Three-quarters of Americans without health insurance are likely to obtain coverage starting in 2014, according to a new survey by the health and life sciences practice of Oliver Wyman. In all, the Patient Protection and Affordable Care Act seems on track to reduce the uninsured to 5% of the population.

Under PPACA, roughly 33 million Americans will be required to purchase health insurance for themselves. Many will receive federal subsidies, and those who choose not to obtain coverage will pay a penalty. The study looked not just at whether this group will buy, but also at what kind of coverage they would buy and what drives their decisions.

A key part of the survey was a series of personalized, realistic choice scenarios. Participants were presented various fictional insurance policies with prices that were actuarially valid and reflected ACA subsidies for the participants’ actual income levels. Participants could also elect not to buy insurance and instead pay the penalty appropriate for their income.

Overall, 76% of respondents chose to purchase insurance.

“Our research shows that uninsured Americans overwhelmingly see value in coverage,” says Terry Stone, a partner in Oliver Wyman’s health and life sciences practice and one of the authors of the study. “But few really understand their options or even what a health care exchange is. They need to be educated.”

The uninsured are also price-sensitive. This means that subsidies will play a major role in keeping consumers in the program. Interestingly, if falling subsidies drive consumers back to the ranks of the uninsured, middle-income consumers will suffer more than poor consumers.

Consumers are ready to make tradeoffs to get the kind of coverage they want and need at a price they can afford—paying more for convenience and access, or agreeing to lifestyle changes for a discount.

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