Becker’s Healthcare
by Ayla Ellison

More than 9 million people have gained insurance coverage under the Patient Protection and Affordable Care Act. However, due to a number of challenges, the number of insured may begin to decrease, as some people cancel or forgo renewing coverage due to frustration and lack of use of their new health plans.

Here are four challenges that could negatively affect PPACA success.

1. Health literacy. Just weeks before open enrollment for state and federal exchanges began last year, 42 percent of Americans were unable to explain a deductible and 62 percent did not know a HMO plan had greater restrictions than a PPO, according to a study by researchers at the University of Southern California’s Schaeffer Center for Health Policy & Economics in Los Angeles. Researchers also found low-income and uninsured Americans — those most likely to benefit from the PPACA — had the least awareness of health reform.

Americans began signing up for health insurance under the PPACA nine months ago, and it is becoming apparent many of them are extremely confused by the insurance plans they signed up for. Christine Barber, a senior policy analyst with Boston-based Community Catalyst, told the Washington Post that hospitals across the country are being swamped with calls from newly insured individuals who are saying “Okay, I have my card. What do I do now?”

2. Language barriers. Many of the newly insured have limited English proficiency, which creates a steep learning curve when trying to understand their policies. A recent study from the Greenlining Institute found 90 percent of Covered California enrollees speak English as their primary language, despite over half of all Californians and 40 percent of those eligible for Covered California having limited English proficiency. Although specific to California, the study’s findings indicate many people may be foregoing enrolling in insurance under the PPACA because of a language barrier.

3. Technical glitches. Some of the newly insured who purchased their insurance through the federal and state-run marketplaces still have not received their insurance cards due to technical problems. In addition to problems last fall with the federal HealthCare.gov website, many of the 14 states that created their own health insurance exchanges have dealt with malfunctioning systems. For instance, the federal government spent a total of $474 million on the development of exchanges that failed because of technical problems in Massachusetts, Maryland, Oregon and Nevada.

4. Data discrepancies. In June, the government began asking millions of people who enrolled in subsidized insurance coverage through HealthCare.gov to provide additional documents to verify information to resolve data discrepancies in their insurance applications. A data discrepancy in an application means the information the individual supplied on their application does not match the information the government has on record. Most of the inconsistencies were related to income, citizenship and immigration status.

In July, HHS’ Office of the Inspector General announced 2.6 million of the 2.9 million inconsistencies — 89.6 percent — were still unresolved. The legal status to obtain insurance coverage and the amount paid for coverage of those with discrepancies still remaining in their applications could be affected.

Author