While 76% of American adults are aware of the Affordable Care Act’s (ACA’s) individual mandate, only 40% know that the new health insurance marketplaces open tomorrow.

Very few people with low-to-moderate incomes are aware there is financial assistance available to help them to help pay their health insurance premiums, the Commonwealth Fund Health Insurance Marketplace Survey found.

The survey was carried out between July and September 2013. It is part of the Commonwealth Fund’s efforts to track implementation of the health reform law.

The survey also found that support for expanding Medicate was high in all states.

Sixty-eight percent of adults said they were somewhat or strongly in favor of making Medicaid available to more people in their state.

The Commonwealth Fund has found that those most likely to benefit from the health insurance marketplaces and premium subsidies tend to be the ones who are least aware of them.

The report “What Americans Think of the New Insurance Marketplaces and Medicaid Expansion”, informed:

Just 32% of those with no health insurance coverage during the past 12 months know about the marketplaces, compared to 43% of people with health coverage.

Only 31% of individuals with no coverage over the last 12 month know there are subsidies available to help them, compared to 43% of insured people.

Thirty-two percent of people whose income is less than 250% of the *federal poverty level know there are subsidies, compared to 47% of individuals with higher incomes.

(250% of the federal poverty level equals $28,725 for an individual and $58,875 for a family).

The authors of the report said that as soon as people were told about the marketplaces, 61% of those who were eligible said they were very or somewhat likely to shop around for coverage in the marketplaces.

Only 55% of 19 to 29 year-olds who are potentially eligible for coverage say they are somewhat or very likely to use the marketplaces, compared to 65% of those aged from 30 to 49.

Sixty-five percent of eligible adults with health problems say they will use the marketplaces, compared to 57% of healthy eligible adults.

Sixty-seven percent of people identifying themselves as Democrats who are potentially eligible say they are somewhat or very likely to shop in the marketplaces, compared to 63% among their Republican counterparts. The authors wrote that this is not a statistically significant difference.

Study lead author and Commonwealth Fund vice president Sara Collins, Ph.D., said:

“These survey findings demonstrate that people who need the health insurance coverage the marketplaces will offer want to shop for plans and find out if they are eligible for financial help. However, more work needs to be done to ensure that people who may be eligible are aware of the marketplaces and the subsidies.

State and federal efforts to educate people about the marketplaces during the six-month enrollment period beginning in October need to be intensive enough to help close the information gaps this survey highlights.”

Strong majority of Americans support Medicaid

While 68% of adults in ALL states are somewhat or strongly in favor of making Medicaid available to more residents in their states, only 25 states plus the District of Columbia have agreed to expand Medicaid under the ACA (Affordable Care Act).

The authors also reported that:

78% of individuals with no health insurance for some time during the previous 12 months and 82% of those earning less than $32,499 a year for a family of four, are in favor of expanding Medicaid to more people in their state.

91% of Democrats with no insurance, 73% of Republicans with no insurance, and 78% of uninsured Independents say they are strongly or somewhat in favor of their state making Medicaid available to more residents.

90% of Democrats, 75% of Republicans, and 79% of Independents earning less than $32,499 a year for a family of four believe Medicaid should be made available to more people.

Approximately 85% of people surveyed do not know how their state decided with regard to Medicaid expansion. Sixty-eight percent of those who do know say they agree with their state’s decision.

Commonwealth Fund president David Blumenthal, M.D., said:

“The strong support for expanding Medicaid is consistent with past studies showing that Americans generally like the individual components of the Affordable Care Act when they understand them. This study also shows that there is a great deal of work to be done to ensure that Americans have a clear, accurate view of the law and what it offers the American people.”