U.S. Uninsured Still Rate Exchange Experience Negatively
Well-Being

U.S. Uninsured Still Rate Exchange Experience Negatively

Twenty-six percent of uninsured Americans have visited an exchange website

PRINCETON, NJ -- Uninsured Americans who have visited a health insurance exchange website mostly say their experience was negative rather than positive, by 59% to 39%. That reading, from Gallup Daily tracking throughout December, is only a slight improvement from Gallup's combined October and November polling, when 63% reported a negative experience and 33% a positive one.

Uninsured Americans' Ratings of Health Insurance Exchange Websites

The latest figures are based on Dec. 1-29 Gallup Daily tracking interviews with more than 1,500 uninsured Americans, including roughly 450 who have visited a health insurance exchange website. Since the exchanges opened on Oct. 1, the federally run websites have been plagued by technical problems, while the state-run exchanges have reportedly performed better. Among uninsured Americans who have visited an exchange, 24% say they went to a federal exchange, 20% to a state exchange, 17% to both, and 37% are unsure.

The Obama administration set a goal of having the major technical problems with the federal exchanges fixed by Nov. 30. Thus, all of the recent interviews followed that date. However, some of the respondents interviewed in December may have visited exchanges prior to Nov. 30. Still, the update suggests the website fixes have not dramatically improved the customer experience for uninsured Americans seeking health insurance to comply with requirements of the Affordable Care Act, also known as "Obamacare."

One in Four Uninsured Have Visited Exchanges

Currently, 26% of uninsured Americans say they have visited a health insurance exchange website, up from 20% in October and November polling.

The health insurance exchanges were set up as part of the healthcare law to allow Americans to compare insurance plan specifics and to see if they qualify for a government subsidy to help offset insurance premiums. With the exchanges as the primary new way to get insurance, assuming most Americans intend to comply with the law, one might have expected many more than 26% of uninsured Americans to have visited exchange websites.

Since the December result covers interviews across the entire month, it could slightly underestimate the actual percentage of uninsured Americans who have visited an exchange site if proportionately more visited near the end of the month to meet the deadline for having insurance coverage effective Jan. 1, 2014.

Also, prior Gallup tracking has shown that less than half of uninsured Americans who plan to get insurance say they will do so through an exchange, perhaps opting instead to take an employer-sponsored plan or get covered on a family member's plan. In addition, roughly 30% of uninsured Americans say they are more likely to forego insurance and pay the government fine than to sign up for insurance.

Implications

The Obama administration recently announced that roughly 2 million Americans have signed up for insurance through a federal or state health insurance exchange. Most of those enrollments happened in December, particularly in the latter part of the month given the deadline to have coverage effective Jan. 1. The rise in exchange visits in December could, to some degree, reflect improvements in the health insurance exchange websites, as people who wanted to sign up for insurance were more easily able to do so. Also, the increased exchange website traffic may be due to procrastination on the part of those seeking insurance. Uninsured Americans still have time in 2014 to sign up for insurance and avoid paying a fine, so exchange visits may continue to increase.

However, the fact that most uninsured Americans who have visited the exchanges report a negative experience is problematic, particularly given the Obama administration's efforts to improve the federal sites. If uninsured Americans continue to have bad experiences with the exchanges, it could hinder the Obama administration's goal to insure as many Americans as possible.

Survey Methods

Results for this Gallup poll are based on telephone interviews conducted Dec. 1-29, 2013, on the Gallup Daily tracking survey, with a random sample of 1,563 adults, aged 18 and older, living in all 50 U.S. states and the District of Columbia, who do not currently have health insurance.

For results based on the total sample of uninsured adults, the margin of sampling error is ±3 percentage points at the 95% confidence level.

For results based on the total sample of 454 uninsured adults who have visited a health insurance exchange website, the margin of sampling error is ±6 percentage points at the 95% confidence level.

Interviews are conducted with respondents on landline telephones and cellular phones, with interviews conducted in Spanish for respondents who are primarily Spanish-speaking. Each sample of national adults includes a minimum quota of 50% cellphone respondents and 50% landline respondents, with additional minimum quotas by region. Landline and cellphone numbers are selected using random-digit-dial methods. Landline respondents are chosen at random within each household on the basis of which member had the most recent birthday.

Samples are weighted to correct for unequal selection probability, nonresponse, and double coverage of landline and cell users in the two sampling frames. They are also weighted to match the national demographics of gender, age, race, Hispanic ethnicity, education, region, population density, and phone status (cellphone only/landline only/both, and cellphone mostly). Demographic weighting targets are based on the March 2012 Current Population Survey figures for the aged 18 and older U.S. population. Phone status targets are based on the July-December 2011 National Health Interview Survey. Population density targets are based on the 2010 census. All reported margins of sampling error include the computed design effects for weighting.

In addition to sampling error, question wording and practical difficulties in conducting surveys can introduce error or bias into the findings of public opinion polls.

View methodology, full question results, and trend data.

For more details on Gallup's polling methodology, visit www.gallup.com.

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