March 2013
Public
Opinion on Health Care Issues
Three years after the passage of the Patient Protection and Affordable Care Act (the ACA), but still many months away from the implementation of most of its major provisions, the latest Kaiser Health Tracking Poll finds that a majority of Americans are unsure how the law will impact them, and few are paying attention to the details of state‐level decisions about implementation. Though opinion on the law overall remains nearly evenly divided, opponents’ attacks seem to have taken a toll on the public’s expectations, and Americans are now more likely to think the law will make things worse rather than better for their own families. While most of the law’s individual provisions remain popular, many of the most well‐liked elements are the least well‐known among the public. Public knowledge of the ACA’s provisions has not increased since 2010, and awareness of some key provisions has declined somewhat since the law’s passage when media attention was at its height. On another health policy topic that has been in the news, while national data shows that health care cost growth has slowed down in recent years, a majority of the public perceives that the country’s health costs have been going up faster than usual. PUBLIC NOT PAYING MUCH ATTENTION TO STATE DECISIONS ON EXCHANGES, MEDICAID EXPANSION While state and federal policymakers are busy making decisions about the Medicaid expansion and working out the logistics of their health insurance exchanges before 2014, the public at large hasn’t been paying much attention to either of these topics. Asked how much they have heard about their own state’s decision on whether to create a state‐run exchange, roughly half the public (48 percent) reports hearing “nothing at all,” while just over one in five have heard “a lot” (7 percent) or “some” (15 percent). Further, when asked what they know about their governor’s decision on whether to expand Medicaid in their state, the vast majority (78 percent) say they haven’t heard enough to say whether the governor has announced a decision or what that decision is. This is equally true in states where the governor has stated that they will expand Medicaid (80 percent say they haven’t heard enough to say) and in those whose governor has said they will not move forward with the expansion (74 percent). Few Have Heard About State Decisions on Exchanges and
Medicaid Expansion
How much, if anything have you heard about your
state’s decision on whether to create a state-run
health insurance exchange or marketplace where
people who don’t get coverage through their jobs can
shop for insurance?
A lot
7%
Some
15%
Nothing at
all
48%
As far as you know, has your state’s governor
announced that your state will expand Medicaid,
announced that your state will not expand Medicaid,
not announced their decision, or have you not heard
enough about this to say?
Has not
announced
decision
Announced
6%
state will
not expand
Medicaid
7%
Announced
state will
expand
Medicaid
7%
Only a little
29%
SOURCE: Kaiser Family Foundation Health Tracking Poll (conducted March 5-10, 2013)
Dk/ Ref.
2%
Not heard
enough to
say
78%
1 When asked whether they think their state should implement the Medicaid expansion, with the federal government picking up most of the cost, the survey finds that more Americans are in favor of expanding Medicaid in their state (52 percent) than oppose it (41 percent), shares that have remained similar since last July. A familiar partisan divide is evident, with two‐thirds of Republicans wanting to keep their state’s Medicaid program as it is today, three‐quarters of Democrats wanting to expand it, and independents nearly evenly divided. More Favor Expanding Their State’s Medicaid Program Than
Oppose
As you may know, the health care law expands Medicaid to provide health insurance to more low-income uninsured
adults. The federal government will initially pay the entire cost of this expansion, and after several years, states will
pay 10 percent and the federal government will pay 90 percent. The Supreme Court ruled that states may choose
whether or not to participate in this expansion. What do you think your state should do?
Keep Medicaid as it is today
Total
Democrats
Independents
Republicans
Expand Medicaid to cover more low-income people
41%
52%
20%
76%
46%
44%
67%
26%
NOTE: Other/Neither (vol.) and Don’t know/Refused answers not shown.
SOURCE: Kaiser Family Foundation Health Tracking Poll (conducted March 5-10, 2013)
PUBLIC: WHAT HEALTH COST GROWTH SLOWDOWN? Public: What Health Cost Growth Slowdown?
Analysis of national data has shown that, while health care cost growth continues Would you say the amount you and your family are
Over the past few years, would you say the cost of
to outpace inflation, the rate of growth in paying for health care and health insurance has been
health care for the nation as a whole has been going
going up over the past few years, going down, or staying
up faster than usual, going up slower than usual, or
national health expenditures has slowed about the same? (If going up) Would you say your health
going up abut the same amount?
markedly in recent years.1 The public’s care costs have been going up faster than usual, slower
than usual, or about the same amount?
Going up
perception of the cost trajectory is quite slower than
Going down
different, however. Nearly six in ten Dk/Ref.
usual
2%
4%
4%
adults (58 percent) say that over the past Dk/Ref.
few years, the cost of health care for the 7%
nation as a whole has been going up Going up
faster than
faster than usual, while just 4 percent say usual
Going up
it has been going up slower than usual 34%
Staying
faster than
Going up
about the
usual
and three in ten (31 percent) think it’s about the
same
58%
same
been going up by about the same 32%
amount as
Going up
usual
amount. about the
31%
same
amount as
When it comes to their own experiences Going up
usual
slower than
with rising costs, about a third of 24%
usual
Americans (34 percent) report that their 2%
SOURCE: Kaiser Family Foundation Health Tracking Poll (conducted March 5-10, 2013)
own family’s health care costs have been going up faster than usual, while roughly a quarter say they’ve been going up about the same amount as usual (24 percent), and 32 percent say their costs have held steady in recent years. Only small shares say their costs have been going up more slowly than usual (2 percent) or that their costs have actually come down (2 percent). 1
M Hartman, AB Martin, J Benson, A Catlin, and the National Health Expenditure Accounts Team, “National Health Spending in 2011: Overall Growth Remains Low, But Some Payers and Services Show Signs of Acceleration,” Health Affairs, January 2013, 32:87‐99. 2 PUBLIC OPINION ON THE ACA REMAINS DIVIDED AT 3RD ANNIVERSARY At Three Years, Opinion On ACA Remains Divided
Since the ACA was signed into law in March 2010, overall opinion of the law As you may know, a health reform bill was signed into law in 2010. Given what you know about the health reform
has stayed within a relatively narrow law, do you have a generally favorable or generally unfavorable opinion of it?
band, with roughly equal proportions ACA signed into law
saying they feel favorable and on March 23, 2010
80%
Favorable
Unfavorable
Don't know/Refused
unfavorable towards it. This division of opinion continues on the 3rd anniversary of the ACA, with 37 percent holding a 60%
51
50
50
favorable view and 40 percent 49
48
48
46
46
46
45
44
44
44
44 43 44 43
44 43 45 43 43
43 44 43
43 44
unfavorable. The share of the public who 42 42
42
41
41
41
40%
40%
declined to offer an opinion on the law 43
43 42
42
42
42
41
41
41
41 42 42 42
40 41 41
40
40 41 41
40
40
39
38 38
38 39
37
37
37
37%
remains high this month, at 23 percent. 36
35
34
20%
23 23%
Asked about the reasons behind their 19
19
19
19 18
19
19 19
18 18
18
17 16
17
17
views, the most common response 15
15
15
15
15
14 14
14
14
14
13
12 11
12
10
9 8
among those who view the law favorably 0%
Apr May Jun Jul Aug Sep Oct Nov Dec Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov
Feb Mar
has to do with expanded access to health 2010
2011
2012
2013
care and insurance (58 percent), while those who view the law unfavorably are SOURCE: Kaiser Family Foundation Health Tracking Polls
most likely to cite cost considerations (30 percent), opposition to the individual mandate (15 percent), and concerns about government involvement in health care (13 percent). Three Years Later, Public Still Divided by Party
Percent who say they have a favorable opinion of the health reform law:
80%
ACA signed into law
on March 23, 2010
78
72
69
Democrats
75
73
69 68 69
68
73
66
Independents
Republicans
72
71
65 64
64
60%
65
62
60
64
62
64
66
71
70
72
69
64
62
72
64
57 58%
52
49 48
40%
20%
34
23
21
37 37
34
37
41
35
21
16
13
0%
43
41 42
36 37
11
8
15
17
12 12 11
9
12
38
33
20
33
36
40 40 39
34 33
32
34
30
38
41
35 34
37
32
31%
24
16
19
14
11 12
12
16
12
7 8 7
12
18%
16
8
10
12
Apr May Jun Jul AugSep Oct Nov Dec Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec Jan Feb Mar Apr May Jun Jul AugSep Oct Nov
2010
32
2011
2012
12
Feb Mar
2013
SOURCE: Kaiser Family Foundation Health Tracking Polls
Last month’s drop in the share of Democrats viewing the law favorably leveled off this month, and views by party continue to be as divided as ever, with most Republicans (68 percent) viewing the law unfavorably, a majority of Democrats (58 percent) viewing it favorably, and independents more negative than positive (31 percent favorable, 45 percent unfavorable). The intensity of opinion on the law still lies with the GOP, another aspect of opinion that has been true throughout the last three years of Kaiser polling on the ACA. About half of Republicans (53 percent) say they have a very unfavorable view, compared to three in ten Democrats (31 percent) who say they have a very favorable view. 3 MOST REPORT NO PERSONAL EXPERIENCE WITH LAW YET Thus far, most Americans report having no direct experience, either positive or negative, with the ACA. A little over two in ten say someone in their family has been negatively affected by the law (22 percent), with the most commonly cited reason being increased costs, followed by cuts to benefits. A slightly smaller share feel they’ve personally benefited (17 percent), either through expanded benefits and access to care, lower health care costs, or the provision that allows parents to keep their children under the age of 26 on their insurance plan. Still, the majority of the public – 62 percent – reports that they have not felt any impact either way, a number that has stayed relatively steady since December 2010. Most Report No Experience With Law So Far
So far, would you say you and your family have [personally benefited from/been negatively affected by] the health
reform law, or not?
Percent who say someone in their family has personally benefited from the health reform law
Percent who say someone in their family has been negatively affected by the health reform law
Percent who say they have not been personally impacted yet
80%
60% 66%
71%
68%
69%
68%
72%
67%
64%
62%
40%
20%
20%
20%
17%
18%
18%
15%
14% 13%
14%
15%
Dec
Feb Mar
May
0%
2010
Jul
2011
18%
21%
22%
19%
19%
11%
Nov
17%
14%
Mar
Aug
2012
Mar
2013
SOURCE: Kaiser Family Foundation Health Tracking Polls
TABLE 1: IN THEIR OWN WORDS Among the 17% who say their family has personally benefited from the health reform law: In what ways would you say you have benefited from the health reform law? “My birth control is now free” “We've been able to continue coverage for our child that has graduated from college and we don't have to pay co‐pays for well visits” “Great difference, I don't have to pay as much as I did” “There is a provision where people with Medicare get a wellness annual checkup and I think that's a good idea. And I have had mine and it was very helpful” “Just ease of mind” “Because I didn't have insurance and now I do” “Makes businesses give insurance to employees” “Yearly increase has been lower than in the past 10 years” “Removal of some caps of number of visits a year, specifically for mental health” “I would have been denied insurance for a pre‐existing condition and now I’m not” Among the 22% who say their family has been negatively affected by the health reform law: In what ways would you say you have been negatively affected by the health reform law? “Don't care for the government intrusion” “My doctor will no longer take Medicare patients like he did before. Now he limits the time he will see Medicare patients and they don't pay as well as they did before” “I received a bill for blood work which I have never received before” “My mother is a small business owner and she cannot afford to pay for health care for the employees even though the employees already have health care” “It’s costing me more money for less coverage” “Taking the money out of Medicare to help ObamaCare” “Some of my family members’ hours have been cut so the businesses don't have to participate” “When my husband gets his checks it keeps taking out more” “The taxpayers will have to pay whether they are covered or not, we are covered we should not pay” “Because we don't have all the details yet” PARTS MORE POPULAR THAN THE WHOLE While the public is divided on the law as a complete package, many of its component parts are quite popular, some on a bipartisan basis. Majorities of the public are favorable towards the law’s tax credits for small businesses who offer their employees insurance (88 percent, including 53 percent very favorable), closing the Medicare “doughnut hole” (81 percent, 52 percent very favorable), and the provision allowing young adults to stay on their parents’ health plans up to age 26 (76 percent, 54 percent very favorable). Three of the hallmark features of the law – the health insurance exchanges, subsidies to help individuals purchase insurance, and the Medicaid expansion – are also popular, with between seven and eight in ten Americans favoring each (80 percent, 76 percent, and 71 percent, respectively). But consistent with previous polls, the individual mandate falls at the bottom of this list, with six in ten feeling unfavorable about this provision of the law. 4 Even some of the law’s most fervent opponents like many of the things the ACA has done or will do. A majority of Republicans feel favorable towards seven of the 11 provisions asked about in the March poll, with seven in ten or more favoring tax credits to small businesses, closing the Medicare “doughnut hole”, and the exchanges. Less popular among the GOP: the highly politicized Medicaid expansion (42 percent favorable), increased Medicare payroll tax for those with higher incomes (37 percent), the employer and individual mandates (36 percent and 21 percent, respectively). TABLE 2: MANY ELEMENTS OF ACA CONTINUE TO BE POPULAR ACROSS PARTIES Percent who say they feel favorable about each of the following elements of the health reform law Total Dem Ind Rep Tax credits to small businesses to buy insurance 88% 96% 87% 83% Close Medicare “doughnut hole” 81 90 80 74 Create health insurance exchanges 80 87 78 72 Extension of dependent coverage 76 84 79 68 Subsidy assistance to individuals 76 91 69 61 Medicaid expansion 71 88 70 42 Guaranteed issue 66 75 67 56 Medical loss ratio 65 72 60 62 Increase Medicare payroll tax on upper income 60 80 54 37 Employer mandate/penalty for large employers 57 79 54 36 Individual mandate/penalty 40 55 39 21 Note: Question wording abbreviated. For full question wording, see topline: http://www.kff.org/kaiserpolls/8425.cfm. GAPS IN KNOWLEDGE PERSIST Three years after passage, a majority of Americans (57 percent) say they do not have enough information about the ACA to understand how it will affect them. Perhaps more importantly, this share rises to two‐thirds among some of the key groups the law was designed to help: the uninsured (67 percent) and those with incomes below $40,000 (68 percent). Majority Say They Don’t Understand How ACA Will Impact
Them, Including Two-Thirds of Uninsured and Low-Income
Do you feel you have enough information about the health reform law to understand how it will impact you
personally, or not?
Yes, have enough information
Total
Uninsured (under age 65)
Household income less than $40,000
No, do not have enough information
41%
33%
30%
NOTE: Don’t know/Refused answers not shown.
SOURCE: Kaiser Family Foundation Health Tracking Poll (conducted March 5-10, 2013)
57%
67%
68%
5 While a majority of the public has an accurate perception of how much of the law has been implemented (67 percent say that “some provisions” have been put into place thus far), many continue to have false impressions about which provisions are actually included in the law and which are not. Among the public, the most widely recognized element is the unpopular individual mandate, which three‐quarters (74 percent) of the public say is part of the law. The employer requirement, that companies with 50 or more full‐time employees offer insurance or pay a fine, closely follows (71 percent). Large shares are also aware that the law allows adult children to stay on their parents’ insurance until age 26 (69 percent), provides subsidies to help low and moderate income Americans purchase insurance (62 percent), gives states the option of expanding their Medicaid program (59 percent), and creates insurance exchanges where people can shop for coverage (58 percent). Among the items that are less familiar to the public: just about half recognize that the law increases the Medicare payroll tax for upper‐income Americans (54 percent); prohibits insurance companies from denying coverage to people with pre‐existing conditions (also known as “guaranteed issue,” 53 percent); and provides tax credits to small businesses who cover their workers (52 percent). Even less well‐known are the law’s provisions to close the Medicare prescription drug coverage gap, or “doughnut hole” (46 percent) and the medical loss ratio provision that requires insurance companies to give rebates to customers if they spend too little on health care services and too much on administrative costs and profits (40 percent). TABLE 3: AWARENESS OF PROVISIONS INCLUDED IN THE HEALTH CARE LAW (TRUE STATEMENTS) INCORRECT CORRECT To the best of your knowledge, would you say the health reform law Yes, law does No, law does Don’t Know/ does or does not do each of the following? this not do this Refused Individual mandate/penalty 74% 17% 9% Employer mandate/penalty for large employers 71 17 11 Extension of dependent coverage 69 20 11 Subsidy assistance to individuals 62 29 9 Medicaid expansion 59 25 17 Health insurance exchanges 58 29 13 Increase the Medicare payroll tax on upper income 54 27 19 Guaranteed issue 53 36 11 Tax credits to small businesses to buy insurance 52 26 22 Close Medicare “doughnut hole” 46 31 22 Medical loss ratio 40 37 23 Note: Question wording abbreviated. For full question wording, see topline: http://www.kff.org/kaiserpolls/8425.cfm. At the same time, many Americans hold misimpressions about the law’s contents. Just under six in ten (57 percent) mistakenly think the law creates a government‐run health plan (the so‐called “public option”). And close to half (47 percent) say the law allows undocumented immigrants to receive financial help from the government to buy health insurance, when in fact they are not eligible for subsidies. Many (40 percent, including 35 percent of seniors) continue to hold on to the myth that the law allows a government panel to make decisions about end‐of‐life care for people on Medicare (the so‐called “death panels”) and another two in ten aren’t sure (21 percent). TABLE 4: MISPERCEPTIONS ABOUT PROVISIONS NOT INCLUDED IN THE LAW (FALSE STATEMENTS) INCORRECT CORRECT To the best of your knowledge, would you say the health reform law No, law does Yes, law does Don’t Know/ does or does not do each of the following? not do this this Refused Cut benefits for people in Medicare 43% 44% 14% Establish a government panel to make decisions about end‐of‐life 39 40 21 care for people on Medicare Allow undocumented immigrants to receive subsidies to purchase 33 47 21 insurance Public option 28 57 15 Note: Question wording abbreviated. For full question wording, see topline: http://www.kff.org/kaiserpolls/8425.cfm. 6 As previous Kaiser polls have shown, some of the most popular provisions of the law are among the least widely recognized, and vice versa. For example, three‐quarters of Americans recognize that the individual mandate is part of the law, but only four in ten have a favorable view. Larger shares report having positive views of less well‐known provisions. For example, 88 percent of Americans favor providing tax credits to small businesses that offer health insurance, while just about half (52 percent) are aware the law includes such a provision. Most Popular Provisions Among Least Widely Recognized
(And Vice Versa)
Percent who say they feel favorable about each of the following and percent who say they are aware each is
included in the health reform law:
Percent with a favorable view of element
Percent who are aware element is included in ACA
Tax credits to small businesses to buy insurance
Close Medicare "doughnut hole"
88%
52%
81%
46%
Create health insurance exchanges
80%
58%
Extension of dependent coverage
69%
Subsidy assistance to individuals
53%
40%
66%
65%
60%
54%
57%
Increase Medicare payroll tax
Employer mandate/penalty for large employers
Individual mandate/penalty
71%
59%
Guaranteed issue
Medical loss ratio
76%
62%
Medicaid expansion
40%
76%
71%
74%
NOTE: Items asked of separate half samples. Question wording abbreviated. See topline (http://www.kff.org/kaiserpolls/8425.cfm)
for complete wording.
SOURCE: Kaiser Family Foundation Health Tracking Poll (conducted March 5-10, 2013)
Public knowledge about these provisions has not increased since 2010, and awareness of some of the most popular provisions has actually decreased. For example, compared with April 2010, the shares who recognize that the law includes tax credits to small businesses to buy insurance, subsidy assistance for individuals, and guaranteed issue of health insurance are down 14, 13, and 11 percentage points, respectively. TABLE 5: DECLINES IN AWARENESS OF SOME KEY PROVISIONS Percent who say the health reform law does each of the following: April 2010 March 2013 Tax credits to small businesses to buy insurance 66% 52% Subsidy assistance to individuals 75 62 Guaranteed issue 64 53 Medicaid expansion 64 59 Health insurance exchanges 62 58 Medical loss ratio 37 40 Extension of dependent coverage 70 69 Individual mandate/penalty 71 74 Note: Question wording abbreviated. For full question wording, see topline: http://www.kff.org/kaiserpolls/8425.cfm. 7 EXPECTATIONS OF THE LAW’S IMPACT Three years after the ACA passed, and months away from the implementation of most of its major provisions, a plurality of Americans (40 percent) say they don’t expect the law to make much difference for their families overall. Those who do expect to see an impact are more likely to say it will leave them worse off (29 percent) rather than better (21 percent). Like favorability, expectations of the law’s personal impact have also bounced around within a narrow band, but in most months since 2011, those saying they expect to be worse off have outnumbered those expecting to be better off, with the largest share saying they expect to see little difference in their own lives. Trend in Opinion on Personal Impact of ACA
Do you think you and your family will be better off or worse off under the health reform law, or don’t you think it will
make much difference?
80%
ACA signed into law
on March 23, 2010
Better off
Won't make much difference
Worse off
60%
40%
20%
0%
44
44
41
41 39
37
35
36
32
32
34
34 34
33
32
33
32
31 30
33
29
3028 3230
28 28
31
31
32
32
33 32
33 27 33 32
34
31
31 31 31
31
30
28
28
29 28 29 29 28 29
27 28 27
27
26
26
26
26 26
25
23
25
24
24
23
20
18
39
38 39
37 38 35
39
37 34
Apr May Jun Jul AugSep Oct Nov Dec Jan Feb Mar Apr May Jun Jul AugSep Oct Nov Dec Jan Feb Mar Apr May
2010
2011
37 37
32
30
33 33
31 32
25 26 26 26
Jul AugSep Oct
2012
40%
36
32
29%
24
21%
Feb Mar
2013
NOTE: Don’t know/Refused answers not shown.
SOURCE: Kaiser Family Foundation Health Tracking Polls
Expectations for ACA’s Impact on Cost and Quality More
Negative Than Positive
Under the health reform law, do you think each of the following will get better, worse, or will it stay about the same?
Worse
NATIONAL IMPACTS
The cost of health care for the nation as a whole
55%
The quality of health care in the nation
Consumer protections for the average person with private health insurance
Access to health care for the uninsured
Stay about the same
18%
45%
39%
28%
Better
21%
26%
24%
36%
16%
24%
40%
PERSONAL IMPACTS
The cost of health care for you and your family
The quality of your own health care
Your ability to get and keep health insurance
NOTE: Items asked of half sample. Don’t know/Refused answers not shown.
SOURCE: Kaiser Family Foundation Health Tracking Poll (conducted March 5-10, 2013)
49%
34%
28%
33%
48%
46%
15%
15%
20%
Drilling down further into the specifics, the latest poll finds Americans’ expectations about the law’s impacts on health care costs, quality, and consumer protections are also more negative than positive. The biggest area of concern is costs; more than half (55 percent) say the cost of health care for the nation as a whole will get worse under the law, and nearly as many (49 percent) say the same about their own personal health care costs. Americans are also much more likely to say things will get worse rather than better in terms of quality of care in the nation (45 percent vs. 24 percent) and consumer protections for the average person with health insurance (39 percent vs. 16 percent). When it comes to the quality of their own care and their ability to get and keep insurance, nearly half don’t expect to see much change, but larger shares expect things to get worse rather than better. The one area asked about in the survey where the public’s expectations are more positive is access to health care for the uninsured: 40 percent expect it to get better under the law, while 28 percent expect it to get worse. 8 Not surprisingly, expectations about the law’s impacts in each of these areas are also divided sharply by party, with Republicans far more likely than Democrats to think things will get worse, both for themselves and for the nation. For example, while 73 percent of Republicans say the quality of care in the nation will worsen, four in ten Democrats (39 percent) expect it to get better under the law. Similarly, more than half (53 percent) of Democrats expect the uninsured will have better access to care, while Republicans are divided as to whether access will get better (31 percent) or worse (33 percent). It’s worth noting, however, that even Democrats, who favor the law for the most part, are divided as to whether the law will make things better or worse in terms of national health care costs (37 percent better vs. 34 percent worse), consumer protections (27 percent vs. 24 percent), and their own families’ health care costs (23 percent vs. 26 percent), with substantial shares saying it won’t make much difference. TABLE 6: PARTISAN DIFFERENCES IN PERCEPTIONS OF LAW’S IMPACTS Under the health reform law, do you think each of the following will get better, worse, or stay about the same? Total NATIONAL IMPACTS The cost of health care for the nation as a whole Better 21% Worse 55 Stay about the same 18 The quality of health care in the nation Better 24 Worse 45 Stay about the same 26 Consumer protections for the average person with private health insurance Better 16 Worse 39 Stay about the same 36 Access to health care for the uninsured Better 40 Worse 28 Stay about the same 24 PERSONAL IMPACTS The cost of health care for you and your family Better 15 Worse 49 Stay about the same 33 The quality of your own health care Better 15 Worse 34 Stay about the same 48 Your ability to get and keep health insurance Better 20 Worse 28 Stay about the same 46 Dem Ind Rep 37% 34 26 39 25 34 16% 57 21 18 55 22 6% 83 8 5 73 17 27 24 40 53 21 21 13 33 44 36 28 30 8 69 14 31 33 22 23 26 46 25 16 55 34 17 43 10 59 28 11 39 48 14 31 52 10 72 18 6 54 35 9 42 42 9 EXPEC
CTATIONS OF CHANGES RELATED TO INDIV
VIDUAL MAND
DATE In ano
other measure
e of people’s exxpectations ab
bout the law, th
he survey findss that just undeer three in ten
n Americans (28
8 percent) say they eexpect to make some sort off change to the
eir current health insurance aarrangements as a result of the ACA’s indivvidual mand
date. Of those who say they w
will have to maake different health care arraangements, mo
ost expect those changes to come in the form of needing to get new coverrage or paying more for their current coverrage. Not surprrisingly, the gro
oup that is most likely to say nge their arrangements are th
hose who are ccurrently uninssured (62 perccent, versus 22 percent of thee insured). they eexpect to chan
nges will leave
e them worse ooff (19 percentt) than better (7 percent). Ho
owever, the Overaall, people are more likely to say these chan
uninssured are some
ewhat more evvenly divided o
on the impact o
of these new h ealth care arraangements – 2
23 percent say the changes will leeave them bettter off, compared to 34 percent who say th
he changes wil l leave them w
worse off. TA
ABLE 7: EXPECTA
ATIONS OF IMPA
ACTS RELATED T
TO INDIVIDUAL M
MANDATE Wh
hen the requirem
ment that nearlyy all Americans h
have health insurance goes into effect in 2014, do you think you will havee to change yourr current health insurance arrrangements, or not? Do you thin
nk that change w
will leave you beetter off or worsee off? Yes, will have to ch
hange health inssurance arrangements Better off Worse off Won’t make m
much difference e
either way (VOLL.) Don’t know/Re
efused No
o, will not have tto change Do
on’t know/Refussed TTotal 228% 7 19 1 1 66 6 Insured (under age 65) 22% 4 16 1 1 73 5 Uninsured (u
under age 65) 62% 23 34 1 3 32 6 This Kaiser Health
h Tracking Poll w
was designed and analyzed by public opinion ressearchers at thee Kaiser Family FFoundation led b
by Mollyann B
Brodie, Ph.D., inccluding Liz Hame
el, Claudia Deane
e, Sarah Cho, and Bianca DiJulio . The survey was conducted Maarch 5‐10, 2013, among a nationally representative random
m digit dial telep
phone sample of 1,204 adults agges 18 and older,, living in the Un
nited States, including Alaska and Hawaii (note
e: persons without a telephone ccould not be inclluded in the ran dom selection pprocess). Compu
uter‐assisted teleephone in
nterviews condu
ucted by landline
e (602) and cell p
phone (602, including 315 who hhad no landline telephone) weree carried out in English and Spanish by Prince
eton Data Source
e under the dire
ection of Princeto
on Survey Reseaarch Associates International. Th
he combined lan
ndline and ceell phone sample was weighted to balance the ssample demograaphics to match Census estimattes for the nation
nal population o
on sex, age, education, race, Hispanic origin, nativity (for Hisp
panics only), reggion, and telephoone usage. All sttatistical tests off significance account for the effect of weightin
ng. The margin o
of sampling error including the d
design effect forr the full sample is plus or minuss 3 percentage p
points. For reesults based on other subgroupss, the margin of sampling error may be higher. N
Note that sampling error is onlyy one of many po
otential so
ources of error in this or any oth
her public opinio
on poll. The full question wording and me
ethodology of th
he polls can be vviewed online att: http://www.kfff.org/kaiserpolls/8425.cfm. This publication (#8425-F) is available on the Kaiser Family Foundation’s website at www.kff.org.
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