Uninsured Adults' Marketplace Knowledge Gaps Persisted in April 2021

A fact sheet assesses the basic knowledge gap experienced by uninsured adults in 2021 to better identify people who may benefit from additional enrollment initiatives as enhanced funding for outreach is distributed and the implementation of the 2021 American Rescue Plan (ARP) resumes.

The Issue

Research suggests that uninsured adults are often unaware of Marketplaces and subsidies that help people afford basic health care and coverage due to a lack of access to information about the ARP’s new affordability provisions and difficulties reaching certain populations.

Key Findings

Using data from the Urban Institute’s Health Reform Monitoring Survey, researchers prepared a fact sheet of primary findings:

• Fewer than half (48.2 percent) of nonelderly adults uninsured in April 2021 reported having heard a lot or some about the Marketplaces, and fewer than a third (32.2 percent) reported having heard a lot or some about subsidies; the remainder of both groups had heard only a little or nothing at all.
• Among uninsured adults who were at least somewhat familiar with Marketplaces but had not sought or enrolled in a plan, most reported that the main reason was cost—indicating need for broader outreach about affordability provisions even among people aware of Marketplaces.
• Among uninsured adults who had heard only a little or nothing about Marketplace plans or subsidies, more than half were younger than 35 and nearly half were not unemployed. More than a quarter were bilingual or Spanish-speaking, more than one-in-five lacked a high school degree, and more than one-in-seven lacked home internet access.

Conclusion

Without targeted, multilingual outreach and increased efforts to assist uninsured adults with enrollment, both on- and offline, Marketplace knowledge discrepancies could prevent many from taking advantage of newly expanded enrollment opportunities and subsidies under the ARP.

About the Urban Institute

The nonprofit Urban Institute is dedicated to elevating the debate on social and economic policy. For nearly five decades, Urban scholars have conducted research and offered evidence-based solutions that improve lives and strengthen communities across a rapidly urbanizing world. Their objective research helps expand opportunities for all, reduce hardship among the most vulnerable, and strengthen the effectiveness of the public sector. Visit the Urban Institute’s Health Policy Center for more information specific to its staff and its recent research.