PRINCETON, NJ -- Fifty-six percent of uninsured Americans who plan to get health insurance say they will do so through a government health insurance exchange. That figure has steadily increased since Gallup began tracking uninsured Americans' intentions in October.
One possible factor in the growing popularity of exchange-based plans versus other sources is improvements made to the federal exchange website to correct a wide array of technical issues that plagued the site. Another factor may be that previously uninsured Americans who now have health insurance for 2014 had other options, such as insurance through an employer or signing up on a spouse's or parent's plan. Those options may not be as available to those who remain uninsured.
The latest results are based on Jan. 2-28 Gallup Daily tracking interviews with more than 1,500 Americans who currently do not have health insurance.
Currently, 53% of all uninsured Americans say they plan to get insurance, while 38% say they are more likely to pay the fine the government will assess most Americans who lack health insurance.
The percentage planning to get insurance is down from 60% of the then-uninsured pool in December. This decline may be attributable as much to the shrinking uninsured population as to changes in uninsured Americans' intentions for obtaining insurance. In other words, fewer Americans are now uninsured, and those who remain uninsured as time goes on are least motivated to get insurance.
Likewise, fewer of those who were uninsured in January (72%) were aware of the federal requirement to have health insurance than was true for those who were uninsured in December (80%).
Gallup previously reported a drop in the uninsured rate, from 17.3% in December to 16.1% in early January, a figure that remains unchanged through Jan. 28 interviewing. If the uninsured rate continues to drop in the coming months, the percentage of uninsured Americans aware of the requirement and the percentage planning to get insurance may also continue to decline.
Uninsured Exchange Visits, Familiarity Still Lacking
A fairly small minority of the uninsured, 23%, say they have visited, or have attempted to visit, a federal or state health insurance exchange website. That number is little changed from 26% in December, and 20% in October and November, when many Americans had difficulty accessing the sites because of technical issues.
Perhaps surprisingly, exchange website visits are no more common, 21%, among uninsured Americans who plan to get insurance. Thus, apparently many of those who plan to get insurance have yet to take specific steps toward doing so.
Because relatively few uninsured Americans have visited insurance exchange websites, it follows that 67% claim to be unfamiliar with these exchanges. Thirty-one percent of uninsured Americans say they are "very" or "somewhat familiar" with the exchanges.
Implications
A small but notable drop in the percentage of Americans who are uninsured in January, the first month new health plans went into effect, is a positive sign the Affordable Care Act is making progress toward its goal of getting more Americans covered. Another positive sign may be the increasing percentage of the remaining pool of the uninsured who are planning to get insurance through the exchanges that were created by the law.
Still, both trends represent only modest improvements, and it may get harder to convince the remaining uninsured population to sign up for health insurance in the coming months. Gallup will continue to track the U.S. uninsured rate, and uninsured Americans' intentions for obtaining insurance, in the months ahead. Both measures will continue to gauge the early outcomes of one of the more significant recent pieces of domestic legislation.
Survey Methods
Results for this Gallup poll are based on telephone interviews conducted Jan. 2-28, 2014, on the Gallup Daily tracking survey, with a random sample of 1,593 adults, aged 18 and older, living in all 50 U.S. states and the District of Columbia, who do not have health insurance.
For results based on the total sample of uninsured adults, the margin of sampling error is ±3 percentage points at the 95% confidence level.
Interviews are conducted with respondents on landline telephones and cellular phones, with interviews conducted in Spanish for respondents who are primarily Spanish-speaking. Each sample of national adults includes a minimum quota of 50% cellphone respondents and 50% landline respondents, with additional minimum quotas by time zone within region. Landline and cellular telephone numbers are selected using random-digit-dial methods. Landline respondents are chosen at random within each household on the basis of which member had the most recent birthday.
Samples are weighted to correct for unequal selection probability, nonresponse, and double coverage of landline and cell users in the two sampling frames. They are also weighted to match the national demographics of gender, age, race, Hispanic ethnicity, education, region, population density, and phone status (cellphone only/landline only/both, cellphone mostly, and having an unlisted landline number). Demographic weighting targets are based on the most recent Current Population Survey figures for the aged 18 and older U.S. population. Phone status targets are based on the most recent National Health Interview Survey. Population density targets are based on the most recent U.S. census. All reported margins of sampling error include the computed design effects for weighting.
In addition to sampling error, question wording and practical difficulties in conducting surveys can introduce error or bias into the findings of public opinion polls.
For more details on Gallup's polling methodology, visit www.gallup.com.
