Americans have mixed perceptions about the Affordable Care Act (ACA), responding in significantly different ways to various questions about the federal health-care law, according to a new study by the Kaiser Family Foundation (KFF).
Most provisions of the ACA have gone into effect, but many people are still unsure of whether the reform is positive. Forty-one percent of people responding to the KFF poll said they view the law favorably, compared with 46 percent viewing it unfavorably.
People’s opinions of the ACA change drastically when responding to questions about specific provisions of the law, indicating that although Americans may not like the idea of Obamacare, they steadfastly support many of the specific reforms put in place by the law.
The survey also found that views of Obamacare aren’t fixed, and that, given more information, people seem to like the law more.
Sex. Abortion. Parenthood. Power.
The latest news, delivered straight to your inbox.
More than two years after the Supreme Court largely upheld the ACA, the only major provision of the law that hasn’t taken effect is the employer mandate, which will require businesses with more than 100 employees to offer those workers basic health insurance.
That provision will finally take effect in early 2015, and the public largely supports the measure; 60 percent of Americans favor the employer mandate and 38 percent do not, according to the KFF survey.
Opinion of the employer mandate is also not static, showing that the way in which the provision is portrayed greatly affects its popularity. When given the statement that “most employers with 100 or more workers already offer health insurance and won’t have to pay the fine” reserved for those who don’t satisfy the federal mandate, the number of respondents in favor of the provision increased by more than 15 percent.
When given the statement that “some employers are moving some workers from full time to part time to avoid paying the fine,” the number of people with an unfavorable opinion increased by 30 percent.
The individual mandate, which went into effect this year, is by far the most unpopular provision of the ACA, with 35 percent of the American public saying they have a positive opinion of it, according to the poll. In comparison, 75 percent of the public favors Medicaid expansion, 76 percent favors insurance subsidies, and 78 percent favors the creation of online health insurance exchanges—all central pieces to the ACA, which is being actively undermined in red states like Missouri.
But like the employer mandate, opinion of the individual mandate is malleable, and when given specific statements that qualify the mandate, people’s opinions change.
For example, when asked to consider, “Most Americans still get coverage through their employers or a public insurance program” and, “People would not be held to this requirement if the cost of coverage would consume too large a share of income,” many of the people who previously opposed the individual mandate said they felt positively about it.
When provided the statement, “Requiring all Americans to have health insurance could mean that some people would be required to buy health insurance that they find too expensive or did not want,” 15 percent of those with a previously favorable opinion said they felt negatively about the mandate.
Political scientist Jonathan Bernstein wrote last week that people’s view of President Obama largely determines the way they perceive the signature achievement of his presidency. It shouldn’t surprise policymakers that voters support most elements of the health-care reform law but oppose the ACA as a whole, Bernstein wrote.
Despite the evidence from the KFF poll that shows most people favor provisions like Medicaid expansion, many conservative legislatures across the country have done their best to halt implementation of the health-care reform law.
Almost half of the states still have not expanded Medicaid, a Republican policy decision that affects millions of people across the country. As Rewire reported in September, seven of the 11 major metropolitan areas with uninsured rates higher than the national average are in states that have opted out of expanding health insurance for low-income residents.