A new survey by National Public Radio and the Robert Wood Johnson Foundation reveals attitudes about the Affordable Care Act in its sixth year.
Views on the Affordable Care Act (ACA), also called Obamacare, are mixed among adults in the U.S (Figure 18). When asked about its effects on the people of their state, more than a third (35%) of adults say they believe national health reform has directly helped residents, while a similar proportion (27%) say they believe the law has directly harmed residents. On a more personal level, most (56%) Americans do not believe the ACA has directly impacted them. Among those who believe it had an impact, more say it has directly hurt them (25%), as individuals, than those who say national health reform has directly helped them (15%).
These numbers reflect what is known as the “healthcare paradox.” Simply stated, before the ACA, the overwhelming majority of Americans were happy with their health insurance. Poll after poll pegged this number around 80-85%. The overwhelming majority of Americans also agreed that our healthcare system needed to be reformed. Herein lies the paradox. People wanted the health care system to change, but were for the most part happy with what they have. Hence the centrality of the President’s if-you-like-your-plan-you-can-keep-your-plan lie. This resolved the paradox, and was essential to the enactment of the reform.
Six years later, 15% say the law helped them. This no doubt overlaps with the 15% of people before the ACA who were not satisfied with their health insurance. Yet, 25% think they are worse off–through higher premiums and reduced benefits.
The continued vitality of the ACA depends on how many people think the law hurts them, and how many thinks it helps them. Short of “removing lines around states”–which is not particularly effective–reform will become essential regardless of who is in office.