Health Reform WK-EDGE KKF poll tracks ACA awareness and views on health care expansion options (2)
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Tuesday, February 5, 2019

KKF poll tracks ACA awareness and views on health care expansion options

By Harold Bishop, J.D.

A recent Kaiser Family Foundation poll tracks public awareness of the ACA’s current validity; the public’s viewpoint on various health care expansion options, such as Medicare-for-all and Medicaid buy-in plans; and the partisan health care focus of Democrats, Republicans, and Independents.

The January 2019 Kaiser Family Foundation (KFF) Health Tracking Poll has found that 55 percent of the American public are unaware of the decision of a Texas federal district court that since the 2017 tax bill passed by Congress zeroed out the penalty for not having health insurance, the Patient Protection and Affordable Care Act (ACA) (P.L. 111-148) is no longer valid. While the Fifth Circuit Court of Appeals has stayed the decision in Texas v. United States, keeping the ACA in effect for now, KFF believes the ramifications of the decision, if upheld, will be substantial (see Federal judge lets ACA fall, saying Congress sawed off its last leg, December 19, 2018).

Public views on Texas v. U.S. decision. According to the KFF tracking poll, 44 percent of the public are aware of the Texas court’s decision, with 20 percent saying that the decision is in favor of the ACA, while 35 percent are unsure. The poll also shows that the reaction to the decision varies based on party affiliation. For example, 81 percent of Republicans approve of the decision, 84 percent of Democrats disapprove, and 49 percent of Independents disapprove.

Among those who originally approved of the decision, the poll found that 13 percent changed their mind after hearing that this means that people with pre-existing conditions may have to pay more for coverage or could be denied coverage, and 8 percent changed their minds after hearing that young adults would no longer be able to stay on their parents’ insurance until the age of 26.

Expanding health care coverage options. The poll also found that 56 percent of the public favor a national health plan (Medicare-for all), 77 percent favor a Medicare buy-in plan for adults between the ages of 50 and 64, 75 percent favor percent a Medicaid buy-in plan for individuals who don’t receive health coverage through their employer, and 74 percent favor an optional program similar to Medicare for those who want it.

Possible impacts alter support. The poll also measured net favorability towards a national Medicare-for-all plan (measured as the share in favor minus the share opposed). It found percentage point ranges from +14 to +45 when people hear the argument that this type of plan would guarantee health insurance for all Americans. The poll, however, found that net favorability drops as low as -44 percentage points when people hear the argument that this would lead to delays in some people getting some medical tests and treatments, -28 points when people hear it would threaten the current Medicare program, -23 points when people hear that most Americans will have to pay more in taxes, and -21 points when they hear it may eliminate private health insurance companies.

Partisan focus. The poll found that 51 percent of Democrats say that House Democrats should focus on the ACA while 38 percent say they should focus on passing a national Medicare-for-all plan. Independents that lean Democratic would rather that the House focus its efforts on passing a national Medicare-for-all plan (54 percent) than improving the ACA (39 percent). Thirty-one percent of Democrats, 24 percent of Independents, and 11 percent of Republicans said that continuing the ACA’s pre-existing condition protections is the top priority. In addition, 27 percent of Republicans said that repealing and replacing the ACA remains a top priority, while 20 percent said prescription drug costs was at the top.

Companies: Kaiser Family Foundation

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