More on Medicare & Medicaid

Health insurance confusion is growing in America, finds annual survey

More than 85% don't know the basic benefits that health insurance plans must cover under the Affordable Care Act, a rise from previous years.

Jeff Lagasse, Associate Editor

Americans' lack of health care literacy may be leading them to avoid medical care.

More than one in four people (27.2%) have avoided care or treatment because they were unsure of what their health insurance covered, according to a new survey from Policygenius.


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The findings suggest people are increasingly confused about their coverage. For instance, this year's survey found more than 85% don't know the basic benefits that health insurance plans must cover under the Affordable Care Act, compared to 80% in 2018 and 78% in 2017.

Americans are also confused about basic health insurance facts. Only 29.3% of respondents were able to correctly define all three of the most common health care expenses -- premiums, copays and deductibles. Even among people with health insurance, only 36.1% knew all three terms.

Only 11.9% of respondents knew the correct dates for 2019 federal open enrollment, and only one in five (21.9%) knew they could get aid to purchase an Obamacare plan -- and at 15.6%, awareness was even lower among people lacking coverage.

About 80%  erroneously believed there is still a tax penalty for foregoing health insurance. And 13.2% were unsure if they had health insurance at all.

The survey is based on responses from a nationally representative group of 1,500 Americans ages 18 and older. It was conducted through Google Consumer Surveys from October 1 to October 3, 2019.


Health insurance has been a hot topic of debate in the lead-up to the 2020 presidential election, particularly among Democrats. The party remains divided, with some, like Senators Bernie Sanders and Elizabeth Warren, favoring a Medicare-For-All approach that would effectively eliminate the private insurance industry. Front-runner Joe Biden favors retaining private insurance and instead strengthening and expanding the Affordable Care Act, former President Barack Obama's signature piece of healthcare legislation.

Both providers and payers are against a Medicare-For-All approach. Insurers are against a plan that would eliminate private insurance, while providers say a government-run health plan would ultimately result in lower reimbursement.

Medicare pays at a lower rate than private insurance, with hospitals that heavily rely on government payments struggling to break even. Rural hospitals are already at risk of closing from receiving more of their payments from lower reimbursement rates.

Also, half of consumers may be confused about a Medicare for All plan. Fifty percent who answered a recent Eligibility survey found that they believed Medicare coverage is free. Sanders' plan would cap premiums at about 9.5 percent of household income.

Twitter: @JELagasse

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