Americans Remain Divided, Confused About Health Law As Anniversary Nears

A year after Democrats in Congress pushed through the law overhauling U.S. health care, Americans remain as split as ever about it, according to a poll released today.

A survey this month by the Kaiser Family Foundation found 42 percent of Americans support the health law while 46 percent are opposed. Although both figures were down slightly from February, overall they have changed little since President Barack Obama signed the landmark bill into law on March 23, 2010. (KHN is an editorially independent program of the foundation.) The law, which will extend coverage to 32 million Americans, has come under a blistering attack from Republicans in Congress who are trying to repeal it and Republican governors who have filed suit seeking the Supreme Court to declare it unconstitutional.

The survey found last April that 46 percent of Americans favored the law and 40 percent opposed it. But both sides have been up and down since then, although neither side has been able to move beyond 50 percent over the course of the year.

Not surprisingly, public opinion of the law varies along partisan lines, with 71 percent of Democrats supporting the law while 82 percent of Republicans oppose it in the latest survey. Of those who oppose the law, 20 percent say they are most concerned about its costs, 19 percent are worried about the government’s role and 18 percent don’t like the law’s mandate that individuals get coverage.

The public also remains as confused about the law today as it was a year ago: About 53 percent of Americans said they are confused, the survey found. That is even more widespread among the uninsured and low-income Americans – the groups who have the most to gain from the law, particularly when most coverage expansions take effect in 2014. About six in 10 in these groups report a lack of understand.

Senior citizens, the vital voting bloc that gained several new benefits in the Medicare program from the law, remains the most skeptical age group, with 52 percent opposing the law. That’s down 7 percentage points from the February survey. About 39 percent of seniors believe Medicare will be worse off under the law, compared to 19 percent who think it will be better off. The health law extends the solvency of the Medicare Trust Fund by 12 years, gradually closes the gap in coverage in the Medicare prescription drug benefit and eliminates Medicare co-payments for many preventive services. Republicans have raised concerns about cuts in the growth of Medicare payments to hospitals and other providers that finance the law’s coverage expansions and reductions in payments to Medicare health plans under the law that could result in reduced benefits.

The poll also delivers some bad news for Republicans pushing for repeal of the law. Less than 40 percent of Americans favor repeal, with about 21 percent of respondents favor repealing the law and not returning to the issue, while 18 percent want the law repealed and replaced by a Republican alternative plan, the survey found.

The poll found that 21 percent of Americans would like to keep the law intact, while another 30 percent favor expanding it.

The Obama administration has said that it would favor allowing states to implement their own programs if those plans met the same standards for coverage and cost that the federal law demands. The poll found that two-thirds of Americans favor that option, but only if the states don’t offer insurance that is less generous than the federal plan.

The foundation conducted the telephone survey of 1,202 adults between March 8 and March 13. The margin of error was +/- 3 percentage points.