ANALYSIS & COMMENTARY: Liking Health Reform But Turned Off By Toxic Politics

Six years after the Affordable Care Act (ACA) became law, the number of nonelderly Americans with health insurance has expanded by twenty million, and the uninsurance rate has declined nearly 9 percentage points. Nevertheless, public opinion about the law remains deeply divided. We investigated how...

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Bibliographic Details
Published inHealth Affairs Vol. 35; no. 5; p. 915
Main Authors Jacobs, Lawrence R, Mettler, Suzanne
Format Journal Article
LanguageEnglish
Published Chevy Chase The People to People Health Foundation, Inc., Project HOPE 01.05.2016
Subjects
Access
Correlation analysis
Health care
Health care industry
Health care policy
Health insurance
Health services
Implementation
Insurance
Insurance coverage
Law
Laws
Medicaid
Patient Protection & Affordable Care Act 2010-US
Perceptions
Political identity
Political parties
Politics
Public opinion
Reforms
Respondents
Trust
Variables
United States > US
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Summary:Six years after the Affordable Care Act (ACA) became law, the number of nonelderly Americans with health insurance has expanded by twenty million, and the uninsurance rate has declined nearly 9 percentage points. Nevertheless, public opinion about the law remains deeply divided. We investigated how individuals may be experiencing and responding to health reform implementation by analyzing three waves of a panel study we conducted in 2010, 2012, and 2014. While public opinion about the ACA remains split (45.6 percent unfavorable and 36.2 percent favorable), there have been several detectable shifts. The share of respondents believing that reform had little or no impact on access to health insurance or medical care diminished by 18 percentage points from 2010 to 2014, while those considering reform to have some or a great impact increased by 19 percentage points. Among individuals who held unfavorable views toward the law in 2010, the percentage who supported repeal-while still high, at 72 percent-shrank by 9 percentage points from 2010 to 2014. We found that party affiliation and distrust in government were influential factors in explaining the continuing divide over the law. The ACA has delivered discernible benefits, and some Americans are increasingly recognizing that it is improving access to health insurance and medical care.
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ISSN:0278-2715
1544-5208
DOI:10.1377/hlthaff.2015.1313