CHAMPAIGN, Ill. - Young adults in Illinois who recently obtained coverage under Illinois' expanded Medicaid program said they were unfamiliar with "Obamacare" and were unaware that their Medicaid benefits were related to the federal health care law, according to a new survey of community college students conducted by researchers at the University of Illinois.
Laura Payne, a faculty member in the College of Applied Health Sciences, and Marian Huhman, a professor in the department of communication, are leading a multidisciplinary research project that is examining community college students' awareness and attitudes toward health insurance and the Affordable Care Act.
About 850 students at six community colleges across Illinois participated in an online survey, and 24 students participated in focus groups that the researchers conducted in May and early June.
Like many of their counterparts across the nation, the Illinois students were foggy about Obamacare, especially essential benefits like the premium subsidies and the escalating penalties for noncompliance. However, half of the respondents said they had not seen, read or heard any media messages about health care reform, and almost as many (48 percent) said they opposed the ACA. The findings suggest that state officials will have to overcome both knowledge barriers and the "digital divide" to ensure that its uninsured residents comply with the ACA and obtain health insurance coverage.
"We chose community colleges as the basis for the study because these institutions typically don't offer students health insurance, like universities and four-year colleges do," said Payne, who is a professor of recreation, sport and tourism and a recreation specialist with the U. of I. Extension. "And community college students are part of that young adult group that is so important to enroll."
The average age of the survey participants was 26. Slightly more than half (56 percent) were single, and more than a third of them had one child or more.
The students are part of the "young invincibles" demographic - the healthy 18- to 34-year-olds who often forgo insurance coverage because they don't expect to get sick, but whose enrollment is critical to the success of the national health care program.
Many of the respondents said they found the federal portal, Healthcare.gov, confusing and difficult to use, and they gave up trying to enroll in a health plan after struggling with the website's technological glitches.
Some participants found the information about the various health plans so overwhelming and the enrollment procedures so daunting that they decided they would rather pay out of pocket for their health care costs than follow through with enrollment.
A man with a heart condition, whose girlfriend and baby had health insurance, said he preferred to stay on a payment plan with his own physician rather than "go through the gobbledygook of getting himself signed up," Payne said.
Providing knowledgeable personal assistants to help people understand their coverage options and guide them through the enrollment process may be critical to reaching these outliers who have not yet obtained coverage, the researchers said.
"Wisely, the ACA started out with that whole idea of trained assistants and navigators," Huhman said. "So one of the challenges for us is to make that happen on these community college campuses. We'll look at how feasible this is to do, what resources are available in the communities, and we'll make some recommendations. We hope to have people available that are trained to answer basic questions, and then send people to a local agency that has on-site navigators or to the Get Covered Illinois website, where they can find a trained navigator to assist them."
The open enrollment period for coverage during 2015 begins on Nov. 15, 2014, and the researchers plan to implement awareness campaigns on the U. of I. Extension website, social media and other media at the beginning of November.
The researchers currently are exploring the types of messages that resonate with this demographic group and are most likely to prompt them to obtain health insurance.
"We're finding that they are more moved to consider enrollment when the messages say that it's good for them personally, or that having coverage will make them feel more secure, independent and good about themselves," Huhman said.
The opinions of this demographic group's nearest and dearest seem to be particularly influential, however - "if mom says you should have insurance, for example," Huhman said.
Another challenge for Illinois will be reaching its uninsured populations living in rural communities who aren't computer savvy or who lack Web connectivity.
The researchers hope that the community college students will be "really good ambassadors that carry the educational information upstream to other family members that may be uninsured," Payne said.
The study is one of seven projects to receive funding through the U. of I. Extension and Outreach Initiative, which is expanding the Extension's programming beyond the College of
Agricultural, Consumer and Environmental Sciences to collaborative projects with other campus units and researchers. The $1.2 million initiative is a partnership among ACES, the Extension and the
Office of the Provost.