Survey: Majority of Americans believe ACA marketplaces are 'collapsing'

As lawmakers moved to eliminate the ACA's individual mandate penalty beginning in 2019, approximately half the American public believes ACA marketplaces are "collapsing," including six in ten of those with coverage purchased through these marketplaces, according to a Kaiser Family Foundation survey.

Kaiser Family Foundation researchers conducted interviews by telephone during February and March 2018 among a nationally representative random digit dial telephone sample of 2,534 adult U.S. residents. 

Respondents were considered non-group enrollees if they were between the ages of 18 to 64 and their main source of coverage is health insurance they purchase themselves.

Here are five findings from the survey.

1. Approximately 1 in 5 non-group enrollees (19 percent) said they are aware the mandate penalty has been repealed but is still in effect for this year. Regardless of the lack of awareness, 9 in 10 non-group enrollees intend to continue buying their own insurance even with the individual mandate repeal.

2. The mandate ranks low on a list of "major reasons" respondents gave for buying their own insurance, below reasons such as protecting against high medical bills (75 percent), peace of mind (66 percent) or because they or a family member has an ongoing health condition (41 percent).

3. The survey also found approximately half (53 percent) of the public believe the ACA marketplaces are "collapsing," including 6 in 10 who purchase insurance through marketplaces. When examining across party identification and insurance type, more people said the marketplaces are collapsing than said they are not collapsing.

4. Over half (52 percent) of all non-group enrollees and marketplace enrollees (58 percent) reported they are "very" or "somewhat" worried there will be no insurance to sell plans in their area in the future. Similar percentages worry their current insurance company will no longer sell plans in their area (49 percent and 58 percent, respectively).

5. More than one-third (34 percent) of marketplace enrollees said their premiums are "about the same" as last year and 23 percent said their premiums went down. Forty-two percent said their premiums have increased. These breakdowns are similar to the share of the overall non-group market who said their premiums have increased (46 percent), stayed the same (35 percent) or decreased (18 percent).

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