law work financially. The Affordable Care Act prevents insurers from discriminating against sick and older people who want to get insured, a population that is likely to cost insurers more, so companies need young and healthy people to pay into the system to offset that new spending.”

It is in this context that the results of a new national survey  of 19-29 year-olds by the Commonwealth Fund are a potential danger sign for Obamacare. As shown in the following screenshot from the Commonwealth Fund's "chartpack," awareness of the exchanges in young adults is low (you can click on the graphic to enlarge it).

Overall, only 27% of young adults are aware of the exchanges. Arguably, however, the more relevant figure is the percent of uninsured young adults who know of the exchanges, as those already with insurance would not be looking for it. When the results are broken down by whether respondents were insured or uninsured, only 19% of the latter know about the exchanges (note from the graphic that the researchers used a definition of the "uninsured" that includes people who had insurance at the time of the survey, but were uninsured in the past year).

Some states will begin marketing the exchanges to their citizens (see here and here). Nationally, drugstore chains CVS and Walgreen's will be publicizing Obamacare. The president has also tried to publicize the exchanges through professional sports teams, with limited success thus far. Sports telecasts and in-person events are thought to be a good venue for reaching the young-adult demographic. Anecdotally, an information table at the Kentucky State Fair with free tote bags seems to have generated interest in KYnect, the state's exchange.

As efforts to promote the exchanges intensify in the coming months, it will be interesting to see if awareness of the program and favorability toward it increase as well, not only among young adults, but all segments of the population.