By Jhanidya Bermeo
Nearly a month has passed since open enrollment in the Health Insurance marketplaces, as stipulated by the Patient Protection and Affordable Care Act (ACA), began. During this month, the ACA was the center of a political battle that resulted in a 16-day long government shutdown and a threat of default on public debt. Although the ACA survived this battle, the controversy continues as the Health Insurance marketplace has been plagued with glitches since its inauguration, preventing many from receiving information and signing up for health insurance. This Public Opinion Monthly takes a look at the public’s view of the Act before and after Oct 1st, as well as opinion on federal government intervention in health care and beliefs surrounding the ACA’s perceived impact on women, the poor and immigrants.
The American public has closely followed news regarding the government shutdown and debt limit increase, as well as news on the opening of the Health Insurance marketplaces. A national survey conducted by Pew Research shows that 65% of those polled in October were aware of the health insurance exchange in their state. The survey also indicates a poor initial impression of the marketplaces, with 49% of respondents expressing that they were working not too well or not at all well.
Americans have been long split in their opinion of the Affordable Care Act. Trend data from Gallup shows that, although the majority of Americans polled continue to view the ACA negatively (50%), there was a four percentage point increase in approval of the ACA after the government shutdown (45% approve compared to 41% in August). Although increase among all voters is rather small, there was a large shift among Democratic voters: 12% more of the latter approved of the ACA than they did in August bringing support to 83% compared to previously 71%. Given how politicized views of the ACA have been all along, it is likely that the government shutdown rallied Democratic support behind President Obama's signature legislation. A survey by Brookings Institution found similar partisan differences.
Do you generally approve or disapprove of the 2010 Affordable Care Act, signed into law by President Obama that restructured the U.S. health care system?
Source: Gallup Poll, October 2013
Similarly, the American public is divided in their views on federal government intervention in healthcare in general, with polls showing slightly higher opposition. A survey conducted by the Kaiser Family Foundation found that when asked what kind of role the federal government should play in healthcare, the majority indicated the government should play a minor role or no role (53%). An earlier 2012 telephone interview by Gallup asked respondents whether they believed it is the federal government’s responsibility to ensure health coverage for all Americans. Of those polled, 44% held it is the government’s responsibility and 54% held it was not the government’s responsibility.
When it comes to making the health care system in America work well, do you think the federal government should play a major role, a minor role or no role?
Source: Kaiser/Harvard/Robert Wood Johnson Foundation, January 2013
The Affordable Care Act seeks to expand health insurance coverage and benefits for women by ending coverage discrimination based on gender and increasing the number of women’s health services included in insurance packages. A poll by Democracy Corps indicates that knowledge of these provisions increases support for the Affordable Care Act, with 57% of likely voters interviewed stating they were “much more supportive” or “somewhat more supportive” of the Act.
[…] please tell me whether it makes you much more supportive of Obamacare, somewhat more supportive, a little more supportive, no more supportive, or less supportive of Obamacare... Women can't be charged more than men. Having a baby is no longer considered a pre-existing condition. All plans must cover preventive health services, mammograms and contraception. This coverage is long overdue and a big deal for women.
Source: Democracy Corps/Women's Voices, Oct 2013
The ACA also seeks to increase access to insurance coverage for low-income individuals and families by expanding Medicaid. Data from the Kaiser Health Tracking poll indicates that 50% of interviewed adults in April 2013 believed Medicaid should be expanded to cover low-income people in their state, while 41% believed it should not be expanded. Twenty-six states have declined to participate in the Medicaid expansion, as allowed by a 2012 Supreme Court ruling, thus making many poor Americans ineligible for health insurance. Despite this, when asked if the ACA will “make things better or worse” for the poor, the majority of those interviewed by the Congressional Connection Poll believe that health care reform will make things better for the poor, if not for anyone else. The Congressional Connection Poll also indicates that minorities are more likely to believe the ACA will positively impact groups including the poor as opposed to Whites.
Americans hold misconceptions about the Affordable Care Act, in particular about the ACA’s impact on undocumented immigrants. A survey conducted by Pew Research in 2009 asked respondents whether undocumented immigrant coverage was a major reason, minor reason or not a reason to oppose health care reform. A whopping 87% of those interviewed indicated it was a reason for their opposition. While undocumented immigrants are not eligible for Medicaid coverage or private insurance tax credits, high numbers of Americans believe that they are. A survey conducted by the Henry J. Kaiser Foundation finds that, of the national adults interviewed, 42% believe undocumented immigrants are eligible for Medicaid under the ACA and 42% believe undocumented immigrants can receive financial help to purchase insurance.
[…] to the best of your knowledge, would you say the health care law does or does not...allow undocumented immigrants to enroll in the Medicaid program?
Source: Kaiser Health Tracking, Feb 2013