ECONOMIC SCIENCES Correction for “Preparedness of Americans for the Affordable Care Act,” by Silvia Helena Barcellos, Amelie C. Wuppermann, Katherine Grace Carman, Sebastian Bauhoff, Daniel L. McFadden, Arie Kapteyn, Joachim K. Winter, and Dana Goldman, which appeared in issue 15, April 15, 2014, of Proc Natl Acad Sci USA (111:5497–5502; first published March 24, 2014; 10.1073/pnas.1320488111).
The authors note that, due to a coding error, multiple sections of the article appeared incorrectly. The coding error caused income as percent of the Federal Poverty Line (FPL) to be calculated based on Alaska's guidelines for the entire sample of respondents, irrespective of the respondents' actual state of residence. As Alaska's guidelines are higher than those in all other states, too few respondents were classified as having income higher than 400% of the FPL. Correcting this error resulted in small changes to our numeric results and did not influence any of the main conclusions of the paper. The corrections to figures, tables and main text are listed below.
Figs. 3 and 4 appeared incorrectly. The corrected figures and their legends appear below.
Fig. 3.
ACA subjective and objective knowledge. Point estimates of odds ratios and 95% confidence intervals after logit estimation, full models are displayed in columns 1 and 2 of SI Appendix, Table A1. An odds ratio smaller than 1 indicates that people who have the stated condition are less likely to score above the median on ACA knowledge questions than people who do not have the stated condition when everything else is equal.
Fig. 4.
Health insurance subjective and objective knowledge. Point estimates of odds ratios and 95% confidence intervals after logit estimation, full models are displayed in columns 3 and 4 of SI Appendix, Table A1. An odds ratio smaller than 1 indicates that people who have the stated condition are less likely to score above the median on health insurance knowledge questions than people who do not have the stated condition when everything else is equal.
The authors also note that Tables 1, 2 and 3 appeared incorrectly. The corrected tables appear below.
Table 1.
Descriptive statistics
| Variable | ALP (%) | CPS (%) |
| Health Insurance | ||
| Yes | 81 | 79 |
| No | 19 | 21 |
| Income | ||
| <100% of FPL | 18 | 16 |
| 100-250% of FPL | 27 | 26 |
| 251-400% of FPL | 20 | 22 |
| >400% of FPL | 35 | 36 |
| Education | ||
| No degree | 11 | 12 |
| High school or equivalent degree | 28 | 29 |
| Some college | 20 | 20 |
| Associate degree | 10 | 10 |
| Bachelor's degree | 20 | 19 |
| More than Bachelors' degree | 10 | 10 |
| Gender | ||
| Male | 49 | 49 |
| Female | 51 | 51 |
| Age | ||
| Younger than 26 | 15 | 18 |
| 26-44 | 41 | 40 |
| 45 and older | 44 | 42 |
| Marital Status | ||
| Not married | 37 | 47 |
| Married | 63 | 53 |
| Race | ||
| White | 75 | 78 |
| Nonwhite | 25 | 22 |
| Ethnicity | ||
| Non-Hispanic | 79 | 84 |
| Hispanic | 21 | 16 |
| Health | ||
| Excellent/very good/good | 86 | 88 |
| Fair/poor | 14 | 12 |
| State of residence | ||
| Red state in 2012 election | 38 | 38 |
| Blue state in 2012 election | 62 | 62 |
| Federal exchange | 51 | 54 |
| State exchange | 37 | 36 |
| Partnership exchange | 12 | 11 |
| State likely to expand Medicaid | ||
| Yes | 58 | 54 |
| No | 42 | 46 |
| Number of observations | 3,414 | 122,296 |
Weighted averages using ALP survey 356 and 2012 March CPS, individuals younger than 65.
Table 2.
Knowledge about the Affordable Care Act, health insurance, and financial literacy
| Income in % of FPL | ||||||
| All (%) | Uninsured (%) | <100 (%) | 100–250 (%) | 251–400 (%) | >400 (%) | |
| Knowledge about Affordable Care Act (ACA) | ||||||
| Knows a great deal/fair amount | 24 | 17 | 16 | 18 | 26 | 33 |
| Average number correct ACA knowledge questions | 4.46 | 3.26 | 2.57 | 3.76 | 4.68 | 5.85 |
| More than median correct ACA knowledge questions | 50 | 34 | 24 | 39 | 55 | 68 |
| Has heard of healthcare reform | 78 | 64 | 51 | 72 | 86 | 93 |
| Knows about new exchanges | 51 | 36 | 33 | 42 | 48 | 68 |
| Knows about penalty | 63 | 52 | 41 | 59 | 69 | 75 |
| Knows about subsidy | 46 | 31 | 27 | 39 | 48 | 60 |
| Health Insurance Literacy | ||||||
| Strongly agrees to be confident in financial matters | 46 | 34 | 24 | 41 | 46 | 61 |
| Strongly agrees to be good at mathematics | 28 | 25 | 21 | 25 | 26 | 35 |
| Average number correct HI knowledge questions | 4.84 | 3.70 | 3.06 | 4.44 | 5.22 | 5.84 |
| More than median correct HI knowledge questions | 49 | 27 | 15 | 35 | 57 | 72 |
| Can describe a deductible | 58 | 42 | 27 | 51 | 66 | 76 |
| Knows about deductible/premium trade-off | 61 | 42 | 29 | 51 | 70 | 80 |
| Knows that HMO greater provider restriction than PPO | 38 | 19 | 19 | 27 | 37 | 56 |
| Average expected changes in health care | ||||||
| Family will be better off (1), no change (0), worse off (−1) | −0.23 | −0.09 | −0.08 | −0.16 | −0.32 | −0.30 |
| Average Index for different dimensions | −1.44 | −0.83 | −0.73 | −1.24 | −1.72 | −1.79 |
| Expects access to care to increase (1), stay unchanged (0), decrease (−1) | −0.23 | −0.05 | −0.03 | −0.13 | −0.34 | −0.34 |
| Expects waiting times decrease (1), no change (0), increase (−1) | −0.36 | −0.28 | −0.24 | −0.31 | −0.39 | −0.43 |
| Expects quality of care increase (1), no change (0), decrease (−1) | −0.25 | −0.13 | −0.07 | −0.23 | −0.30 | −0.32 |
| Expects out-of-pocket decrease (1), no change (0), increase (−1) | −0.33 | −0.18 | −0.20 | −0.31 | −0.34 | −0.40 |
| Expects ER costs decrease (1), no change (0), increase (−1) | −0.28 | −0.19 | −0.19 | −0.26 | −0.34 | −0.31 |
| Number of observations | 3414 | 698 | 781 | 1003 | 634 | 996 |
| Financial Literacy (FL) | ||||||
| Numeracy | 85 | 71 | 66 | 82 | 83 | 95 |
| Inflation | 73 | 55 | 41 | 64 | 77 | 87 |
| Risk diversification | 62 | 42 | 33 | 48 | 63 | 81 |
| Average FL Index | 2.20 | 1.68 | 1.39 | 1.94 | 2.23 | 2.63 |
| Number of observations | 2246 | 401 | 398 | 638 | 458 | 752 |
ALP survey 356, individuals younger than 65, raking weights used. Financial literacy is only available for a subset of respondents that have also answered ALP survey 243. FL index is the sum of correct answers to the three financial literacy questions.
Table 3.
Expected changes due to health reform
| Specific Dimension | Overall | |||
| OLS | Ordered Logit | OLS | Ordered Logit | |
| (1) | (2) | (3) | (4) | |
| No health insurance | 0.350*** (0.103) | 0.283*** (0.082) | 0.114*** (0.032) | 0.311*** (0.088) |
| Income <100% of FPL | 0.334** (0.134) | 0.228** (0.109) | 0.071* (0.040) | 0.196* (0.117) |
| Income 100–250% of FPL | 0.178 (0.112) | 0.106 (0.091) | 0.060* (0.034) | 0.160 (0.098) |
| Income 251–400% of FPL | 0.008 (0.114) | −0.018 (0.094) | −0.010 (0.034) | −0.028 (0.101) |
| Younger than 26 | 0.262* (0.156) | 0.264** (0.130) | −0.111** (0.046) | −0.270* (0.139) |
| 26–44 | 0.059 (0.082) | 0.041 (0.067) | −0.025 (0.025) | −0.058 (0.072) |
| Female | −0.016 (0.077) | −0.018 (0.063) | 0.004 (0.024) | 0.021 (0.069) |
| Not married | 0.339*** (0.080) | 0.279*** (0.066) | 0.094*** (0.025) | 0.272*** (0.072) |
| Nonwhite | 0.579*** (0.089) | 0.452*** (0.075) | 0.318*** (0.028) | 0.891*** (0.081) |
| Hispanic | 0.452*** (0.097) | 0.348*** (0.080) | 0.188*** (0.030) | 0.557*** (0.086) |
| No degree | −0.200 (0.175) | −0.205 (0.159) | −0.211*** (0.059) | −0.598*** (0.173) |
| High school or equivalent | −0.363*** (0.139) | −0.307*** (0.117) | −0.240*** (0.043) | −0.672*** (0.127) |
| Some college | −0.529*** (0.130) | −0.469*** (0.108) | −0.207*** (0.040) | −0.575*** (0.116) |
| Associate degree | −0.721*** (0.154) | −0.616*** (0.123) | −0.210*** (0.045) | −0.573*** (0.131) |
| Bachelor's degree | −0.456*** (0.130) | −0.402*** (0.107) | −0.123*** (0.041) | −0.351*** (0.115) |
| Fair/poor health | 0.037 (0.107) | 0.035 (0.087) | 0.010 (0.033) | 0.035 (0.093) |
| State likely to expand Medicaid | 0.155 (0.130) | 0.111 (0.109) | 0.109** (0.042) | 0.311*** (0.120) |
| Federal exchange | −0.233* (0.127) | −0.157 (0.107) | −0.030 (0.042) | −0.087 (0.118) |
| Partnership exchange | −0.416*** (0.131) | −0.308*** (0.108) | −0.184*** (0.040) | −0.504*** (0.119) |
| Blue state in 2012 election | 0.341*** (0.097) | 0.291*** (0.080) | 0.120*** (0.030) | 0.359*** (0.087) |
| Constant | −1.734*** (0.181) | −0.316*** (0.058) | ||
| Number of observations | 3414 | 3414 | 3414 | 3414 |
Coefficients and SEs after OLS and ordered logit estimation respectively. Estimates of cutpoints for ordered logit models not reported. Columns 1 and 2 use an index that averages information on expected changes in five different dimensions (access to care, quality of care, waiting times, out-of-pocket costs, and costs for emergency care) as dependent variables. The index counts 1 for improvement, 0 for no change, and −1 for deterioration. Columns 3 and 4 use expected overall changes for the family as dependent variables. 1 indicates that family will be better off, 0 not much change, and −1 that family will be worse off. *P < 0.10, **P < 0.05, ***P <0.01.
The authors also note that, in the Abstract, the following text appears incorrectly: in lines 12–15, “correctly answered, on average, 4 out of 11 questions about health reform and 4.6 out of 7 questions about health insurance. This compares with 6.1 and 5.9 correct answers” should instead appear as “3.8 out of 11 questions about health reform and 4.4 out of 7 questions about health insurance. This compares with 5.9 and 5.8 correct answers;” and in line 16, “a low-income person is 31% less likely” should instead appear as “a low-income person is 33% less likely.”
Also, on page 5499, right column, the first full paragraph should instead appear as: “Table 1 presents weighted descriptive statistics of the ALP sample; column 2 presents similar statistics using the 18–64 sample from the 2012 March CPS. Eighteen percent of the sample had incomes below 100% of the FPL and are likely eligible for Medicaid, 47% had incomes 100–400% of FPL and may be eligible for subsidies in the exchanges, and 19% were uninsured. Overall, the figures in our ALP sample correspond well to those in the CPS. The only exception is marital status, for which the discrepancies might be explained by differences in survey questions. While the ALP question includes cohabitating partners as married, the CPS does not include them.”
Also, on page 5500, left column, second full paragraph, lines 5–12 “Approximately 58% of those earning 100–250% of FPL have not heard about the exchanges or subsidies, and 44% do not know or have an incorrect understanding of the relationship between deductibles and premiums. Those earning 100–250% of FPL correctly answered, on average, 4 out of 11 questions about health reform and 4.6 out of 7 questions about health insurance. This compares with 6.1 and 5.9 correct answers, respectively, for those in the top income category (P = 0.00)” should instead appear as “Approximately 60% of those earning 100–250% of FPL have not heard about the exchanges or subsidies, and 59% do not know or have an incorrect understanding of the relationship between deductibles and premiums. Those earning 100–250% of FPL correctly answered, on average, 3.8 out of 11 questions about health reform and 4.4 out of 7 questions about health insurance. This compares with 5.9 and 5.8 correct answers, respectively, for those in the top income category (P = 0.00).”
Also, on page 5500, left column, fourth full paragraph, the following text appears incorrectly: lines 11–15 “A person in the lowest income category is 53% less likely to score above the median on ACA knowledge than a person in the top income category [odds ratio (OR) = 0.47, P = 0.00]; this figure is 31% (OR = 0.69, P = 0.00) for a person with income 100–250% of FPL” should instead appear as “A person in the lowest income category is 54% less likely to score above the median on ACA knowledge than a person in the top income category [odds ratio (OR) = 0.46, P = 0.00]; this figure is 33% (OR = 0.67, P = 0.00) for a person with income 100–250% of FPL;” and in lines 22–23 “20% less likely (OR = 0.80, P = 0.05)” should instead appear as “21% less likely (OR = 0.79, P = 0.08).”
Also, on page 5500, right column, second full paragraph, lines 4–10 “The odds of scoring above the median on health insurance knowledge questions are 70% lower for an individual in the bottom income category (OR = 0.30, P = 0.00), 54% lower for an individual at 100–250% of FPL (OR = 0.46, P = 0.00), and 26% lower for an individual at 251–400% of FPL (OR = 0.74, P = 0.05), relative to an individual in the top income category” should instead appear as “The odds of scoring above the median on health insurance knowledge questions are 74% lower for an individual in the bottom income category (OR = 0.26, P = 0.00), 54% lower for an individual at 100–250% of FPL (OR = 0.46, P = 0.00), and 31% lower for an individual at 251–400% of FPL (OR = 0.69, P = 0.00), relative to an individual in the top income category.”
Also on page 5500, right column, third full paragraph, lines 14–17 “Two exceptions are the results using the questions on plan standardization and benefits for undocumented immigrants, where income and education (the latter only in the case of the standardization question) do not predict knowledge” should instead appear as “Two exceptions are the results using the questions on plan standardization and benefits for undocumented immigrants, where income does not predict knowledge.”