Obama Speak
Image source: White House on Flickr.

Stop me if you've heard this one before: consumers, as a whole, don't like the Affordable Care Act, which you probably know best as Obamacare.

According to the December 2015 Kaiser Health Tracking Poll from the Kaiser Family Foundation, the number of respondents who have an unfavorable view of the law are once again in the majority, albeit by a slim margin, over those who have a favorable view of Obamacare. Since being signed into law in March 2010, you can count on two hands how many months a majority of respondents have shared a "favorable" view of Obamacare. 

Why consumers dislike Obamacare
Why don't consumers like Obamacare? Based on data collected by KFF's Tracking Poll, a majority of American families either aren't affected by the law enough to care, or they don't believe it's benefited them. Combining the responses from all persons questioned, regardless of political affiliation, a whopping 51% stated the law had no direct impact on them or their family, 29% noted that Obamacare hurt their family, and only 17% said Obamacare has helped them or their family.

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Image source: Flickr user Bark.

The primary objection to Obamacare has been, and still is, cost. Of the individuals and families who claimed to have been hurt by Obamacare, approximately two-thirds of the aforementioned 29% cited increased healthcare costs, while another 15% of those "hurt" by Obamacare cited difficulty in getting the healthcare they need as their primary gripe.

As a whole, cost is also the number one reason why the uninsured remain uninsured, at least according to those polled. Almost half (46%) of all uninsured adults between the ages of 18 and 64 polled simply said that the coverage was too expensive. About 9% also said they'd rather pay the shared responsibility penalty than purchase health insurance.

Is a lack of education Obamacare's biggest downfall?
However, KFF's latest Health Tracking Poll raised a number of additional points that tie back to one big issue: a lack of education on the part of the consumer.

Right now we're in the midst of Obamacare's third open enrollment period. Enrollment began on Nov. 1, 2015, and it's slated to end on Jan. 31, 2016. The enrollment period has shifted each time: Oct 1, 2013 through Mar 31, 2014 for calendar year 2014, and Nov. 15, 2014 through Feb. 15, 2015 for calendar year 2015. Now most uninsured consumers have little clue about when they're supposed to enroll by. KFF asked uninsured Americans when the enrollment deadline for 2016 coverage was, and a mere 7% -- seven percent -- got it right. One fifth thought the enrollment deadline was the end of 2015, 6% thought it already passed at the time of the poll (Dec. 1 through Dec. 7), and 3% listed some other time. An overwhelming 65% simply didn't even know enough to venture a guess.

Next up, uninsured Americans were asked by KFF if they'd been contacted by anyone within the past six months about enrolling for health insurance. Just one in five people affirmed that they had been, meaning 80% of those polled are uninsured and not being marketed to by insurers or health agencies in any way.

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Image source: Flickr user Helga Weber.

Lastly, KFF asked uninsured adults if they thought they were personally required to have health insurance, or if the requirement didn't apply to them. Mind you, the individual mandate penalty is pretty clear that you need to purchase health insurance or face a penalty. Only 65% responded in the affirmative that they're required to have health insurance, with 27% suggesting it wasn't a requirement, or that it didn't apply to them, and another 8% refusing to answer. Keep in mind that some of those who said "no" (almost half of the aforementioned 27%) did so with the belief that they would qualify for an exemption from the shared responsibility payment. Nonetheless, the takeaway is that not everyone realizes they're supposed to be purchasing health insurance.

These apparent shortfalls suggest it could be extremely difficult to get the remaining uninsured consumers to enroll moving forward.

Setting things straight
The good news is that two of the aforementioned questions that seem to be baffling the uninsured can be answered with relative ease. Providing the correct answers could be the spark needed to get some of the remaining uninsured enrolled.

To begin with, as noted earlier, the enrollment deadline for coverage in 2016 is Jan. 31, 2016. This past week, HealthCare.gov, the federally run website that's operating on behalf of 38 states, extending its enrollment deadline for coverage to begin by Jan. 1, 2016 from Dec. 15 to Dec. 17. For many states the deadline for coverage beginning on Jan. 1 can vary from Dec. 15 to as late as Dec. 31. If you live in one of the 12 states that does operate its own exchange, you'll want to check the home page for your marketplace exchange for the exact cutoff date for January 2016 coverage.

Another important date you'll want to keep on your calendar if you haven't already enrolled is Jan. 15, 2016. This is the date you'll need to enroll by if you want your coverage to begin by Feb. 1, 2016. Any enrollments following this date, but before 11:59pm on Jan. 31, 2016, will start coverage by March 1, 2016.

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Image source: Flickr user Dafne Cholet.

As to whether or not consumers are required to purchase health insurance, the answer is they do indeed need to, otherwise they could be staring down a penalty in 2016 that's the greater of $695 or 2.5% of an individual's modified adjusted gross income. The Kaiser Family Foundation has estimated the 2016 penalty to be $969 per non-compliant household, up 47% from the estimated $661 shared responsibility payment in 2015. 

Now, it's important to remember that certain exemptions, such as low income, incarceration, or having a certain religious or tribal status, will exempt you from having to purchase health insurance. There's also a list of more than one dozen hardship exemptions that consumers may qualify for that'll negate the shared responsibility penalty.

One enrollment obstacle that's still not resolved
The one obstacle that could prove tricky to tackle is getting marketing and advertising information to the uninsured. The likely reason so few uninsured respondents have been approached about purchasing health insurance over the last six months is that Obamacare's margins have been considerably lower than expected for insurers.

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Image source: Flickr user Francisco Osorio.

UnitedHealth Group (NYSE:UNH), the nation's largest health insurance company, has pulled all of its Obamacare marketplace exchange advertising this year and threatened to leave the exchanges by as early as 2017. The reason? UnitedHealth simply hasn't make money on the plans it's selling via the exchanges. UnitedHealth specifically cited consumers' ease of switching plans, and higher than expected use of their insurance, as reasons why its costs have been higher than expected.

Compounding these problems, the risk corridor, or financial program designed to take funds from top-performing insurers on Obamacare to support excessive losses for insurers that priced their plans too low, is only delivering a fraction of the money some insurers expected. The lack of risk corridor funding is what put more than half of Obamacare's healthcare cooperatives out of business, and it could seriously hamper the competitive landscape moving forward.

In other words, if insurers don't feel as if Obamacare is improving their business model, they have no incentive to advertise to the uninsured. Ultimately, we may need to a see a structural fix to the rules governing money-losing plans on Obamacare, or we'll need to see stepped up action and/or spending on the part of the Department of Health and Human Services to make more consumers aware of their options when it comes to health insurance.

I've said it before, and I'll end on this note again: Obamacare still has as many (if not more) questions as answers.

Sean Williams has no material interest in any companies mentioned in this article. You can follow him on CAPS under the screen name TMFUltraLong, track every pick he makes under the screen name TrackUltraLong, and check him out on Twitter, where he goes by the handle @TMFUltraLong.

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