Knowledge Gap May Hinder Needed Help for Uninsured

An information gap could keep the Affordable Care Act from helping those who really need the law’s help.

An October survey from health care think tank Kaiser Family Foundation found that 89 percent of the nation’s uninsured have no idea that open enrollment through the law’s insurance exchanges starts Saturday.

Two-thirds of the uninsured said they knew “only a little” or “nothing at all” about the state and federal exchanges through which people can buy subsidized coverage. And more than half – 53 percent – said they didn’t know that federal tax credits could help them pay for a plan.

Those survey results are a problem because they mean the consumers who are supposed to benefit most from the Affordable Care Act may be less likely to take advantage of the assistance the law provides.

The knowledge deficit is also a bit surprising considering the amount of attention the law received in late 2013 and early 2014 with the rollout of exchanges. The Affordable Care Act has been a hot topic during 2014’s election campaign season as well.

So the question becomes: How do public officials reach a bloc that doesn’t yet seem to have gotten the message?

The job may not be as tough in Nevada as it is in other states, officials here say.

That’s because the Silver State was one of just 14 states that developed its own insurance marketplace, and the advertising budgets that came with that launch have meant higher awareness here, said Bruce Gilbert, executive director of the Silver State Health Insurance Exchange. In states that threw in with the federal exchange, enrollment periods may not have received as much media attention, he said.

A spring survey put name recognition of the exchange’s Nevada Health Link website at 61 percent, spokesman Tyler Klimas said.

Plus, it’s important to note that many state exchanges, including Nevada’s, have intentionally held off on advertising and marketing because they “don’t want the message to get trampled in the midst of all of the election media,” Gilbert said.

Still, observers agree it’ll take a special effort to get enrollment news out to Nevada’s uninsured, even if they know a bit more about the process here.

That’s partly because big chunks of the uncovered population don’t consume media through traditional channels such as newspapers and TV news, said Andres Ramirez, president of The Ramirez Group, Nevada’s largest employer of enrollment navigators.

There’s also some confusion because a lot of uninsured Nevadans are eligible for Medicaid, and there’s no specific enrollment period for the public insurance program for low-income consumers. That creates “an ongoing messaging issue that we need to clarify,” Ramirez said.

The state exchange will spend $2.9 million on marketing during a stretch that started Monday and ends Feb. 15. But money alone won’t educate consumers. In their bid to reach uninsured, single, healthy “young invincibles” and young families, exchange officials will target digital media on top of traditional outlets, Klimas said. One example: The exchange will produce videos for YouTube.

Any strategy should also include community outreach and work with groups that provide services to the uninsured population, Ramirez said. To that end, his agency will hold a “Get Healthy. Get Covered” fair Saturday at the Rio Conference Center to advise consumers on how and when to sign up. A similar event in March at Cashman Center drew 13,000 people.

Nevada Health Link officials will be at community events, too, looking to connect with people who need but don’t have coverage.

“We recognize that we have to spend a lot of time and effort building a foundation that will provide success,” Gilbert said. “Between our focus groups, looking at various digital channels and working to understand segments of the population we deal with, we’ve laid the foundation to drive education.”

We’ve seen a lot of tax-credit calculators out there for people who want to know how much federal help they can get covering their premiums. What we haven’t seen much of, though, are programs that tabulate how much it will cost to opt out of insurance.

A consumer website is changing that with a calculator designed to tell you the federal tax you’ll owe if you go uncovered.’s three-step calculator takes information including income and how many people live in your household, and spits out your exact penalty.

The calculator also shows how dramatically those fines will jump from 2014 to 2015.

A single person with no children who makes $30,000 a year can expect to pay out $198.50, a fine that will essentially double in 2015 to $394. A family of four with an income of $50,000 a year is on the hook for $297 in 2014, and nearly $1,000 in 2015.

As a general rule, the cost of going uninsured in 2015 will cost at least $325 a year or 2 percent of income, whichever is higher. That’s up from $95 or 1 percent in 2014.

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