Aug. 21—Only about one-quarter of the young adults needed to ensure successful launches of health insurance marketplaces next year are even aware of them, according to a new survey.

A spring survey of 19- to 29-year-old young adults released Aug. 21 by the liberal Commonwealth Fund found 27 percent were familiar with health insurance marketplaces, formerly known as exchanges, and knew that enrollment in the marketplaces would begin Oct. 1. But 70 percent were unaware of the marketplaces, which were authorized by the Affordable Care Act to sell individual and small group insurance plans in each state. Exchange awareness generally declined with income.

“The survey findings demonstrate just how critical outreach and education will be to inform young adults about their new options,” a report on the survey results stated.

Taking a Closer Look

The Obama administration and several allied outside organizations launched enrollment initiatives this summer aimed at increasing awareness of the exchanges and expanded Medicaid access that will begin in many states next year.

Enrollment of so-called young invincible aduilts in exchange plans is widely viewed by health policy experts as critical to ensuring the financial viability of the insurance products. The premiums of millions of healthy enrollees are expected to offset the cost of insuring seriously ill enrollees, for whom the federal law barred many previous underwriting practices.

Survey findings indicate that many young adults want employer-sponsored insurance, even if they are aware of the insurance marketplaces. Specifically, the survey found two-thirds of young adults who were offered health insurance coverage through an employer accepted it.

“There is a stereotype that young adults believe they are 'invincible' and don’t want or need health insurance," Sara Collins, Ph.D., vice president, Commonwealth Fund and the study’s lead author, said in a  release. “This survey shows that is a myth.”

The survey also found the incomes of 82 percent of the 15.7 million young adults who were uninsured at some point in 2013 would qualify them for either subsidized marketplace coverage or coverage through expanded Medicaid eligibility.

However, at least 21 states are not moving forward with expanding their Medicaid eligibility to all residents with incomes of up to 138 percent of the federal poverty level (FPL), according to the Kaiser Family Foundation. In nonexpanding states, people with incomes from 100 percent to 138 percent of the FPL will be eligible for subsidized private health insurance through the new marketplaces. But the survey found up to 28 percent of young people could miss out on either marketplace or Medicaid coverage because their incomes are less than 100 percent of the FPL.

Publication Date: Wednesday, August 21, 2013