The "Millenials" poll out earlier this week showing (among other things) younger people unenthusiastic about the ACA has sparked a fair amount of discussion, but there's one particular point I haven't seen made. I'm highly suspicious of the reported finding that only a third of the uninsured from ages 18 through 29 intend to enroll through the exchanges.
There are just too many things out there for me to believe that there's any kind of predictable relationship between what they tell a pollster and what they'll actually do.
Let's see...first of all, I'm pretty skeptical about asking the younger part of this cohort about personal intentions with regard to health insurance at all. Perhaps I find it hard to put myself in their shoes, since I was a full-time college student at that age and from a middle class family; I didn't have to think about health insurance at all until after graduation. At any rate, for those at ages 18 through 25, the survey asked what they would do "after you are no longer eligible to stay on your parents plan." As far as I can tell from the survey, that was used for everyone in that age range, regardless of whether they had insurance on a parent plan now. If that's case, then I'd suggest it's totally meaningless what a 18 year old tells a pollster she expects to do about obtaining health insurance over five years into the future.
And then there's the question of what they're signing up for. The poll used a split sample to ask about both "Affordable Care Act" and "Obamacare," which is great. But there's no mention of Healthcare.gov in either case; instead, it refers to only "government-run exchanges." I'm really not confident that most young people know what that means -- or that they would need to in order to sign up. Then there's the issue of the state-run exchanges; people in Kentucky or California may believe that they're not signing up for "Obamacare" at all. It's also true, although again there's no way to know how it affects polling responses, that a fair number of uninsured young people will be eligible for expanded Medicaid. Would they say they are planning on using "government-run exchanges" or not? That's not even figuring out what to think about those who would be eligible for Medicaid but have the bad luck to be in Texas or some other state that didn't participate.
One more thing: even for those who are eligible for the exchanges now and understand what they are, it's still not clear how well what they tell pollsters of their intentions will match what they eventually do. Some may say they intend to sign up but then never get around to it, or start shopping and then decide it's a bad deal for them. Others may not intend to and then find out that subsidies make it a good deal.
My guess is that for most young people, at some point they'll confront the question of "how do I get health insurance?" for the first time -- in many cases, because a parent is nagging them about it -- and unless they have employment-linked coverage, the answer is going to be to go to Healthcare.gov or their state exchange. And, yeah, it won't really feel like signing up for Obamacare; it's just going to be how you get (private) health insurance.
Which, I should add, is not a prediction about how many will sign up and at what age, and how that will affect the overall pool (and thus the degree to which the ACA exchanges work or don't work).
At any rate, I don't think the poll tells us anything about what young people are going to do when they get to that point of seeking insurance. General point: be very suspicious any time people answer polling question about intentions they might not have had until they were asked. Ignore those polls!