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Americans and the ACA: A Quick Trip Through Two Years of Public Opinion Data

This presentation analyzes two years of public opinion data on the Affordable Care Act (ACA) in the United States. It explores the split opinions, partisan gaps, and views on key provisions of the ACA. The data also examines the understanding and recognition of the law among the general public.

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Americans and the ACA: A Quick Trip Through Two Years of Public Opinion Data

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  1. Americans and the ACA:A Quick Trip Through Two Years of Public Opinion Data Claudia Deane Assoc. Director, Public Opinion & Survey Research Kaiser Family Foundation March 2012

  2. SLIDE 1 KFF Monthly Tracking Survey Since 2008 (Trust But Verify) • Standard survey methodology = RDD(random digit dial) • Each month interview roughly 1,200 randomly selected adults, aged 18 and over, over a 6-night field period • Interviews conducted by telephone • Landline • Cell phone • Conduct interviews in English and Spanish • Find all our tracking surveys at: www.kff.org/kaiserpolls

  3. SLIDE 2 Since Passage, Public Has Remained Largely Split On ACA As you may know, a health reform bill was signed into law in 2010. Given what you know about the health reform law, do you have a generally favorable or generally unfavorable opinion of it? Favorable Unfavorable Don’t know/Refused ACA signed into law on March 23, 2010 2010 2011 2012 Source: Kaiser Family Foundation Health Tracking Polls

  4. SLIDE 3 Note Some Diversity In Measurement… But Basically Same Picture Pollster.com aggregation of favor/oppose measures from various surveys accessed 2/16/12. Available at: http://www.pollster.com/polls/us/healthplan.php

  5. SLIDE 4 Partisan Gap, and Intensity Gap to Boot As you may know, a health reform bill was signed into law in 2010. Given what you know about the health reform law, do you have a generally favorable or generally unfavorable opinion of it? Very favorable Somewhat favorable Somewhat unfavorable Very unfavorable Total Democrats Independents Republicans Note: Don’t know/Refused answers not shown. Source: Kaiser Family Foundation Health Tracking Poll (conducted February 13-19, 2012)

  6. SLIDE 5 Partisan Gap Began Before Passage, and Has Persisted Percent who say they have a favorable opinion of the health reform law: Democrats Independents Republicans ACA signed into law on March 23, 2010 2010 2011 2012 Source: Kaiser Family Foundation Health Tracking Polls

  7. SLIDE 6 A Look at Key Subgroups… Percent who say they have a favorable opinion of the health reform law: BY AGE BY RACE/ETHNICITY 2010 2010 2010 2011 2011 2011 2012 2012 2012 BY GENDER Source: Kaiser Family Foundation Health Tracking Polls

  8. …More Key Subgroups Percent who say they have a favorable opinion of the health reform law: BY INCOME BY INSURANCE STATUS (<65) 2010 2010 2011 2011 2012 2012 Source: Kaiser Family Foundation Health Tracking Polls

  9. SLIDE 8 Majority Favor Main Provisions Of ACA, Except Individual Mandate I’m going to read you several elements of the health reform law. As I read each one, please tell me whether you feel very favorable, somewhat favorable, somewhat unfavorable, or very unfavorable about it. Very favorable Health insurance exchanges Somewhat favorable Subsidy assistance to individuals Somewhat unfavorable Medicaid expansion Very unfavorable Employer mandate/penalty for large employers Individual mandate/penalty Note: Response wording abbreviated. See Topline: http://www.kff.org/kaiserpolls/8265.cfmfor complete wording. Don’t know/Refused answers not shown. Source: Kaiser Family Foundation Health Tracking Poll (conducted December 8-13, 2011)

  10. SLIDE 9 Views Of Personal Impact? Divided 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? Better off Won’t make much difference Worse off ACA signed into law on March 23, 2010 2010 2011 2012 Note: Don’t know/Refused answers not shown. Source: Kaiser Family Foundation Health Tracking Polls

  11. SLIDE 10 Who Will Benefit? Uninsured, Low-Income, Chronically Ill Do you think each of the following will be better off or worse off under the health reform law, or don’t you think it will make much difference? Don’t know/ Refused Won’t make much difference Better off Worse off The uninsured Lower income Americans People with pre-existing health conditions The country as a whole Seniors, that is those ages 65 and older Middle class Americans You and your family The Medicare program Source: Kaiser Family Foundation Health Tracking Poll (conducted November 10-15, 2011)

  12. SLIDE 11 Half Still Say They Don’t Understand Law’s Personal Impact Do you feel you have enough information about the health reform law to understand how it will impact you personally, or not? APRIL 2010 MARCH 2011 NOVEMBER 2011 Yes, have enough info No, don’t understand personal impact Yes, have enough info No, don’t understand personal impact Yes, have enough info No, don’t understand personal impact Don’t know/ Refused Don’t know/ Refused Don’t know/ Refused Source: Kaiser Family Foundation Health Tracking Polls

  13. SLIDE 12 Do People Recognize What’s In The Law? Yes, …. Note: Items asked of separate half samples. Source: Kaiser Family Foundation Health Tracking Poll (conducted November 10-15, 2011)

  14. SLIDE 13 ….. And No Note: Items asked of separate half samples. Source: Kaiser Family Foundation Health Tracking Poll (conducted November 10-15, 2011)

  15. SLIDE 14 Only Half Of Uninsured Aware Of Specific Elements Of ACA I’m going to read you a list of specific reform proposals. For each, please tell me whether you think it was included in the health reform law, or not. AMONG UNINSURED AGES 18-64 Don’t know/Refused Yes, law will do this No, law will not do this Provide financial help to low and moderate income Americans who don’t get insurance through their jobs to help them purchase coverage Require nearly all Americans to have health insurance by 2014 or else pay a fine Expand the existing Medicaid program to cover low-income, uninsured adults regardless of whether they have children Source: Kaiser Family Foundation Health Tracking Poll (conducted August 10-15, 2011)

  16. SLIDE 15 Americans Learning About The Law From A Variety Of Sources Percent who say the following has been their MOST IMPORTANT source of news and information about the health reform law: Percent who say they have gotten information about the health reform law from each of the following: Newspapers, radio, or other online sources Conversations with friends and family Cable news National broadcast network news Local news President Obama/other Democratic leaders Republican candidates for president Your doctor or another health care professional Federal agencies Health insurance company State agencies An employer None of the above/Something else (vol.) n/a Source: Kaiser Family Foundation Health Tracking Poll (conducted December 8-13, 2011)

  17. SLIDE 16 What to Expect in Terms of Public Opinion… People continue to have fairly limited familiarity with what is, and is NOT, in the law Key stakeholders have limited familiarity with the benefits that would accrue to them in 2014 Opinion may not change much until law is a REALITY, affecting real people’s everyday lives, rather than an ideological debate Given the election year climate, for the foreseeable future, health reform will be seen through a political lens… which means partisan divisions will continue Supreme Court debates: public opinion wild card

  18. SLIDE 17 Supreme Court Basics: The ‘Whys’ Behind Opinion on Mandate As you may know, the health reform law will require nearly all Americans to have health insurance by 2014 or else pay a fine. Would you say you feel very favorable, somewhat favorable, somewhat unfavorable or very unfavorable about that provision of the law? Could you tell me in your own words what is the main reason you have a favorable/unfavorable opinion? REASONS FOR UNFAVORABLE OPINION (among the 67% with unfavorable view) REASONS FOR FAVORABLE OPINION (among the 30% with favorable view) Everyone needs health care/Insurance (32%) Government overreach (30%) Expands coverage (17%) Insurance is too expensive (25%) Favorable People should pay fair share (16%) Complaints about fine (22%) Unfavorable Controls costs (15%) Unconstitutional (5%) Don’t know/ Refused Note: Only the top 4 responses for each opinion listed. Source: Kaiser Family Foundation Health Tracking Poll (conducted January 12-17, 2012)

  19. In your own opinion, do you think the Supreme Court should rule that it is constitutional or unconstitutional for the federal government to require all Americans to have health insurance, or do you not know enough to say? SLIDE 18 More Than Half Expect Court To Find Mandate Unconstitutional Constitutional Constitutional Unconstitutional Don’t know enough to say/Refused Source: Kaiser Family Foundation Health Tracking Poll (conducted January 12-17, 2012)

  20. SLIDE 19 Most Think Justices’ Ideology Plays A Role In Decision-Making In ruling on this case, do you think the Supreme Court Justices will base their decision on legal analysis without regard to ideology or politics or do you think they will let their own ideological views influence their decision? Will base decision on legal analysis Will let own ideological views influence their decision Don’t know/ Refused Source: Kaiser Family Foundation Health Tracking Poll (conducted January 12-17, 2012)

  21. SLIDE 20 Most Believe Some of ACA Will Be Implemented, Even Without Mandate If the Supreme Court rules that the federal government cannot require Americans to have health insurance, do you expect some parts of the health care law will still be implemented, or do you think this will effectively mean the end of the entire law? Effectively means end of the entire law Some parts of the law will still be implemented Don’t know/ Refused Source: Kaiser Family Foundation Health Tracking Poll (conducted January 12-17, 2012)

  22. CDeane@kff.org IMPROVE U.S. DATA QUALITY…. TAKE A SURVEY

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