Over a year after the landmark health care reform legislation passed—the Affordable Care Act (ACA)—the majority of Americans are still scratching their heads and asking how this legislation will help our health care system become more cost-effective and efficient. While there has been vast support for certain provisions, such as extending insurance to children up to the age of 26, no lifetime limits or limits on pre-existing conditions, Americans are still concerned about the overall legislation.
In fact, a recent survey from Kaiser Health showed that a majority of Americans (52 percent) continue to oppose the new health care law that was enacted by the Obama administration and Congress in 2010. Dating back to the summer of 2009 and continuing through passage, Kaiser’s polling has demonstrated net negatives for the health care plan.
What is “also striking in its consistency is the intensity of antipathy toward the health care legislation. Two-in-five voters (40 percent) strongly oppose this law, compared to only 22 percent who strongly support it. Importantly, a majority (53 percent) of the all important Independent voters who tend to decide elections oppose the new law -- another consistency in Kasier’s tracking over the last year.”
Along party lines, the Kaiser survey showed that 73 percent of Republicans strongly oppose the new law, while only 43 percent of Democrats strongly support the law one year later – a 30 point intensity gap.
Additionally, during the recent 2010 election, 45 percent of 2010 election voters said they wanted their vote to be read as a signal to oppose the law, while only 28 percent indicated their vote was supportive of the law. Much of the concern surrounding health care reform is about:
- The impact on the federal debt (55 percent say it will make the federal budget deficit larger);
- The perception government will be too involved in health care decisions (54 percent say it will lead to too much government involvement; 9 percent say not enough government involvement in the health system); and
- A concern that the law does not address the escalating cost of health care (55 percent say the cost of their health care will increase as a result of the law).
One affect on participants in Kaiser’s recent poll came from the decisions by federal judges on whether the individual mandate is constitutional or not. When given the opportunity to provide a rationale for their opposition to the law, “voters increasingly point to their belief that the government does not have the right to force people to buy insurance coverage and/or an assertion that the law is unconstitutional because of this provision.”
Another concern from participants in the survey is that voters are anxious over losing current coverage, especially if insurers begin to pull out of markets (72 percent say the current health system is meeting their needs and the needs of their family). This emerging concern is likely coming much sooner than when health exchanges come on line in 2014.
Consequently, in response to these numbers, Kaiser Health News also published an article showing the positive support health care reform has thus far received. For example, the authors pointed out how the Affordable Care Act got a critical boost from several key early implementation milestones, including extending coverage for young adults; eliminating pre-existing conditions for children; the down payment it made on the closing of the Medicare prescription drug doughnut hole; coverage of preventive health services for seniors; prohibiting arbitrary insurers from canceling coverage when a consumer gets sick; eliminating secret limits on lifetime and annual caps; and enacting small-business tax credits.
They also pointed out the $4.3 billion in savings from a crackdown on Medicare fraud and waste, which has become an important populist proof point for advocates in an era of deficits and concerns about government spending. Interestingly, the article noted that a recent Kaiser Family Foundation tracking poll found that 64 percent of Americans oppose cutting off funding for the law, and just 30 percent support ending its funding.
While we could play with the poll numbers forever, the reality is that Americans are still concerned about health care reform and this issue will remain at the forefront during the 2012 Presidential election. As the field of Republican candidates begin to shape up, largely fueled by an active Tea Party, which helped change the current balance of the House and Senate, it is almost certain that all candidates will support repealing the Affordable Care Act. The distinguishing factors will be what Republicans have to offer in its place, what reforms from the ACA they will keep, and how well they can educate the public and get their support.
Ultimately, there is no question that America needs meaningful health care reform to address the disparities in access, delivery, and quality of care. While some of the provisions contained within the ACA have promise, it attempts to do too much, too soon, and in the midst of a severe economic recovery, where 8.8% of Americans are still unemployed. As we wait for the Supreme Court to take up the issue of the individual mandate, whatever the outcome will be over the next few years, American’s will all be closely watching.