Much of the Affordable Care Act narrative recently has surrounded the seeming catch-22 of enrolling young, healthy people in the new insurance exchanges: that those most crucial to the success of the exchanges would also be the most challenging to recruit. Yet a poll released Wednesday challenges some assumptions about the behavior of these coveted young consumers.
The poll, conducted by The Morning Consult, a health care policy media company, found that young adults are the most supportive of the health care law across age groups. A full 56 percent of adults 18-29 approve of the law, compared with 44 percent of adults 30-44; 43 percent of adults 45-64; and 37 percent of adults 65 and older. Seniors are the most strongly opposed to the law, with 58 percent of those 65 and older disapproving of Obamacare, compared with 38 percent of young adults 18-29.
Not only are young adults more supportive of the law overall, they are notably more likely to consider purchasing insurance on the exchanges. The poll found that 35 percent of those ages 18-29 are "almost certain to purchase" or "very likely" to consider it, while 39 percent are about 50-50, and 27 percent are "not too likely" or "not at all likely." As age increases, respondents become less likely to consider buying coverage. Among seniors ages 65 and older, only 8 percent are likely to consider purchasing insurance on the exchanges, while 76 percent are not likely to consider it.
The findings counter the widespread concern that generally healthier young adults may forgo coverage altogether and pay the fine instead, which would leave the insurance pool full of older and sicker individuals and result in premium spikes and an unsustainable market.
Michael Ramlet, editor in chief of The Morning Consult, told National Journal that there are two main reasons for the higher rate of receptiveness among young adults: the large amount of education outreach regarding the health law targeted to young people, and their higher comfort level with purchasing insurance online and sharing information. "Young people have seen the message more, and are more receptive to finding it," Ramlet said. "The comfort level in sharing information is playing a role we hadn't really expected.... [The exchanges] are ready-made for a younger audience."
He cautioned, however, that "just because the respondents are interested in the insurance exchanges, it shouldn't be taken as a decision to purchase." Decisions will likely depend on the state, many of which have not yet released premium information. As Ramlet points out, it's not clear how much consideration respondents gave to price before demonstrating their interest.
Meanwhile, the poll did not actually find much difference in support across income level or insurance status, two factors that largely determine the law's impact. The similarity in responses across income and insurance levels indicates that certain populations may be voting against their own interests. "In this case, politics and ideology are likely playing a role," Ramlet said.
Looking further ahead, Ramlet noted that the polling across demographics also has implications for the 2014 midterm elections. While the regional breakdown (higher support for the law in the West and Northeast than the South and Midwest) and the racial breakdown (dramatically higher approval for the law among African-Americans and Hispanics than among whites) are not particularly surprising, they are potentially reflective of the political environment and different voter demographics. With the health care law likely to remain a divisive and key issue into the 2014 and even 2016 elections, candidates may use it to drive approval among different groups.