WASHINGTON -- More than a year after the passage of landmark health reform legislation, Americans remain divided on the law and are mostly skeptical of its benefits, according to a new tracking survey released by the Kaiser Family Foundation. But many Americans are also unfamiliar with key provisions of the bill, including those affecting Medicare, the report found.
In June, slightly fewer people rated the law favorably (42 percent) than unfavorably (46 percent), roughly matching results from the monthly Kaiser Foundation tracking surveys conducted over the last year. This month just 24 percent believed the law will leave their own families better off, 35 percent said they will be worse off, while the rest said it will make no difference (34 percent) or were unsure what the impact would be. Nonetheless, more Americans would expand the law (31 percent) or keep it as is (20 percent) than repeal it and replace with a Republican alternative (19 percent) or repeal it with no replacement (19 percent).
But the lack of familiarity with key aspects of the law -- and not the distaste for repealing it -- may provide the most important lessons to lawmakers now debating potential cuts and major changes to Medicare as part of an effort to reduce the deficit. For example, despite the best efforts of the Obama administration and Democrats in Congress, many Americans say they are unfamiliar with some of the key provisions of the law affecting Medicare. That lack of familiarity (or confidence) is even higher with seniors. Specifically:
- Only 45 percent of adults and 42 percent of seniors say that the health reform law will "gradually close the Medicare 'doughnut hole.' "
- Only 36 percent of adults and 21 percent of seniors say the law will "eliminate co-pays and deductibles for many preventative services under Medicare."
- Only 47 percent of adults and 37 percent of seniors know the law creates "an expert panel to recommend ways to reduce Medicare spending if costs grow too rapidly."
Meanwhile, large numbers of Americans continue to believe the health care law affects Medicare in ways it does not. For example:
- 31 percent of adults and 22 percent of seniors say the law "allow[s] a government panel to make decisions about end-of-life care for people on Medicare" -- another 20 percent of adults and 31 percent of seniors are unsure.
- 48 percent of adults and 35 percent of seniors say the law will "cut benefits that were previously provided to all people on Medicare."
This continuing lack of awareness (or dogged skepticism) should serve as a warning to policymakers about the limits of their ability to "sell" the public and seniors on the details of complex legislation affecting Medicare.
These latest results are consistent with findings from a March Kaiser Foundation survey, which found a majority of Americans saying they remain "confused" about the new law (53 percent) and still lacked sufficient information to understand how it will affect them personally (52 percent). This confusion persists despite -- or perhaps because of -- more than $200 million in television advertising during the health reform debate, one of the most heavily covered and closely watched legislative battles in many years.
One of the ironies revealed by the new survey is that when it comes to reducing Medicare spending and keeping the program sustainable, Americans say the would be more trusting of "an independent panel of full-time experts appointed by the president and confirmed by the Senate" (55 percent trust a great deal or fair amount) than "the federal agency that runs Medicare" (40 percent), Congress (34 percent) or private insurance companies (34 percent). Yet the independent panel described by the question is an initiative of the existing health reform law, something fewer than half the respondents were aware of.
The poll also found Americans divided on a plan, proposed by Republicans, to change Medicare to system where, as described by the survey, "people choose their insurance from a list of private health plans that may offer different benefits at different premium amounts, and the government pays a fixed amount toward that cost." Slightly fewer preferred such a program (45 percent) to keeping Medicare as it is today (49 percent), although the question came near the end of the survey and immediately followed a question that posed the possibility that Medicare is either "going bankrupt" or "is facing a funding shortfall."
[READ the full Kaiser Family Foundation report]