A decade of the ACA: Enrollees mixed as election priorities shift
Nearly 6 in 10 ACA plan enrollees consider their health insurance premiums affordable, but only 46% believe their copays, deductibles and other out-of-pocket costs are affordable.
It has been 10 years since the Affordable Care Act went into full effect. Despite attempts to revise, repeal or replace it, millions of Americans rely on the ACA for health coverage.
With the presidential and congressional elections fast approaching, eHealh asked 330 recipients about the success of the law, their satisfaction with their coverage and its affordability. Among the findings:
- Enrollees give the ACA a mixed report card. Although 44% believe the ACA succeeded in its aim to make health insurance more affordable and accessible, 37% disagree and 19% are unsure. Nearly 6 in 10 ACA plan enrollees consider their health insurance premiums affordable, but only 46% believe their copays, deductibles and other out-of-pocket costs are affordable.
- Most are satisfied with their coverage but would prefer alternatives. Overall, 68% say they are satisfied with their ACA plan. However, only 27% would keep it if other options (such as employer-based coverage) were available to them.
- Subsidized and unsubsidized ACA enrollees have different takes on coverage. Two-thirds of the subsidized consider the ACA a success, compared to 34% of the unsubsidized. Eighty-one percent of the subsidized call their premiums affordable, compared to 46% of the unsubsidized.
Related: Down to the wire: 2024 elections impacting health care and employee benefits
- Health care is a big concern this election year for ACA enrollees. Among likely voters, two-thirds say health care is a top-three voting issue for them. However, only 7% say it is their top priority, and one-third do not consider health care one of their top three voting priorities this year
- Lowering costs is the biggest priority for ACA enrollees. Fifty-six percent would like to see monthly premiums come down; the same percentage want lower out-of-pocket costs; and 41% want broader access to doctors. Only 5% said they would change nothing.
- Some would not object to those at higher risk paying more for coverage. Contrary to a founding principle of the ACA, nearly 3 in 10 believe some people at higher risk of needing medical care should pay more for coverage. Among these, three-fourths believe heavy drinkers should pay more, while 73% say smokers should pay more. By contrast, only 28% say people with preexisting medical conditions should pay more, and only 3% believe women should pay more than men.