Kaiser Study Shows Less Confusion, Fading Enthusiasm over PPACA

In the past month, fewer and fewer Americans have said that they are confused about the new health reform law. Though more than four in 10 continue to struggle, and just over one-third say they don’t understand how the law will affect them personally, the basic shape of opinion overall on the reform law remains unchanged, with the nation still firmly divided along partisan lines.

According to the May Kaiser health tracking survey, there is less enthusiasm about health reform. Those who look upon the law favorably tend to focus on the ways it will increase access to coverage and care, while those who view the law unfavorably have a more splintered array of reasoning – beginning with concerns about cost and government control.

Less confusion

While more than half of the public (55 percent) said that the word “confused” aptly described their feelings about the new health reform law in April, that proportion dropped by 11 percentage points in May. The drop was particularly evident among women, who are more likely to be making health care decisions for the household; 60 percent felt confused in April compared with 45 percent in May, bringing them more in line with the results among men.

Those with more education and higher incomes also dispelled their confusion at a higher rate this spring than those with less education and lower incomes. Even with the decrease, however, a substantial minority – 44 percent – say they remain confused about the health reform law.

Overall, a solid majority of Americans (61 percent) say they feel like they “understand what the impact of the health reform law will be” on themselves and their families, while 35 percent say they do not understand how they will be affected.

Americans living in households that bring in less than $40,000 a year and those who are uninsured are somewhat more likely than their counterparts to say they do not understand how the law will affect their own families, even though many components are specifically targeted at lower-income households.

Waning enthusiasm

Overall, the public continues to be divided in their views of the health reform law, with the poll finding 41 percent holding favorable views, 44 percent unfavorable views, and 14 percent undecided or unsure. These views continue to differ markedly by party, with most Democrats holding favorable views, most Republicans unfavorable views, and political independents tilting toward a negative viewpoint. As was true in April, voters who say they are likely to vote in the midterm elections are somewhat more likely to tilt negative in their views of health reform.

In terms of the trend in opinion, between April and May, there was a falloff in strong supporters, with 23 percent in April saying they held “very favorable” views of the new law, compared with 14 percent now. Most of this falloff came from Democrats themselves, whose “rally round the flag” sentiments may be waning as passage fades into the rearview mirror. In April, 43 percent of self‐identified Democrats said they had “very favorable” views of the reform law, compared with 30 percent now. Only time can tell whether this is a blip or the start of a trend.

Meanwhile, the percentage with “very unfavorable” views of the legislation hasn’t changed appreciably since April, hovering at around three in 10 overall, and rising to seven in 10 among Republicans. Feelings continue to be stronger, then, among opponents than among proponents of the law.

When asked to explain the main reason for their favorable views in their own words, supporters offered reasoning that related to increasing Americans’ access to health insurance and to health care itself (47 percent). Others offered answers focusing on their hope that costs will come down under reform (12 percent), and some focused on such insurance reforms as the end of exclusions based on pre‐existing conditions (4 percent).

Those with unfavorable views of the law had a much more disparate group of reasons for their negative perceptions. Topping the list were concerns about the cost of the reforms (27 percent) and opposition to the government’s perceived role in the changes (17 percent).

There has been little change since April in the proportion that expects to benefit from the new law. About three in 10 say they do believe they’ll benefit from the provisions, while just as many expect to suffer in some way and another one-third don’t expect to be affected.

Calming emotions

As health reform is replaced by other pressing policy issues on the front pages of newspapers and websites, it may also be ceding its place in the forefront of people’s minds. The Kaiser survey suggests that fewer Americans report holding strong emotions – either positive or negative – about the new law. In addition to the drop in the proportion who said they were confused, there was also a drop in the proportion who said they felt relieved or pleased (down 8 percentage points to 32 percent and down 6 percentage points to 39 percent, respectively), as well as a drop in those who reported feeling anxious (down 6 percentage points to 36 percent). The proportion who felt disappointed, however, did not change, remaining at 45 percent and now roughly tied with confusion as the most predominant emotion. Neither did the proportion who felt angry change, which hovered at 30 percent. 

Source: Kaiser Family Foundation

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