Survey Shows Confusion Over Health Care Law but Support for Medicaid Expansion

Survey Shows Confusion Over Health Care Law but Support for Medicaid Expansion

Jane Bornemeier  The New York Times

A day before the new health care exchanges open across the country, a new report shows that the more people understand it, the more they’re inclined to participate. But while most people are aware of the law’s requirement to buy insurance or face a penalty, a much smaller number have any understanding of the insurance exchanges opening on Tuesday or of the financial aid available to help people buy insurance.

The findings, by The Commonwealth Fund, indicate that the Obama administration still has a long way to go to make the law’s complicated provisions clear to prospective buyers.

The study also shows strong support for Medicaid expansion, even though many states – mostly in the country’s more conservative regions, like the South and Midwest — chose not to participate in the expansion after the Supreme Court ruled earlier this year they could not be compelled to.

Officials in states opting out of Medicaid, Florida and Texas for example, said the costs to taxpayers would be too high.

The telephone survey was conducted using landlines and cellphones between July and September of this year with more than 6,000 adults, ages 19 to 64. It is part of the foundation’s effort to track the health care law as it goes into effect.

Among the findings:
• Only 32 percent of people without health coverage during the last year were aware of the marketplaces.
• Thirty-one percent of people without coverage were aware of the subsidies that are available.
• Just under one-third (32 percent) of adults with incomes under 250 percent of the federal poverty level ($28,725 for an individual and $58,875 for a family) were aware of the subsidies, compared to 47 percent of those with higher incomes.

The survey found that once people were made aware of the marketplaces, 61 percent of those who are potentially eligible — because they were either uninsured at the time of the survey or had purchased an individual insurance plan — said they were very or somewhat likely to shop for coverage on the exchanges.

Only a slight majority (55 percent) of young adults aged 19 to 29 who are potentially eligible for the coverage options said they were very or somewhat likely to use the marketplaces, compared to 65 percent of those ages 30 to 49.

Potentially eligible adults with health problems were slightly more likely to say they would use the marketplaces than adults with no health problems (65 percent vs. 57 percent). Nearly equal shares of potentially eligible people who identify themselves as Democrats or Republicans said they were very or somewhat likely to shop in the marketplaces (67 percent vs. 63 percent), though Democrats expressed somewhat stronger interest.

Though only 25 states and the District of Columbia have agreed to expand Medicaid under the Affordable Care Act, strong majorities of Americans support doing so. Across the country, 68 percent of adults are somewhat or strongly in favor of making Medicaid available to more residents in their state.

The report also found that:
• Seventy-eight percent of people without insurance for a time during the last year, and 82 percent of people earning less than $32,499 a year for a family of four, support expanding Medicaid to more people in their state.
• Ninety-one percent of uninsured Democrats, 78 percent of uninsured Independents and 73 percent of uninsured Republicans strongly or somewhat favor their state making Medicaid available to more residents.
• Ninety percent of Democrats, 79 percent of Independents and 75 percent of Republicans making less than $32,499 a year for a family of four are in favor of making Medicaid available to more people.

While 85 percent of adults surveyed did not know what their state had decided regarding the Medicaid expansion, among those who did, two-thirds (68 percent) of those who were aware their state was expanding Medicaid were in favor of that decision. Only 38 percent of adults who knew their state was not expanding Medicaid were strongly or somewhat in favor of that decision.