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Can Obamacare Lure the Uninsured?

Can Obamacare Lure Uninsured AmericansThe Henry J. Kaiser Family Foundation conducted a poll in February that shows 56% of the uninsured had an unfavorable view of the Affordable Care Act (ACA), more widely known as Obamacare. Only 22% of the uninsured view it favorably.  The legislation is now viewed less favorably among the uninsured than it was in October, when enrollment via the Exchanges began.

In fact, the uninsured view the ACA less favorably than does the general public, 35% of which approve of the law. This is problematic when the Obama administration is trying to get a sufficient number of Americans to enroll before the March 31 deadline.

While the ACA is supposed to focus on three pillars of health care — increasing access, decreasing costs and improving quality — many Americans perceive that Obamacare is primarily about covering the uninsured. If this population is opposed to the ACA, achieving widespread support for the law will be challenging.

Trying to gain advocacy among the uninsured

President Obama, Vice President Biden, and Health and Human Services Secretary Kathleen Sebelius are actively promoting the ACA across the country and media outlets. Organizations like Enroll America and Organizing for Action have mobilized to drive grassroots support for the legislation and its programs. 

They face an uphill battle, as the Kaiser poll found that 25% of the uninsured know nothing about the Health Insurance Exchanges, and 60% of the uninsured do not know that March 31 is the last day in 2014 to obtain health insurance before financial penalties kick in for violating the law’s individual mandate.

Much of this would seem counter-intuitive, as many of the uninsured would be heavily subsidized for their health insurance coverage.  Why wouldn’t people want to have valuable health insurance, in many instances at low or no cost?

The disastrous rollout of did not help engender trust for the program, to be sure. All the media attention and negative publicity would cause understandable wariness.

Perhaps, though, many uninsured do not see a relevant and prioritized benefit. The administration may not be selling Obamacare effectively, because they are using the wrong messages. 

The uninsured are heavily skewed toward one psychographic segment

c2b solutions identified five, distinct psychographic segments among consumers based on their attitudes and motivations regarding health and wellness. The Willful Endurer segment is clearly over-represented among the uninsured, followed by Balance Seekers:

c2b psychographic segments uninsured americans

Willful Endurers are the most reactive, and least engaged, of the segments when in come to health care. They generally live in the here-and-now and do not invest in their future wellness. Telling an uninsured Willful Endurer that having health insurance is a great idea “in case something happens,” or that it will allow them to get preventive care, are not motivating propositions.

The most challenging consumer segment CAN be motivated to act

c2b solutions has demonstrated that segment-specific messaging can motivate behavior change, even among the most challenging consumer segments like the Willful Endurer. Each segment has its own preferred set of propositions, wording and influential information sources, and efforts against any segment will be suboptimal without delivering against these preferences. 

The new era of health care consumerism requires health care organizations to appeal to consumer motivations to improve medical outcomes and patient satisfaction. Importantly, Willful Endurers are not just among the uninsured; this psychographic segment represents 27% of the general population. Health insurance companies, Accountable Care Organizations (ACOs) and other providers managing risk have a vested interest in driving positive behaviors among this population.

The good news is that it can be accomplished.

Psychographic Segmentation and its Practical Application in Patient Engagement and Behavior Change


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