Majority Favors the Affordable Care Act’s Employer Mandate, But Opinion Can Shift When Presented With Pros and Cons

Recent news stories on the heath law did not attract most Americans’ attention, and many are unaware of details and implications of the developments

Weeks before the Affordable Care Act’s employer mandate takes effect in January, a new Kaiser Family Foundation tracking poll finds that six in 10 Americans (60%) say they have a favorable view of the provision, which in 2015 requires employers with 100 or more full time workers to offer health coverage or pay a penalty. In comparison, 38 percent say they have an unfavorable view.

But opinions on the employer mandate aren’t necessarily fixed. The share with a favorable view rises from 60 to 76 percent after opponents are told that “most employers with 100 or more workers already offer health insurance and won’t have to pay the fine.” In contrast, the share with an unfavorable opinion rises from 38 to 68 percent after supporters are told that “some employers are moving some workers from full time to part time to avoid paying the fine.”

As with other elements of the ACA, the poll shows a partisan divide in perception of the employer mandate, with 34 percent of Republicans reporting a favorable view, compared to 78 percent of Democrats and 61 percent of independents.

Meanwhile, the Kaiser Health Policy News Index for December finds that several ACA-related news stories didn’t attract the attention of the majority of Americans. Additionally, few correctly answered some basic questions about details reported in the stories.

A large majority (84%) say they have heard “only a little” or “nothing at all” about the U.S. Supreme Court’s announcement in early November that it will hear the King vs. Burwell case. The case addresses whether low- and moderate-income people in states using the ACA’s federally-operated health insurance marketplace will remain eligible for financial help from the government to pay for plans. Americans are largely unaware that 37 states are using the federally-run marketplace, with roughly three in 10 (28%) correctly noting that more than half of the states use Healthcare.gov.

Another health policy news story, the revision of the official estimate of people signing up for health plans during the marketplaces’ first open enrollment period, also drew limited attention, with about a third of Americans (34%) saying they closely followed coverage (10% very, 24% fairly closely).  Of those, only a third (32%) are aware that the revised number was smaller rather than larger.

Of the stories included in the poll, the public reported giving the least attention to comments about the health law made by MIT health economist Jonathan Gruber, with only 22 percent saying they closely followed coverage (10% very and 12% fairly). 

On the other hand, nearly half (45%) of Americans say they closely monitored coverage of the lawsuit filed by House Republicans against President Barack Obama over the implementation of the Affordable Care Act. People are more-or-less divided about the perceived motivation behind the suit, with half (50%) saying Republicans are trying to gain political advantage and about four in 10 (38%) saying Republicans believe the president overstepped his legal authority. Opinions varied starkly, and predictably, by party identification.

A year after the ACA’s coverage expansions took effect, the tracking poll shows that the public’s overall view of the law continues to be stable, with 46 percent of Americans reporting an unfavorable opinion and 41 percent reporting a favorable view.

Large shares report a favorable view of several specific provisions, including the creation of insurance marketplaces (78%), availability of financial assistance for low- and moderate-income people to pay for health plans (76%) and the option for states to expand their Medicaid programs (75%). The individual mandate, however, remains largely unpopular with about a third (35%) saying they view it favorably. As with the employer mandate, though, opinion can shift with additional information and that share rises as high as 62 percent or falls as low as 18 percent depending on what else Americans are told about that provision.

Other findings from the poll include:

•  A month into the ACA’s second open enrollment period, just 5 percent of the uninsured give the correct deadline for signing up for a health plan in the marketplaces. The vast majority (97%) of the uninsured are unaware of the correct fine amount for 2015, although more than a third (37%) think they will have to pay it for 2014.

• Just under three in 10 Americans are closely following news coverage of the second ACA open enrollment period (7% very closely, 21% fairly closely).  Nearly half (48%) of the public say there have been fewer problems with the functionality of Healthcare.gov than in the previous sign up period, while 31 percent say the number of problems is about the same and 9 percent say there are more. Republicans (36%) are less likely than Democrats (61%) and independents (48%) to say there have been fewer problems this year. However, across party lines, small shares report thinking there were more problems with the website compared to the first open enrollment period.

 METHODOLOGY

The latest tracking poll was designed and analyzed by public opinion researchers at the Kaiser Family Foundation and was conducted from December 2-9, 2014 among a nationally representative random digit dial telephone sample of 1,505 adults ages 18 and older. Interviews were conducted in English and Spanish by landline (750) and cell phone (755). The margin of sampling error is plus or minus 3 percentage points for the full sample. For results based on other subgroups, the margin of sampling error may be higher.