By SHANA MARTIN
Donald Trump may have been elected for his strong stance against the Affordable Care Act, but his presidency has done little to change Americans' attitude toward the nation's health care system as more than half of the population feels the same about Obamacare as they did before the 2016 presidential race.
A new survey conducted by Princeton Survey Research Associates International on behalf of insuranceQuotes finds that 53 percent of Americans’ opinion toward the ACA, also known as Obamacare, has not budged.
The survey, conducted Aug. 3-6 of more than 1,000 U.S. adults, also found that the greatest percentage of respondents surveyed (38 percent) want health care reform to be a top priority for President Trump and Congress. Other priorities are reforming the tax code (20 percent), improving national security (18 percent) and changing immigration laws (14 percent).
Of the 38 percent of respondents who want health care reform to be a top priority:
- Party affiliation is divided almost equally among Democrats (38 percent), Republicans (34 percent) and independents (39 percent).
- More are female (45 percent) than are male (32 percent).
- Parental status is divided almost equally between those with children (37 percent) and those without children (39 percent).
- Those who make an annual income higher than $75,000 are less likely feel this way (33 percent) than those whose annual income is under $30,000 (36 percent).
“This finding is neither surprising nor new,” says David Henry, vice president of human resources at Foundation Building Materials (FBM) which has locations in 32 states and in Canada. “Health care reform has been a high priority for Americans over the last 15-20 years and I don’t see it changing anytime soon.”
Respondents were also asked about the future of the U.S. health care system and to which degree they favor or oppose controversial provisions of the ACA.
A substantial majority of respondents are in favor of:
- the federal government providing financial assistance to low-income Americans so they can afford health insurance (78 percent)
- allowing young adults to stay on their parents’ health insurance plans until age 26 (78 percent)
- requiring health insurance companies to cover people with pre-existing conditions (87 percent)
- allowing states to offer health insurance through Medicaid to more low-income people (79 percent)
In contrast, a majority of respondents are opposed to requiring nearly all Americans to have health insurance or else pay a fine (57 percent).
Though overall support for the ACA has varied since the law was introduced in 2010 (highest after President Obama took office and lowest a year before the 2016 presidential election), the election has not changed overall sentiment according to the insuranceQuotes survey.
One possible explanation for why Americans feel the same toward health care laws since the election may be because health care situations have not changed yet.
“Before the election, people were calling us all the time with concern that they’d lose their medical and insurance subsidies,” says Catherine Fredriks, a Certified Covered California Agent at Susan Polk Agency, Inc. “Since the election, we haven’t seen a whole lot of changes that have impacted our customers, so things calmed down.”
That is, until recently.
“Our phones are starting to ring again with the recent Anthem announcement,” says Fredriks, who is referring to news earlier this month made by Anthem, the nation’s second largest health insurer, that it is pulling out of most of California’s individual markets citing the uncertainty of the ACA.
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This comes on the heels of previous announcements that it will duck out of ACA exchanges next year in Ohio, Indiana and Wisconsin, and partially in Nevada.
What Millennials think of health care
As to be expected, varying attitudes about health care is often generational. Baby Boomers, Gen Xers and Millennials do not see eye-to-eye on what reform should or shouldn’t include. The survey found that:
- Millennials, particularly Younger Millennials (age 18-26) are least likely to believe health care reform a priority (33 percent) when compared with older Millennials (37 percent), Gen Xers (35 percent) and Baby Boomers (42 percent), Silent (40 percent).
- Younger Baby Boomers (age 53-62) are most likely to say health care reform should be a top priority (46 percent) and are most likely to strongly oppose requiring nearly all Americans to have health insurance or else pay a fine (49 percent).
- Younger Millennials (age 18-26) are most likely to favor allowing young adults to stay on their parents’ health insurance plans until age 26 (88 percent).
When compared to all other generations, Millennials are:
- Most likely to favor the federal government providing financial assistance to low-income Americans so they can afford health insurance (84 percent).
- Most likely to want young adults to stay on their parents’ health insurance plans until age 26 (81 percent).
- Most likely to want states to offer health insurance through Medicaid to more low-income people (87 percent).
While Millennials are less likely to believe health care reform is a priority when compared to other generations, survey findings suggest that they are paying more attention to health care than one might believe.
Younger Millennials were the most likely to say the ACA will be repealed and replaced (40 percent.)
“I don’t think Millennials are much different from generations before,” says Henry, who believes much of their perspective on health care is mainly a function of their age.
As an executive leader who actively seeks feedback from employees of all ages on how they feel about health plan options, he says with respect to the ACA, employees were mainly concerned with losing their PPO option.
Fredriks, who works mainly with individuals and families to obtain non-group medical coverage, views the situation similarly.
"For my customers who have families and are already paying exorbitant premiums, there is increasing concern that choices will be even more limited now that Anthem has pulled out,” Fredriks says.
What's the future of health care?
Despite the highest percentage of respondents citing healthcare reform a top priority, Americans are finding it much less clear to paint a unified picture of what reform looks like in the future.
When asked to cast aside personal feelings about the ACA and imagine what the future holds regarding the 2010 law, respondents cited split scenarios. A slight majority believe it will be repealed and replaced with a new law (31 percent) while fewer respondents believe it will still be in place but updated (27 percent). Even fewer believe it will be the same as it is today (24 percent).
If the Trump administration goes through with its threats to let Obamacare implode, the outcomes may also sway public sentiment. The Congressional Budget Office and the Joint Committee on Taxation just announced that a termination of subsidies to insurance companies under Obamacare would result in a 20 percent increase in premiums for major health plans in 2018 (25 percent or higher by 2020) and an increase in the federal budget deficit of $194 billion in the next decade.
Not everyone believes this unstable climate would be much different today had the new administration adopted the ACA this past January. Henry points to built-in provisions designed to take effect this year and next that would force employers to make hard choices regardless.
One is a 40 percent excise tax on health insurers and health plan administrators with premiums exceeding a certain amount. Another is a requirement for health insurance plans to cover preventative care and checkups without copayments.
Both are slated for 2018.
“We were destined to be in this position anyway,” Henry says.
For those who live in California, there is less need to worry, according to Covered California, which has served as a model exchange for the rest of the country. They have communicated to their networks that no matter what happens, they will keep their exchange up and running.
For other states, there is less certainty.
With open enrollment fast approaching, Americans will soon have a much better idea of what their choices really are — and if that changes how they feel.