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Americans on Obamacare: Decidedly Undecided


Sixty-four percent of uninsured Americans haven’t yet decided if they will buy insurance by January 1, 2014, when Obamacare’s individual mandate goes into effect. Polling company Princeton Survey Research Associates International recently conducted the survey on behalf of an insurance price comparison website. The reaction by the senior insurance analyst at the website ( hints at the danger this number represents for the ACA. CNBC: 

“I was really shocked that 64 percent [of uninsured adults] said they haven’t decided if they will purchase insurance by the Jan. 1 deadline,” Adams said. “I was definitely surprised by the high number of people who really have no clue what they’re going to do next year.”

“We don’t want these consumers to miss this key deadline,” she said, adding that new heath-care exchanges under Obamacare will begin accepting applications for insurance in less than four months. “They’re going to potentially go without health care for the entire year.”

These numbers are a very bad sign for Obamacare. The success of the ACA depends on convincing a large number of people to sign up for insurance, particularly the healthy and the young. Insurance companies need customers with low medical risk to keep premiums low; if many of them opt out of insurance, those who use a lot of medical services will be over-represented in the insurance pool, driving premiums sky-high through a phenomenon known as adverse selection. Without a large new influx of insured people, Obamacare just cannot work, period.

It’s been clear for a while now that the ACA faces a massive threat from adverse selection. Because the penalty for non-compliance with the mandate is so low compared to the premiums the insured will have to pay, many people will be tempted to pay the penalty and opt-out of the insurance market altogether. This poll suggests that these early fears, if anything, might have even understated the challenge facing the ACA.

Hill Democrats are publicly bullish about the law, but stories like this one and the debacle in California must have them worried about the future of Obama’s signature achievement.

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  • ljgude

    To go back to basic common sense passing a law requiring people to make a substantial expenditure in a time of high unemployment is asking for trouble. With American healthcare costing double what it does in the rest of the developed world as a percentage of GDP and failing to make any serious reduction to that level leads me to believe that this is just not going to work. We started with an overgenerous universal national health system here in Australia in the 70s and slowly reformed it to make it better. I doubt that the ACA is reformable. I know that for most of my younger years I would have paid the fine, but I’m a New Hampshire man and cheap by nature. 😉

  • Tano

    Why is it surprising, or troubling, that some number of people have not decided if they will buy insurance given that the options available to them have not yet been laid out?

    • BrianFrankie

      Buying insurance is not an option under the ACA. The law states that you must buy insurance. See Section 1501.

      • Tano

        So what? Normal people tend to say that they have not decided to buy something until they know what they are going to buy, even if they have to eventually buy something.

      • charlesrwilliams

        Brian, the Supreme Court has determined that the penalties under Obamacare are unconstitutional. They are only a tax and no one is morally obligated to buy insurance as long as they pay that tax.

  • Tano

    And your title seems a little odd. You refer to “Americans” in general, but the article is actually only about the uninsured. And you claim that this group is undecided about Obamacare when in fact the article is about whether or not they personally will buy insurance, a very different issue.

    For the record, much polling seems to indicate that Americans are not really undecided about Obamacare. Consistent results show that roughly 40% support the bill as is, 15% want something more liberal, 35% oppose the bill from the right, and only about 10% seem undecided.

  • BrianFrankie

    ” These numbers are a very bad sign for Obamacare. The success of the ACA depends on convincing a large number of people to sign up for insurance, particularly the healthy and the young.”
    And how, pray tell, is it possible to convince a large number of currently healthy, young, uninsured people to sign up for insurance, when it is manifestly *not* in their economic interest to sign up for insurance?
    Personally, I am going to encourage as many young healthy people as possible not to sign up for insurance, and, furthermore, not to pay the tax associated with this decision. If enough people do this, then we can collapse the current terribly designed health insurance system and start from scratch to build an actual good system.

    • Tano

      Great idea Brian. As a little extra incentive to get them to follow your lead, perhaps you could offer to cover any medical bills they might incur if they happen to have an accident or something – given that you have convinced them to forgo insurance.

      I am sure you wouldn’t want society at large to foot their bills,,,,,right?

      • Douglas Levene

        I believe that under the law, they can sign up for insurance in the ambulance on the way to the hospital. That’s the sensible thing for them to do, no?

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