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Flying Solo: Why Uninsured Coloradans Go Without Health Insurance

The big question of the hour – not to mention the day, the month and the year – is how to encourage the hundreds of thousands of Coloradans who remain uninsured to sign up for health insurance during open enrollment beginning November 15.

Round Two of the Affordable Care Act (ACA) holds special challenges.

Many of the people most likely to enroll, including the 55- to 64-year-old age group as well as those with known health conditions, were quick to sign up during the first open enrollment ending April 15. The most resistant enrollees – those who believe they can’t afford health insurance as well as those who just don’t think they need it – remain to be convinced. And the second open enrollment period, at three months, is half as long as the first.

A new research brief based on data from the Colorado Health Access Survey (CHAS), Flying Solo: Why Uninsured Coloradans Go Without Health Insurance,” is a great new resource that can help Colorado’s enrollment leaders gain a better understanding of the reasons surrounding uninsurance.

Research Analyst Natalie Triedman analyzed the data and wrote the report. Her work joins two research papers commissioned by the Colorado Health Foundation, which were published last month: “Culture of Coverage: Audience Research and Message Testing Among Uninsured Coloradans” and “Barriers to Enrollment in Health Coverage in Colorado.” You can find those research papers here.

Together, the new research provides invaluable data to help Colorado best target its enrollment efforts.

The CHAS, a survey of 10,000 Colorado households that delves deeply into issues around health insurance coverage, provides a unique understanding of the reasons Coloradans don’t have health insurance.

Far and away, the biggest barrier is cost. Four of five uninsured residents say they don’t have coverage because it costs too much. No surprises there, but it speaks to the importance of affordability, as well as communicating the value of health insurance.

The second most common reason for being insured was that a person lost their job or changed employers. This is an example of what health policy experts call “churn,” which can mean losing insurance, gaining coverage after being uninsured, or switching between plans. This will be important to understand and address moving forward.

The most dramatic change in reasons cited for being uninsured came from uninsured Coloradans who said they don’t need health insurance. The percentage more than doubled between 2009 and 2013, increasing from 11.1 percent to 24.9 percent, the biggest shift among the reasons cited. This could reflect a number of factors, including objections to “Obamacare” and its individual mandate.

Here at the Colorado Health Institute, we will continue to monitor how national and state health reform efforts impact the state’s residents.