Chartpack Kaiser Health Tracking Poll: March 2011 March 2011
SLIDE 1 Half Still Say They Don t Understand Law s Personal Impact Do you feel you have enough information about the health reform law to understand how it will impact you personally, or not? THEN NOW APRIL 2010 MARCH 2011 56% No 43% Yes 52% No 47% Yes 2% Don t know/refused Don t know/refused 1% SLIDE 2 Feelings About Health Reform Fairly Stable Percent who say that each of the following describes their feelings about the health reform law: CONFUSED ENTHUSIASTIC 55% 53% 52% 44% 42% 43% 45% 47% 43% 5 53% 35% 33% 3 3 3 Apr May Jun Jul Aug Sep Oct Nov Dec Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec Jan Feb Mar 2010 2011 2010 2011 ANXIOUS ANGRY 42% 42% 39% 39% 36% 3 3 3 Apr May Jun Jul Aug Sep Oct Nov Dec Jan Feb Mar 2010 2011 Apr May Jun Jul Aug Sep Oct Nov Dec Jan Feb Mar 2010 2011 1
SLIDE 3 Confusion Remains High Percent who say that confused describes their feelings about the health reform law: 8 ACA signed into law on March 23, 2010 55% 44% 42% 43% 45% 53% 47% 52% 43% 5 53% Mar Apr May Jun Jul Aug Sep Oct Nov Dec Jan Feb Mar 2010 2011 SLIDE 4 Confusion Most Commonly Expressed Emotion Please tell me if each of the following does or does not describe your own feelings about the health reform law. Describes Does not describe Confused 53% 47% Anxious 39% 61% Angry 66% Enthusiastic 72% Note: Don t know/refused answers not shown. 2
SLIDE 5 At One Year Anniversary, Views on Health Reform Remain Divided As you may know, a health reform bill was signed into law early last year. Given what you know about the health reform law, do you have a generally favorable or generally unfavorable opinion of it? 8 Favorable Unfavorable Don t know/refused ACA signed into law on March 23, 2010 46% 44% 48% 5 45% 49% 44% 42% 42% 5 48% 46% 41% 41% 43% 42% 41% 41% 43% 42% 35% 14% 14% 1 14% 12% 11% 9% 8% 13% Mar Apr May Jun Jul Aug Sep Oct Nov Dec Jan Feb Mar 2010 2011 SLIDE 6 Views on Health Reform Law Differ Sharply by Party Self Identification As you may know, a health reform bill was signed into law early last year. 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 Democrats 7% 9% Independents 17% Republicans 3% 6% 23% 59% Note: Don t know/refused answers not shown. 3
SLIDE 7 Wide Partisan Divide Lasts Throughout Year Percent who say they have a favorable opinion of the health reform law: 10 8 ACA signed into law on March h23, 2010 Democrats Independents Republicans 78% 72% 69% 73% 68% 75% 69% 68% 69% 73% 66% 71% 36% 37% 49% 48% 41% 42% 37% 37% 43% 37% 23% 13% 11% 12% 12% 11% 8% 9% Mar Apr May Jun Jul Aug Sep Oct Nov Dec Jan Feb Mar 2010 2011 SLIDE 8 Support for the ACA Among Key Subgroups Percent who say they have a favorable opinion of the health reform law: BY AGE BY RACE/ETHNICITY 8 18 64 65+ 42% 8 Black Hispanic White Apr May Jun Jul Aug Sep Oct Nov Dec Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec Jan Feb Mar 2010 2011 2010 2011 67% 59% BY INCOME BY INSURANCE STATUS (<65) 8 < $40K $40 $90K $90K+ 42% 41% 41% 8 Insured Uninsured 43% 36% Apr May Jun Jul Aug Sep Oct Nov Dec Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec Jan Feb Mar 2010 2011 2010 2011 4
SLIDE 9 Most Support State Substitution, With a Caveat If a state shows that they can create a health reform plan that covers as many people as the national health reform law, and provides them health insurance that is just as comprehensive and affordable, do you think that state should or should not be permitted to substitute their own plan for the federal one? YES, states should be permitted to substitute own plan NO, states shouldn t be permitted to substitute own plan 66% 29% ASKED OF THOSE WHO SAY STATES SHOULD BE PERMITTED TO SUBSTITUTE OWN PLAN: Would you still favor the idea if some states decided to save money by providing more limited insurance to fewer people than the national health reform law, or would you then oppose the idea? YES, would still favor states being able to substitute NO, oppose the idea 26% 65% Note: Follow up question asked of those who initially said states should be permitted to substitute their own health care plan. Responses on bottom graph are based on total, where no, oppose the idea includes those who initially opposed and those who opposed after hearing the follow up. Don t know/refused answers not shown. SLIDE 10 Still Divided as to What Next for Health Reform What would you like to see Congress do when it comes to the health care law? EXPAND law KEEP law as is REPEAL law and REPLACE with Republicansponsored alternative REPEAL law and NOT REPLACE it Total 3 Democrats 49% 3 6% 7% Independents 19% 25% Republicans 12% 9% 39% 35% Note: Don t know/refused answers not shown. 5
SLIDE 11 Majority Want to Keep Major Elements of Law, Except for Individual Mandate I'm going to read you several elements of the health reform law. For each, please tell me if you think lawmakers should keep it or repeal it. Keep Repeal Tax credits to small businesses 82% Gradually close the Medicare doughnut hole 76% 19% Guaranteed issue 74% 22% Financial help for low and moderate income Americans in need of coverage 72% 24% Increase Medicare payroll tax on wealthy 58% 36% Individual mandate 67% Note: Question responses abbreviated. See Topline: http://www.kff.org/kaiserpolls/8166.cfm for complete wording. Keep it but make changes (vol.) and Don t know/refused answers not shown. SLIDE 12 Even Among Those Who Back Repeal, Many Support Elements of Law I'm going to read you several elements of the health reform law. For each, please tell me if you think lawmakers should keep it or repeal it. Among those who want to REPEAL health reform law Among those who want to KEEP health reform law Democrats Independents Republicans Keep Repeal Keep Repeal Keep Repeal Keep Repeal Keep Repeal Tax credits to small businesses 68% 92% 6% 9 7% 81% 72% 26% Guaranteed Issue 60 36 85 13 85 13 74 22 62 34 Gradually close the Medicare doughnut hole 59 35 88 9 86 12 75 19 64 29 Financial help for low and moderate income Americans in 48 45 89 10 89 10 71 25 47 46 need of coverage Increase Medicare payroll tax on wealthy 34 60 78 18 76 19 55 39 36 58 Individual mandate 9 89 43 50 44 48 25 70 12 86 Note: Question responses abbreviated. See Topline: http://www.kff.org/kaiserpolls/8166.cfm for complete wording. Keep it but make changes (vol.) and Don t know/refused answers not shown. 6
SLIDE 13 Views on Individual Mandate Show Some Malleability Please tell me if you think lawmakers should keep or repeal the element of the health reform law that will require nearly all Americans to have health insurance or else pay a fine. Keep 67% Repeal ASKED OF THOSE WHO THINK LAWMAKERS SHOULD REPEAL INDIVIDUAL MANDATE: What if you heard that under the reform law, most Americans would still get coverage through their employers and so would automatically satisfy the requirement without having to buy any new insurance. Would you still say lawmakers should repeal this part of the law? without such a requirement, people may wait until they are seriously ill to buy health insurance, which will drive up health insurance costs for everyone? Would you still say lawmakers should repeal this part of the law? Keep Still repeal Keep Still repeal 55% 35% 48% Note: Follow up question asked of those who initially said lawmakers should repeal the individual mandate element of the health reform law. Responses on bottom graph are based on total, where keep includes those who initially said keep and those who said keep after hearing the follow up. Don t know/refused answers not shown. SLIDE 14 Most Aware of Lack of Agreed Upon Alternative to ACA As far as you know, do the Republicans in Congress have an agreed upon alternative to the health care reform law that was passed last year, or not? Yes, Republicans have an agreed upon alternative No, they don t Don t know/refused Total 13% 26% Democrats 1 68% Independents 12% 64% 24% Republicans 23% 5 7
SLIDE 15 No Agreement on Whether GOP Reform Proposals Would Be Preferable Compared to the current health reform law, do you think health reform proposals being made by Republicans in Congress would do a better or worse job at each of the following or would it be about the same? Better job About same Worse job Don t know/refused Lowering the amount the nation as a whole spends on health care 25% 3 11% Protecting consumers in the private health insurance market 24% 36% 29% 11% Lowering the amount you and your family pay for health care 19% 43% 1 Covering the uninsured 38% 13% SLIDE 16 Majority Disapproves of Cutting off ACA Funding 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? Disapprove of cutting off funding Approve of cutting off funding Total 64% 3 Democrats 86% 1 Independents 65% 29% Republicans 61% Note: Don t know/refused answers not shown. 8
SLIDE 17 Public Expects Success in Expanding Coverage, Less So on Limiting Cost Please tell me how successful, if at all, you expect the new health reform law to be in accomplishing each of the following goals. Very successful Somewhat successful Not too successful Not at all successful Expanding health insurance coverage for the uninsured 25% 43% 17% 12% Regulating health insurance companies so that the average person with private insurance will have better consumer protections 42% 19% Reducingthe amounttheaveragethe average American has to pay for health care and health insurance 14% 33% 22% Reducing the total amount the country spends on health care 11% 24% 3 Note: Don t know/refused answers not shown. SLIDE 18 Public Split on Personal Impact of Law 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? 8 Better off Won t make much difference Worse off ACA signed into law on March 23, 2010 43% 38% 41% 39% 36% 35% 36% 26% 39% 36% 3 3 29% 29% 44% 39% 26% 3 11% Feb Apr Jun Jul Aug Sep Oct Nov Dec Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec Jan Feb Mar 2009 2010 2011 Note: Depends (vol.) and Don t know/refused answers not shown. 9
SLIDE 19 No Agreement as to Whether Country Will Benefit 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? 8 Better off Won t make much difference Worse off 59% 57% 53% ACA signed into law on March 23, 2010 45% 45% 45% 45% 42% 39% 39% 38% 39% 38% 19% 19% 12% 14% 12% 17% 35% 12% 11% 37% 19% 37% 22% 37% 35% 19% 19% Feb Apr Jun Jul Aug Sep Oct Nov Dec Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec Jan Feb Mar 2009 2010 2011 Note: Depends (vol.) and Don t know/refused answers not shown. SLIDE 20 Little Change in How Americans Expect Law to Affect Their Health Care Under the health reform law, do you think each of the following will get better, worse or will it stay about the same? Better Stay the same Worse THEN APRIL 2010 NOW MARCH 2011 Your ability to get and keep health insurance 19% 26% 46% 25% The cost of health care for you and your family 25% 37% 23% 42% The quality of your own health care 23% 43% 45% Note: Don t know/refused answers not shown. 10
SLIDE 21 Better Access to Care Most Commonly Cited Benefit of Law So far, would you say you and your family have personally benefited from the health reform law, or not? Among the 13% who say they have benefited from the health reform law: In what ways would you say you have benefited from the health reform law? 84% No 13% Yes 3% Don t know/refused Benefit Percent who mentioned Access to health care 39% Lower health care costs 24 Extension of dependent coverage 14 Help for seniors/close Medicare doughnut hole 6 Hl Help dealing with pre existing iti conditions 5 My insurance is good/no changes 4 Other insurance reforms 4 Health reform will help in general 3 Note: Only responses of 3% or more shown. Other and Don t know/refused answers not shown. SLIDE 22 Cost Most Frequently Cited Negative Effect of Law So far, would you say you and your family have been negatively affected by the health reform law, or not? Among the who say they have been negatively affected by the health reform law: In what ways would you say you have been negatively affected by thehealthreform health law? 77% No Yes 3% Don t know/refused Negative Effect Percent who mentioned Cost 58% Cuts to benefits/fewer options 14 Unable to get/dropped by insurance 5 Harm to Medicare/seniors 5 Bad for business/jobs 5 Haven t seen any changes 4 Don t want to pay for freeloaders 3 Declining quality of care 3 Bad for providers/providers have quit 3 Note: Only responses of 3% or more shown. Other and Don t know/refused answers not shown. 11
SLIDE 23 Seniors Views Moderate Somewhat in March As you may know, a health reform bill was signed into law early last year. Given what you know about the health reform law, do you have a generally favorable or generally unfavorable opinion of it? 8 AMONG SENIORS (age 65 and older) ACA signed into law on March 23, 2010 Favorable Unfavorable Don t know/refused 55% 51% 51% 46% 53% 49% 52% 46% 5 59% 52% 35% 38% 38% 38% 26% 12% 14% 17% 13% 13% 1 9% 8% Mar Apr May Jun Jul Aug Sep Oct Nov Dec Jan Feb Mar 2010 2011 SLIDE 24 Plurality of Seniors Continue To See ACA as Challenge for Medicare Do you think the Medicare program will be better off or worse off under the health reform law, or don t you think it will make much difference? 8 AMONG SENIORS (age 65 and older) Better off Won t make much difference Worse off 43% 42% 44% 39% 39% 25% 22% 23% 22% 19% 19% Jul Aug Sep Oct Nov Dec Jan Feb Mar 2010 2011 Note: Don t know/refused answers not shown. 12
SLIDE 25 Three in Ten Not Confident They Can Pay for Needed Care Generally, how are you that you have enough money or health insurance to pay for the usual medical costs that you and your family require? Would you say you are very, somewhat, not too, or not at all? THEN NOW MAY 2010 MARCH 2011 Not too Not at all 29% Very Not too Not at all Very 2% 38% Somewhat 1% 41% Somewhat Don t know/refused Don t know/refused SLIDE 26 Most Uninsured are Unsure They Can Pay for Needed Care Generally how are you that you have enough money or health insurance to pay for the usual medical costs that you and your family require? Would you say you are very, somewhat, not too, or not at all? Very Somewhat Not too Not at all Total 41% Insured (age <65) 45% 14% 9% Uninsured (age <65) 12% 3 Note: Don t know/refused answers not shown. 13
SLIDE 27 Nearly Four in Ten Not Confident Could Pay for Major Illness How are you that you would have enough money or health insurance to pay for a major illness, such as a heart attack, cancer, or a serious injury that required hospitalization? Would you say you are very, somewhat, not too, or not at all? THEN MAY 2010 NOW MARCH 2011 Not at all Very Not at all Very Not too 33% Somewhat Not too 35% Somewhat 2% 1% Don t know/refused Don t know/refused SLIDE 28 Nearly All Uninsured Not Financially Ready for Major Illness How are you that you would have enough money or health insurance to pay for a major illness, such as a heart attack, cancer, or a serious injury that required hospitalization? Would you say you are very, somewhat, not too, or not at all? Very Somewhat Not too Not at all Total 35% Insured (age <65) 3 38% 17% 4% Uninsured (age <65) 17% 13% 67% Note: Don t know/refused answers not shown. 14
SLIDE 29 Half of Insured Say Premiums are Going Up Thinking about your health insurance premiums that is, the amount you pay each month for your health insurance coverage. Does it seem to you that your health insurance premiums have been going up lately, going down, or holding steady? Has this increase been a financial burden for you, or not? Yes, financial burden 22% Holding steady 5 Going up Going 2% down 2% Don t know/refused 6% Don t pay anything toward premiums (vol.) No, not a financial burden Note: Based on those with health insurance coverage. SLIDE 30 Four in Ten Insured Say Deductibles and Co Pays Going Up Thinking about your deductible and co pay that is, the amount you have to pay for medical services above and beyond what insurance covers. Does it seem to you that your deductible and co pay expenses have been going up lately, going down, or holding steady? Has this increase been a financial burden for you, or not? Yes, financial burden 19% 52% Holding steady Going up 5% No, not a financial burden Going down 3% Don t know/refused Note: Based on those with health insurance coverage. 15
SLIDE 31 Most Wrongly Believe Uninsured Population Dominated by Unemployed I d like to ask you to think about uninsured Americans that is, people with no health insurance at all. Would you say that more of them are 8 Employed people and people from families in which someone is employed (correct answer) Unemployed people and people from families in which no one is employed or Don t know (incorrect answer) 66% 58% 58% 52% 63% 5 61% 55% 62% 56% 63% 42% 36% 48% 37% 49% 39% 45% 39% 44% 37% Feb94 Jun96 May98 Nov98 Sep99 Oct99 Feb00 Jul00 Feb03 Apr04 Jun07 Mar11 Note: July 2000 based on registered voters. Source: Kaiser Family Foundation surveys; September 1999 survey by Families USA/Health Insurance Association of America. SLIDE 32 Half Put Off Care Due to Cost Percent who say they or another family member living in their household, have done each of the following in the past 12 months because of the cost: Skipped dental care or checkups Relied on home remedies or over the counter drugs instead of going to see a doctor Put off or postponed getting health care needed Not filled a prescription for a medicine Skipped a recommended medical test or treatment Cut pills in half or skipped doses of medicine 33% Had problems getting mental health care 9% Yes to any of the above 52% 16
SLIDE 33 Uninsured and Low Income More Likely to Skip Needed Care Percent who report All Lower income Americans Uninsured (under age 65) Problems paying medical bills 23% 36% 48% Skipped dental care or checkup 33 50 58 Putting off needed care because of cost 28 43 64 Not filled a prescription for a medicine 21 32 50 SLIDE 34 Rising Cost of Care in Top Three Personal Worries I m going to read you a list of things that some people worry about and others do not. I d like you to tell me how worried you are about each of the following things. Very worried Somewhat worried Not too worried Not at all worried Your income not keeping up with rising prices 38% 14% Not having enough money for retirement 33% Having to pay more for your health care or health insurance 29% Not being able to afford the health care services you think you need 23% 25% Not being able to pay your rent or mortgage 24% 39% Losing your health insurance coverage 1 17% 23% 26% 33% Not being able to afford the prescription drugs you need 25% Losing your job 2 25% 25% Being the victim of a terrorist attack 13% 23% 35% Having to stay in your current job instead of taking a new job for fear of losing health benefits 3 1 44% Note: 1 Based on those with health insurance coverage. 2 Based on employed. 3 Based on those who are employed with health insurance. Don t know/refused answers not shown. 17
SLIDE 35 Methodology This Kaiser Health Tracking Poll was designed and analyzed by public opinion researchers at the Kaiser Family Foundation led by Mollyann Brodie, Ph.D., including Claudia Deane, SarahCho, and Theresa Boston. The survey was conducted March 8 through March 13, 2011, among a nationally representative random sample of 1,202 adults ages 18 and older. Telephone interviews conducted by landline (801) and cell phone (401, including 171 who had no landline telephone) were carried out in English and Spanish by Princeton Survey Research Associates. The margin of sampling error 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. VOL indicates that a response was volunteered by respondent, not an explicitly offered choice. Due to rounding, percentages may not add to 100. 18
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 (#8166 C) is available on the Kaiser Family Foundation website at www.kff.org. The Kaiser Family Foundation is a non profit private operating foundation, based in Menlo Park, California, dedicated to producing and communicating the best possible analysis and information on health issues.