Pulling it Together: The Most Popular Provision in the ACA?

In our most recent monthly tracking poll, we asked the American people what elements of the health reform law they like and dislike. Surprisingly, the runaway favorite was a relatively obscure requirement that health plans provide consumers with a short, easy to understand description of their benefits and coverage. Sixty percent of the American people gave this requirement for greater transparency in health insurance benefits a very favorable rating, the only provision in the law to get such a rating from more than half of the public. The Administration is writing final regulations to implement this provision now.

The summary of benefits provision was followed in popularity by several better known provisions of the law we asked about this time: preventing insurers from denying people coverage if they have preexisting conditions, ranked very favorably by forty-seven percent; closing the Medicare doughnut hole for drug coverage (forty-six percent very favorable rating); and providing tax credits to individuals and small businesses to help pay for coverage (forty-four and forty-five percent very favorable ratings, respectively). The common element in all of the most popular provisions of the law is that you do not have to be a health policy expert to understand them. They provide tangible help to people navigating the health insurance system and paying their health insurance bills. No surprise, the individual mandate, which will be the subject of Supreme Court review, was the least favorable element of the law. Some people don’t want insurance. Others may worry they will not be able to afford it.  But mostly, Americans don’t like to be told what to do or that they will be fined for not doing it.  Opposition softens somewhat if people think the mandate will help spread insurance risk.


Note: Items asked of separate half samples. Response wording abbreviated. See Topline: http://www.kff.org/kaiserpolls/8259.cfm for complete wording.
Source: Kaiser Family Foundation Health Tracking Poll (conducted November 10-15, 2011)

It is no huge surprise that people are confused by their health benefits. And, unlike many elements of the health reform law, there is no apparent downside to the public from requiring health plans to be more up front about what they do and do not cover; although employers and insurers have objected to the rule as a costly and unnecessary new regulatory burden. What is a surprise, though, is that people feel so lost in the health insurance system that they chose a requirement that insurance companies explain their benefits in plain language as the most popular element of the giant health reform law, and by such a wide margin over the many others we asked about.The Affordable Care Act has been largely an ideological battleground fought over hot-button issues like the individual mandate. It will always raise ideological and policy divisions. But, our polling shows people don’t know much about its more consumer friendly provisions which are popular even across partisan lines. As long as that remains the case, people will not perceive the ACA as part of the solution to their everyday problems and public opinion will remain split along the familiar partisan divide. That’s the larger meaning of this finding about a seemingly small provision in the ACA from our monthly tracking poll.

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