The health exchanges created by the Affordable Care Act are scheduled to start enrolling participants in October.  Many believe the success of the ACA is largely dependent on the success of these new marketplaces. Many hope the exchanges will work like Orbitz or Travelocity – allowing consumers to compare plans and prices, and choose the one that fits their needs. But others are skeptical the exchanges will ever enroll enough participants to drive down the cost of quality care.

To understand some of the challenges these exchanges face in enrolling participants, Resonate analyzed the extensive dataset of individual motivations to gain consumer understanding and deliver targeted online media.


Few Uninsured Intend To Purchase Care Through The Exchange, For Now: Though enrollment begins in just two months, only a fifth (22%) of all uninsured report that they plan to purchase care through the exchanges. More (27%) are wholly unaware of the health exchanges.

Two highly sought-after groups within the uninsured bloc are even less likely to be aware of the exchanges; a third of non-white uninsured consumers (33%) and nearly as many uninsured under 35 (30%) are unaware of the exchanges.

Awareness of the exchanges will no doubt increase as states roll out large, targeted media campaigns to enroll participants. Resonate will conduct further research in October (and will be delivering media targeted to this group throughout) as enrollment ramps up. However, the current data is a stark reminder of the difficult challenges these new marketplaces face.

Affordability Prohibits Most From Purchasing Coverage: Pluralities of uninsured consumers cite inability to afford coverage as the reason they lack insurance (37%). Far fewer go without coverage because they feel they don’t need it (8%) or are in-between plans due to a lost, or changed, job (10%). Importantly, cost is the top reason those under 35 (35%), non-white consumers (34%) and uninsured families (38%) lack coverage.

Relative To Consumers Overall, The Uninsured Are More Likely To Consider Convenience and Self-Image When Making Purchases, And Less Likely To Consider Their Health:  Cost is only part of the equation. The uninsured are 29% more likely than consumers overall to purchase products they perceive help them portray a personality attractive to others. 27% of uninsured choose convenience as their primary purchase orientation while 15% of insured choose convenience as their primary purchase orientation.

Meanwhile, and perhaps intuitively, the uninsured are less likely than consumers overall to make a purchase because it contributes to a healthy lifestyle (24% less likely).

Little Evidence Younger Consumers Lack Coverage Because They Believe Themselves To Be “Invincible”: Younger uninsured consumers have long been touted the saviors of the exchanges. Theoretically, these consumers will pay into the system, but request little in return. Conventional wisdom has us believe the true challenge is convincing these consumers they actually need care. After all, they believe themselves to be “invincible.”

But the data tells a different story. Young people lack care due to cost, just like the uninsured overall. Among those under 35 (18-34), a plurality (35%) say they lack care due to cost. Far fewer (11%) report they lack insurance because they feel they don’t need it. Even among younger men, 31% report being uninsured due to affordability. Less than half that (12%) feel they don’t need coverage.