American Health Line

Polls: Young Adults Down on ACA, Prefer Penalty

Topics: Health Care Reform, Uninsured, Exchanges, Individual Mandate

December 05, 2013

Story Highlights:
* Less than one-third of young, uninsured U.S. adults -- a key demographic that could determine the success of the Affordable Care Act -- say they expect to enroll in coverage through the ACA's insurance exchanges, according to a poll released yesterday by the Harvard Institute of Politics.
* The poll -- which surveyed 2,089 voters ages 18 to 29 -- found that those who identified as Democrats are more likely to enroll in coverage in the exchanges than Republican respondents.
* Meanwhile, a new Gallup poll of 655 uninsured adults found that 28% of young, uninsured adults are more likely to pay the penalty for failing to comply with the law's individual mandate.

Less than one-third of young, uninsured U.S. adults -- a key demographic that could determine the success of the Affordable Care Act -- say they expect to enroll in coverage through the ACA's insurance exchanges, according to a poll released Wednesday by the Harvard Institute of Politics, the New York Times' "In Practice" reports (Gay Stolberg, "In Practice," New York Times, 12/4).

The poll surveyed 2,089 voters ages 18 to 29 between Oct. 30 and Nov. 11, a period when media coverage of the problem-plagued rollout of the federal health insurance exchange website had reached a "fever pitch" and just weeks after the federal government reopened following a partial shutdown, The Hill's "Ballot Box" notes (Joseph, "Ballot Box," The Hill, 12/4).

According to The Hill's "Healthwatch," not having a sufficient number of young adults in the marketplace could create a "death spiral" of high premiums that could threaten the long-term viability of the exchange marketplace (Viebeck, "Healthwatch," The Hill, 12/4).

HHS has said it hopes that at least 2.7 million young adults -- or about 39% of the seven million target for total enrollment -- sign up for coverage to help offset higher costs incurred by older, sicker individuals (American Health Line, 12/4).

Poll Findings

The Harvard poll found that just 29% of uninsured young adults plan to sign up for coverage through the insurance marketplaces, with 13% saying they will definitely do so and 16% saying they would likely do so. The percentage fell to 25% when the survey question referred to the law as the "Affordable Care Act," according to the Washington Post's "Post Politics."

Similarly, about 25% of respondents said they are unlikely to or definitely will not enroll in exchange coverage (Blake, "Post Politics," Washington Post, 12/4).

Meanwhile, 41% of respondents said they are "50-50" on whether to enroll in coverage (Howell, "Inside Politics," Washington Times, 12/4). In addition, fewer than one in five respondents said they expect to see their quality of care improve because of the ACA.

The poll also found that respondents' likelihood of purchasing coverage aligned with party affiliation, with 40% of those who identified as Democrats saying they would enroll in coverage, compared with 9% who identified as Republican (Lauter, "Politics Now," Los Angeles Times, 12/4).

Trey Grayson, director of the Harvard Institute of Politics, said the poll results suggest that young adults have become disenchanted with the ACA, in part because of the troubled rollout of HealthCare.gov.

Similarly, John Della Volpe -- the institute's polling director -- attributed the decline in support for the exchanges to high expectations, "not just for the president but for Washington and adults in general that have been unmet" ("In Practice," New York Times, 12/4).

Some Opting for Penalty

Meanwhile, a Gallup poll of 655 uninsured adults across various age groups -- released Tuesday -- found that 28% of young, uninsured adults are more likely to pay the penalty for failing to comply with the law's individual mandate, Politico reports. Overall, 63% of respondents said they plan on getting coverage (McCalmont, Politico, 12/4).

Among respondents who identified themselves as Republican, 46% said they plan to obtain coverage in 2014, while 45% said they plan to pay the fine. Eighty percent of Democrats said they plan to get coverage, compared with 15% who said they would rather pay the penalty. Among independents, 58% said they plan to purchase coverage (Sullivan, "The Fix," Washington Post, 12/4).

-- compiled by Heather Drost