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The Health Management Academy

CONSUMER ANALYTICS

RESISTANCE TO PURCHASING COVERAGE: A PROFILE

Though the Affordable Care Act has increased the number of Americans with health insurance, there are still roughly 30
million Americans without coverage. With open enrollment on the health insurance marketplace (commonly referred to as the
exchanges) beginning on November 1, it is worth identifying those individuals who will opt to not purchase health insurance
coverage and instead be at risk of an IRS-imposed penalty.
On behalf of RBC Capital Markets, The Health Management Academy (The Academy) conducts a quarterly national consumer
healthcare survey, the Consumer Health & Information Technology (CHIT) Survey, which dates back to the fall of 2014. Each
survey features a consistent set of demographic questions, including questions about insurance coverage. One of the insurance
questions asked uninsured respondents whether they plan to purchase health insurance in the next 12 months.
Figure 1 indicates that a majority of uninsured Americans either do not plan to purchase health insurance in the next 12 months
or they are not sure whether they will (the gap between Yes and No/Dont Know (DK) has presumably widened as the folks who
indicated Yes in earlier surveys have since purchased coverage).

Figure 1. Are you planning to purchase health insurance for yourself in the next
12 months? (Asked among uninsured respondents)

53%
46%

44%

60%

58%

56%
42%

39%

Yes
No/Dont Know

Q4 2014

Q1 2015

Q2 2015

Q3 2015

*Data from Health Management Academy national surveys, each of 1,500 adults

THE HEALTH MANAGEMENT ACADEMY | 515 Wythe Street, Alexandria, VA 22314 | (703) 548-1022 | www.hmacademy.com | Page 1

The Academy merged 6,000 national interviews, which have been conducted over the past year, to more closely examine which
groups are most likely and which groups are most resistant to purchasing health insurance coverage.


Millennials A majority of millennials (52%) plan to purchase coverage for themselves in the next year. This is good
news for payers, as millennials are the generation with the highest uninsured concentration. Just 38% of 35-64 year olds
say they plan to purchase insurance, while 62% say they are not planning to purchase coverage or dont know whether
they will.



Minorities A majority (52%) of minority adults plan to purchase coverage in the next year, while just 38% of white
adults say the same.



Midwesterners 55% of uninsured adults in the Midwest will be shopping for healthcare coverage. Conversely, a
majority of uninsured Americans from the south, northeast and west coast do not plan to buy insurance.



Parents While marital status has little impact on intent to purchase health insurance, having children makes a
significant difference. 55% of parents say they plan to buy coverage, while 38% of those without children say the same.



Middle Class Americans 56% of those in $60k-$100k households say they will purchase coverage, compared to 46%
of those in $20k-$60k households. Interestingly, just 41% of those in $100k households without insurance plan to buy
coverage.



Chronic Patients & High Utilizers 50% of uninsured respondents who have been diagnosed with a chronic disease at
some point in their life indicate intention to purchase coverage, compared to 37% of those who have not had a chronic
disease. Further, 68% of high utilizers of care (defined as seeing a medical professional at least once a month) currently
without coverage are planning to shop for insurance; on the contrary, just 40% of low utilizers of care (defined as seeing
a medical professional once a year or less) plan to purchase coverage.



Retail Clinic Patients In a sign they may be ready to receive more sophisticated care, nearly 60% of uninsured
Americans who have received care in a retail clinic setting plan to purchase coverage in the immediate future.

While the underlying reasons or motives for refusal (e.g., cost, choice, etc.) are not known for each of these groups, it is
nonetheless important to understand which segments of the population are least likely to purchase health insurance coverage.
Jarrett Lewis
Executive Director, Consumer Analytics, The Health Management Academy

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