Kaiser Family Foundation July 2012 Affordable Care Act Feelings

Chartpack

Kaiser Health Tracking Poll: July 2012

July 2012

SLIDE 1

Half Say Mind Is Made Up On ACA, But Still Room For Persuasion

Which comes closer to how you feel about the health care law:

20%
You haven’t really
decided how you 52%
feel about the law
Your mind is made
up and it is very
You have an opinion unlikely you will
on the law, but change your opinion
there’s a chance 26% of the law
something could
change your opinion

1%
Dk/Ref.

Source: Kaiser Family Foundation Health Tracking Poll (conducted July 17‐23, 2012)

SLIDE 2

Opponents More Likely To Say They Won’t Change Their Mind On ACA

Which comes closer to how you feel about the health care law:

Your mind is made up and it is You have an opinion on the law,
You haven’t really decided
very unlikely you will change but there’s a chance something
how you feel about the law
your opinion of the law could change your opinion

Total 52% 26% 20%

Among those with a favorable
47% 36% 16%
view of the ACA

Among those with an unfavorable
69% 19% 11%
view of the ACA

Note: Don’t know/Refused answers not shown.

1

SLIDE 3

Views On Congress’ Next Steps Evenly Split This Month

What would you like to see Congress do when it comes to the health care law?

REPEAL law and REPLACE with
EXPAND law or
80% Republican alternative or REPEAL Don’t know/Refused
KEEP law as is
law and NOT REPLACE it

60%
53 54 53
51 52 51 51 52
50 50 50 50
47 47 47 46%

40% 45%
43
40 41
39 39 38 38 39 38 39 38
37 37 37
35

20%
14 13
12 12 11 11 11 12
10 10 10 10 10 9 10 10%

0%
Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec Jan Feb Mar Apr May Jun Jul
2011 2012

Source: Kaiser Family Foundation Health Tracking Polls

SLIDE 4

Partisans Disagree On Next Steps For Health Reform Law

What would you like to see Congress do when it comes to the health care law?

REPEAL law and REPLACE with REPEAL law and
EXPAND law KEEP law as is
Republican‐sponsored alternative NOT REPLACE it

Total 24% 21% 23% 23%

Democrats 39% 36% 6% 11%

Independents 23% 19% 23% 26%

Republicans 10% 7% 43% 32%


2

SLIDE 5

Majority Disapprove Of Cutting Off Funding For Implementation

Some lawmakers who oppose the health reform law say that if Congress isn’t able to repeal the law, they should try to
stop it from being put into place by cutting off funding to implement it. Whether or not you like the health reform law,
would you say you approve or disapprove of cutting off funding as a way to stop some or all of health reform from being
put into place?

Approve of cutting off funding Disapprove of cutting off funding

Total 35% 56%

Democrats 13% 83%

Independents 38% 55%

Republicans 62% 28%


SLIDE 6

Still Divided On ACA, But Unfavorable Views Slightly Outweigh Favorable

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?

80%
Favorable Unfavorable Don’t know/Refused

ACA signed into law
on March 23, 2010
60%

50 50 51
48 49 48
46 45 46 46
44 44 44 43 44 43 44 43 44 43 43 44 44%
42 42 41 41 41
40%
43 42 43 42
40 41 41 40 40 41 41 41 42 42 42 41 41 42
40
42 41
39 38%
37 37 37
35 34

20%

18 18 18 19 19 19 19 18
17 16 17 17%
14 14 14 15 14 15 15 15 15
12 11 13 12
10 9 8
0%
Apr May Jun Jul Aug Sep Oct Nov Dec Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec Jan Feb Mar Apr May Jun Jul
2010 2011 2012


3

SLIDE 7

Chronic Partisan Divide Over ACA

Percent who say they have a favorable opinion of the health reform law:

ACA signed into law Democrats Independents Republicans
on March 23, 2010
80%
75
73 73
78 72 69 69 68 69
71 72
70 71
69%
68
66 65 64 65 66 62
64 64 64
62 62
60
60%
52
49 48
43
41 42 41 40 40 39
38 38
40% 36 37 37 37 37
35 36 35%
34 34 33 33 34 33 34
32
30

20% 24
23 21 21 20 19
16 17 16 16
15 14
13 12 12 11 12
11 11 12 12 12 12%
8 9 8
7 7
0%
2010 2011 2012


SLIDE 8

On ACA, Independents Who Lean Still Look Like Partisans

Percent who say they have a favorable opinion of the health reform law:
Democrats Independents Republicans
ACA signed into law
on March 23, 2010 Independents Who Independents Independents Who
80%
Lean Democratic Who Don’t Lean Lean Republican

66 66 67 67
60% 64 64 65 65 64%
61 61 59 62 62
60 60 59 59 58
56 56
53
42
40%
41 41 42
38
33 33 33 34
32 32
30 29 29
28 28 28%
26 24 26 26 26
20%
21
18 18 19 20
16 17 17
15 15 13 14 15
12 13 12
11 11
8 9 9 8%
0%
2010 2011 2012


4

SLIDE 9

Large Share Of Republicans Intense In Their Opposition To 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?

Very favorable Somewhat favorable Somewhat unfavorable Very unfavorable

Total 20% 18% 13% 31%

Democrats 41% 28% 8% 7%




SLIDE 10

Plurality Anticipate No Personal Impact

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?

80%
ACA signed into law
on March 23, 2010 Better off Won’t make much difference Worse off

60%

44 44
41 41 34
39 38 39 37 38
39 39
40% 36 37 37 37%
34 33 35 35 34 34
32 32 33 33 32 32 31
32 30 30
31 30 28 31 32 28 28 34 29
32 31 33 32 31 31 31 33 27 33 32 32%
30 29 31
28 29 29 28 29 28 28
26 27 28 27 27 26 26 25 26 26
20% 25 24 24 25%
23 23
20
18

0%
2010 2011 2012


5

SLIDE 11

Will Country Benefit From ACA? Another Lasting Division Of Opinion

Do you think the country as a whole will be better off or worse off under the health reform law, or don’t you
think it will make much difference?

80%
ACA signed into law
on March 23, 2010 Better off Won’t make much difference Worse off

60%

45
43 42 43 42 41%
39 38 40 38 39 38 39 38 39 39
39 39 38 39
40% 37 38 36 36 37 37
35
37 36 37 37 37 36 29 35 37 36 37 38
35 35 35 34 34 34 35 35 35 35 34 35%
32 33 32
28
20%
22 21 22 22
19 18 18 19 19 18 19 20 20 18 19 19 18 17
20
18%
15 15 16 15
13
11

0%
2010 2011 2012


SLIDE 12

Uninsured And Low‐income Seen As Most Likely To Benefit

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?

Better off Won’t make much difference Worse off

The uninsured 47% 16% 29%

Lower income Americans 45% 16% 32%

The country as a whole 35% 18% 41%

Your state 33% 19% 40%

Middle class Americans 30% 23% 42%

You and your family 25% 37% 32%


6

SLIDE 13

Most Democrats Expect Their State Will Be Better Off Under ACA, Most
Republicans Say Worse Off
Do you think your state 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

Total 33% 19% 40%

Democrats 59% 18% 16%

Independents 29% 22% 40%

Republicans 12% 14% 69%


SLIDE 14

Should Debate End Now? By Party ID

Which comes closer to your view:

I’m tired of hearing lawmakers debate I think it is important for lawmakers to
the health care law and would like continue the debate over the health
them to move on to other issues care law

Total 54% 44%

Democrats 65% 33%


Republicans 39% 60%


7

SLIDE 15

Most Americans See Lawmakers On Both Sides As In It For Themselves

When lawmakers who OPPOSE the health When lawmakers who SUPPORT the
care law speak out against it, do you think health care law speak out in favor of it, do
they are doing so more because: you think they are doing so more because:

30% 29%
They believe the They believe the
law is the WRONG 57% law is the RIGHT 56%
thing for the thing for the
country They are trying country They are trying
to gain political to gain political
advantage advantage

7% 8%

5% 5%

Dk/Ref. Dk/Ref.
Both equally (vol.) Both equally (vol.)
1% Other/Neither (vol.) 2% Other/Neither (vol.)


SLIDE 16

Half Say Medicaid Is Important To Their Own Family

Next, I’d like to ask you some questions about Medicaid, which is the government program that provides
health insurance and long term care to certain low‐income adults and children. How important for you
and your family is the Medicaid program?*

33% 35%

Not at all Very
important important

13%
17%
Not too
Somewhat
important
important

2%
Dk/Ref.

*Respondents were asked about “the Medicaid program, which may also be known in your state as [INSERT STATE‐SPECIFIC NAME]” since actual Medicaid program
names and insurance options vary from state to state.

8

SLIDE 17

Importance Of Medicaid To Own Family Varies By Household Income

How important for you and your family is the Medicaid program?

Very important Somewhat important Not too important Not at all important

Total 35% 17% 13% 33%

Less than $40,000 51% 18% 10% 19%

$40,000‐$90,000 22% 21% 18% 39%

$90,000 or more 24% 12% 11% 50%


SLIDE 18

Promise Of Safety Net Tops Reasons For Valuing Medicaid

Among the 52% who say Medicaid is very or somewhat
important to their family, the percent who say each of
How important for you and your family is the following is a major reason why Medicaid is
the Medicaid program? important:

You like knowing that the Medicaid
program exists as a safety net to
78%
protect low‐income people who
can’t afford needed care
33% 35% 52%
Not at all NET You think that you or someone in
Very important Very and your family may need to rely on 69%
important
Somewhat Medicaid benefits in the future
important

You or someone you know has
received health coverage through 65%
13% 17%
Medicaid
Not too Somewhat
important important You or someone you know has
received nursing home or long‐
49%
term care services paid for by
2% Medicaid
Dk/Ref.


9

SLIDE 19

Most Support Medicaid Expansion As General Concept

The health reform law will expand the existing Medicaid program to cover more low‐income, uninsured
adults. Would you say you feel very favorable, somewhat favorable, somewhat unfavorable, or very
unfavorable about that?


Total 41% 26% 14% 16%

Democrats 63% 24% 6% 5%




SLIDE 20

Views On Whether Own State Should Expand Medicaid Under ACA

As you may know, the health care law expands Medicaid to provide health insurance to more low‐income uninsured adults,
including adults with no children whose incomes are below about $16,000 a year. The federal government will initially pay the
entire cost of this expansion, and after several years, states will pay 10 percent and the federal government will pay 90
percent. The Supreme Court ruled that states may choose whether or not to participate in this expansion. What do you think
your state should do?

Keep Medicaid as it is today, with no new Expand Medicaid to cover more low‐income uninsured people,
funding from the federal government and no with the federal government initially paying the entire cost of
change in who will be covered by the program the expansion and your state eventually paying 10 percent

Total 43% 49%

Democrats 22% 75%


Republicans 66% 24%

Note: Other/Neither (vol.) and Don’t know/Refused answers not shown.

10

SLIDE 21

Some Room To Move On Views Of State Medicaid Expansion

The Supreme Court ruled that states may choose whether or not to participate in the ACA Medicaid expansion. What do you think your state
should do?
KEEP MEDICAID AS IS EXPAND MEDICAID

43% 49%

ASKED OF THOSE WHO WANT TO KEEP MEDICAID AS IT IS TODAY: ASKED OF THOSE WHO WANT TO EXPAND MEDICAID:
What if you heard that this would mean many low‐income people What if you heard that this expansion would require your state
in your state would be left without health insurance, and your to spend more money on Medicaid, even though the federal
state would be giving up additional federal dollars for covering its government would be picking up most of the cost? Would you
uninsured residents? Would you still prefer to keep Medicaid as it still prefer to expand Medicaid to cover more low‐income
is today, or would you prefer to expand Medicaid to cover more uninsured people in your state, or would you now prefer to
low‐income uninsured people in your state? keep Medicaid as it is today?

31%
59% 52% 43% 38%
Still want to 49%
NET NET Originally Still want to
keep Medicaid Originally expand
EXPAND Medicaid KEEP Medicaid wanted to keep
as is wanted to Medicaid
after hearing after hearing Medicaid
expand follow‐up follow‐up as is
Medicaid argument argument
10%
Other 10%
10% 9% Other

NOW PREFER TO EXPAND Medicaid NOW PREFER TO KEEP Medicaid as is
Note: “Other” includes Other/Neither (vol.) and Don’t know/Refused answers combined.

SLIDE 22

Exchanges, Subsidies, Medicaid Expansion Receive Majority Support; But
Most Continue To Oppose Individual Mandate
Next, 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.


Subsidy assistance to individuals 41% 29% 13% 14%

Medicaid expansion 41% 26% 14% 16%

Health insurance exchanges 39% 32% 12% 13%

Individual mandate 17% 17% 14% 49%

Note: Response wording abbreviated. See Topline: http://www.kff.org/kaiserpolls/8339.cfm for complete wording. Don’t know/Refused answers not shown.

11

SLIDE 23

Support For Individual Provisions By Party ID

Percent who say they feel favorable about each of the following elements of the health reform law:

Total Dem. Ind. Rep.
Health insurance exchanges 71% 86% 70% 56%
Subsidy assistance to individuals 70 90 70 45
Medicaid expansion 67 87 67 39
Individual mandate 34 59 30 18

Note: Response wording abbreviated. See Topline: http://www.kff.org/kaiserpolls/8339.cfm for complete wording.

SLIDE 24

Views On Individual Mandate Don’t Change Whether Called ‘Fine’ Or ‘Tax’

Next, I’m going to read you several elements of the health reform law. As I read each one, please tell me
whether you feel favorable or unfavorable about it.

Favorable Unfavorable

The law will require nearly all Americans
who don’t have health insurance as of 32% 66%
2014 to get it or else pay a FINE

The law will require nearly all Americans
who don’t have health insurance as of 37% 61%
2014 to get it or else pay a TAX

Note: Items asked of separate half samples. Don’t know/Refused answers not shown.

12

SLIDE 25

Most Don’t Expect To Pay Penalty, But More Expect To When Framed As A
Tax

When the requirement that nearly all When the requirement that nearly all
Americans have health insurance or else Americans have health insurance or else
pay a FINE goes into effect in 2014, do you pay a TAX goes into effect in 2014, do you
expect to have to pay that FINE, or not? expect to have to pay that TAX, or not?

12%
Yes, expect
to pay fine 4% 26%
Yes, expect to
pay tax
70%
84% No, do not
expect to pay tax 4%
No, do not
expect to pay fine

Dk/Ref.
Dk/Ref.

Note: Items asked of separate half samples.

SLIDE 26

Some Arguments Move Opinion On Individual Mandate

Favorable Unfavorable
The health reform law will require nearly all Americans to have health
insurance by 2014 or else pay a fine/tax. Would you say you feel 34% 63%
favorable or unfavorable about that?

ASKED OF THOSE WHO HAVE AN UNFAVORABLE VIEW OF THE INDIVIDUAL MANDATE:
What if you heard that… Would you still have an unfavorable view of that requirement or would you now have a favorable view?

Results for total after follow‐up argument:

Originally Now
favorable favorable Still unfavorable
Most Americans would still get coverage through their employers
or a public insurance program and so would automatically 34% 24% 35%
satisfy the requirement without having to buy any new insurance

People would not be held to this requirement if the cost of new
34% 18% 43%
coverage would consume too large a share of their income

After the requirement goes into effect, about one in ten
34% 8% 53%
Americans would have to get insurance or else pay a tax/fine

50%

13

SLIDE 27

Which Candidate, Party Trusted To Handle Health Policy Issues?

Which presidential candidate, Barack Obama Overall, do you trust the Democrats or
or Mitt Romney, do you trust to do a better the Republicans in Congress to do a
job with each of the following? better job with each of the following?
Obama‐Romney Dems‐Reps
Barack Mitt
Percentage Point Dems Reps Percentage Point
Obama Romney
Difference Difference

Handling the Medicare program 45% 34% 11 40% 33% 7

Dealing with the future of the
45% 34% 11 37% 32% 5
2010 health care law

Handling the Medicaid program 44% 34% 10 38% 33% 5

Lowering health care costs for
43% 33% 10 38% 34% 4
people like you

Note: Both (vol.), Neither/Other (vol.), and Don’t know/Refused answers not shown.

SLIDE 28

Methodology

This Kaiser Health Tracking Poll is the second of two polls to be released this month looking at public opinion on
the Affordable Care Act in the wake of the Supreme Court’s decision in the case challenging the law. The poll was
designed and analyzed by public opinion researchers at the Kaiser Family Foundation led by Mollyann Brodie,
Ph.D., including Claudia Deane, Sarah Cho, and Theresa Boston. The survey was conducted July 17‐23, 2012,
among a nationally representative random digit dial telephone sample of 1,227 adults ages 18 and older, living in
the United States, including Alaska and Hawaii (note: persons without a telephone could not be included in the
random selection process). Computer‐assisted telephone interviews conducted by landline (703) and cell phone
(524, including 292 who had no landline telephone) were carried out in English and Spanish by Braun Research,
Inc. under the direction of Princeton Survey Research Associates International (PSRAI). The combined landline and
cell phone sample was weighted to balance the sample demographics to match Census estimates for the national
population on sex, age, education, race, Hispanic origin, nativity (for Hispanics only), region, and telephone
usage.

All statistical tests of significance account for the effect of weighting. The margin of sampling error including the
design effect is plus or minus 3 percentage points. For results based on other subgroups, the margin of sampling
error may be higher. Note that sampling error is only one of many potential sources of error in this or any other
public opinion poll.

The full question wording and methodology of the polls can be viewed online at:
http://www.kff.org/kaiserpolls/8339.cfm.

14

The Henry J. Kaiser Family Foundation

Headquarters
2400 Sand Hill Road
Menlo Park, CA 94025
Phone: (650) 854‐9400    Fax: (650) 854‐4800

Washington Offices and
Barbara Jordan Conference Center
1330 G Street, NW
Washington, DC 20005
Phone: (202) 347‐5270    Fax: (202) 347‐5274

www.kff.org

This publication (#8339‐C) is available on the
Kaiser Family Foundation website at www.kff.org.

The Kaiser Family Foundation, a leader in health policy analysis, health journalism and communication, is dedicated to filling the
need for trusted, independent information on the major health issues facing our nation and its people.
The Foundation is a non‐profit private operating foundation, based in Menlo Park, California.

Kaiser Family Foundation July 2012 Affordable Care Act Feelings

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Kaiser Family Foundation July 2012 Affordable Care Act Feelings