Almost half of uninsured expect no help from health reform

Polling experts said Americans are not focused on changes scheduled to begin in 2014 but on the economy and other issues.

By Doug Trapp — Posted Sept. 12, 2011

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Approximately half of uninsured Americans believe the health system reform law won't affect their access to health care one way or the other, according to the Kaiser Family Foundation's August Health Tracking Poll.

While 31% of poll respondents said the law will help them get health care, 47% said it won't help or hurt their ability to access health care. Another 14% said the law will hurt their access to care partly because it will require them to buy health insurance, according to the poll, conducted between Aug. 10 and 15 and released on Aug. 29.

Knowledge gaps also exist regarding health reform, according to the survey. The law will offer federal subsidies to help people buy coverage through health insurance exchanges if they earn between one and four times the federal poverty level. But 32% of poll respondents said the law will not provide such assistance.

Similarly, 32% of poll respondents said the reform law doesn't include a Medicaid expansion. In fact, the law is expected to allow approximately 32 million uninsured people to gain coverage beginning in 2014. About half will become able to enroll in Medicaid as the program's eligibility expands to 133% of the federal poverty level, and the other half will sign up for new private plans offered in health insurance exchanges.

Two-thirds of respondents correctly said the law will require nearly all Americans to obtain health insurance coverage by 2014 or pay a tax penalty.

One interpretation of the poll results is that health reform supporters have failed to communicate the value of the law, said Kaiser Family Foundation President and CEO Drew Altman, PhD. However, Altman said any such judgment is premature. Americans only will understand the law once it actually affects their health benefits or once they see new reports about how the law is working, he added.

"It will be 2015 or 2016 before there is a real test of awareness and affordability," Altman wrote in an Aug. 29 column published with the poll.

"It's very hard to talk to people about future events when things in the short term aren't going very well for them," said Robert Blendon, ScD, a professor of health policy and political analysis at the Harvard School of Public Health in Boston.

Concerns about unemployment and federal deficits have been at the center of national political debate for most of the summer. Most of the other polling at the moment is not focusing on the health reform law, Blendon said. "Candidates are trying to focus on other issues, particularly relating to the economy."

The frequency of health reform-related polls has declined sharply, according to, a compilation of national polls. In August 2010, national organizations released 13 surveys of public opinion on the health reform law. That decreased to one poll -- the Kaiser survey -- in the same month this year.

Blendon said health care probably will take center stage again when political leaders begin campaigning for the 2012 presidential and congressional elections.

Public opinion of the health reform law has not changed dramatically since the law was enacted in March 2010, Blendon said. More Americans continue to have an unfavorable than favorable view of the statute, according to the Kaiser poll. Forty-four percent had a very or somewhat unfavorable opinion of the law, while 39% said they had a very or somewhat favorable opinion of it.

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Uninsured and skeptical

The health system reform law is expected to reduce the nation's uninsured population by more than half by 2019, but many uninsured people are not confident the law will help them. Most of the uninsured who were polled have been without coverage for more than two years. Figures may not add up due to rounding.

Once implemented, the health reform law will ...
31% Help me get health care
13% Make health insurance more affordable and lower health care costs
12% Help me get health insurance, better access to care or more health security through coverage
3% Other
4% Don't know
14% Hurt my ability to get health care
7% Force me to buy health insurance
4% Increase taxes and costs
2% Not provide adequate coverage
2% Other
47% Not make much difference
7% Don't know/refused to answer

Source: Kaiser Family Foundation, Health Tracking Poll, August (link)

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