Eight months from now, the Affordable Care Act will become personal for millions of Americans, as half of the states expand access to Medicaid and all of them open new market places for private health insurance. The Obama administration is busy building systems to help consumers navigate this massive transition, but new poll results suggest there’s still some work to do.
In its monthly poll of American attitudes on health care, the Kaiser Family Foundation finds that 42% of us don’t know that Obamacare is now the law of the land. For those just tuning in, the Affordable Care Act passed Congress in late 2009, was signed into law in early 2010 and was upheld by the Supreme Court in 2012. It has already expanded insurance access for young adults, set minimum standards for preventive care, and barred insurers from excluding people with pre-existing conditions. The other key provisions take effect at the start of 2014.
“All the implementation issues that are coming up are implementation issues related to that small group of people, 10 to 15 percent of Americans—now, it’s still 30 million Americans, but a relatively narrow group—who don’t have health insurance right now, or are on the individual market and paying exorbitant amounts for coverage that isn’t that great,” President Obama said about the next phase of the health care legislation at a press conference Tuesday.
“And what we’re doing is we’re setting up a pool so that they can all pool together and get a better deal from insurance companies,” Obama said. “And those who can’t afford it, we’re going to provide them with some subsidies. That’s it.”
The public confusion is understandable; the Supreme Court modified the law slightly even while upholding it, and Republicans in Congress have made an annual ritual of voting to repeal the whole thing. According to the new Kaiser poll, 7% of Americans believe the Supreme Court killed Obamacare and 12% believe Congress did the deed. Another 23% say they don’t know enough to say what became of the law.
The 2014 provisions will benefit millions of poor and uninsured Americans by subsidizing coverage for anyone living below four times the federal poverty level (about $92,000 for a family of four). But the Kaiser poll suggests that awareness is lowest among the people who will benefit most. Some 56% of low-income respondents, and 58% of the uninsured, aren’t sure how Obamacare will affect their families. The poll suggests that many people are getting most of their information from family, friends and the news media. Only 8% to 10% of respondents say they’ve learned anything from doctors, employers, insurers, nonprofit organizations or government agencies.
Supporters have criticized Obama for failing to sell the public on health care reform, but the administration’s immediate challenge is to help people navigate it. As insurance becomes more affordable next year, it will also become mandatory. Anyone without an employer-sponsored plan will need to apply for coverage, either through Medicaid or through a state insurance exchange. With that fact in mind, the government has been working to craft application forms that all the exchanges can use. When the Associated Press got hold of a draft application last month, it was 21 pages long and as mind-numbing as a tax return, with a full page devoted to determining whether the applicant was an Alaska native. This week the administration released a cleaner, simpler version—three of them, actually: a three-page short form for single adults who want to apply for assistance, a 12-pager for couples and families who want to know if they’re eligible for help, and an elegant five-pager for those not seeking subsidies. The Centers for Medicare and Medicaid Services hailed the new forms as “a simple, easy-to-understand way to apply for health coverage,” and health advocates were impressed too. “With tens of millions of uninsured people eligible for new help in securing affordable health coverage,” Families USA Director Ron Pollack said in a statement, “it is crucial that the enrollment process is as simple and consumer-friendly as possible. The new, improved forms are a huge step in that direction.” While racing to develop the new insurance clearinghouses over the next eight months, the government will also ramp up a navigator program to ensure that people can find and secure the coverage they need. Until then, anyone with an Internet connection can get useful info at the Enroll America website.
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