QuickTake: Another ACA Knowledge Gap: Many Uninsured Do Not Know about Requirement to Report Health Insurance Status


Adele Shartzer, Genevieve M. Kenney, Sharon K. Long, and Stephen Zuckerman

April 13, 2015


Although the Affordable Care Act (ACA) was passed five years ago, there is still much confusion about some of the law’s basic requirements. For example, in December 2014, more than 4 in 10 uninsured adults had heard little or nothing about the tax penalty they could face for not having health insurance coverage (Karpman, Kenney, Long, and Zuckerman 2015). Concerns over findings such as this led the federal government and most states to set up a special enrollment period, allowing the uninsured who became aware of the penalty when they prepared their 2014 tax returns to enroll and avoid additional penalties for 2015. As of March 29, 2015, only 36,000 individuals have taken advantage of this option, but that could change as the tax deadline approaches.1


According to information collected in early March 2015,2 just over half (52.3 percent) of uninsured nonelderly adults expected to file a 2014 federal income tax return, 22.3 percent said they did not plan to file, and 23.2 percent were not sure whether they would file (figure 1).  Among the uninsured adults who may file a federal tax return, 28.8 percent said they had heard nothing at all about the requirement to report insurance coverage status when they file, 18.7 percent said they had heard a little about the requirement, and 50.0 percent said they had heard some or a lot about it. These findings add to the growing body of evidence that even after five years and almost two complete open enrollment periods, there is a continued need for outreach and education efforts to improve awareness of some of the ACA’s basic features. 






Michael Karpman, Genevieve M. Kenney, Sharon K. Long, and Stephen Zuckerman. 2015. “QuickTake: As of December, Many Uninsured Adults Were Not Aware of Tax Penalties for Not Having Coverage, the Marketplaces, or the Open Enrollment Deadline.” Washington, DC: Urban Institute.


About the Series


This QuickTake is part of a series drawing on the HRMS, a quarterly survey of the nonelderly population that explores the value of cutting-edge Internet-based survey methods to monitor the ACA before data from federal government surveys are available. Funding for the core HRMS is provided by the Robert Wood Johnson Foundation and the Urban Institute.


For more information on the HRMS and for other QuickTakes in this series, visit www.urban.org/hrms.



1 Centers for Medicare and Medicaid Services, “Fifteen Days Remain before Tax Filing Deadline,” press release, April 1, 2015.

2 Over 90 percent of respondents to the March HRMS had completed the survey by March 14, 2015.



Urban Institute Robert Wood Johnson Foundation