Many people have stumbled over a central question: What does reform mean to me? “Even if they have a sense of what’s in the law, they don’t know what it will mean for them and their family,” says Mollyann Brodie, a Kaiser Family Foundation vice president.
The public confusion wasn’t helped by months of partisan debate and misinformation about the bill. Also, reform will affect people in different ways, depending on their circumstances: whether they are uninsured, have a government plan, or are privately insured; whether they’re buying coverage on their own or are part of a large employer plan; what their family income is; and whether they have a medical condition.
And the current health care system is confusing by itself. “It’s a big, complicated system, and a big, complicated bill,” says Donald Taylor, a Duke University health policy professor.
Polls show the public is divided about the new law. Are there any areas of agreement for most Americans?
The Kaiser Foundation poll in April shows large majorities support several provisions that will kick in this year. For example, 86% favor providing tax credits to small businesses that want to provide coverage for workers. Almost eight in 10 have favorable views of financial help for seniors who hit the gap in Medicare drug coverage known as the “doughnut hole.” The provision to allow young adults to remain on their parents’ health plan until age 26 is favored by three of four Americans. The young adult provision is “quite significant,” says Sara Collins, a Commonwealth Fund vice president. “In this economy, that will probably affect more young adults than it would have in the past.”
Many states don’t want to participate in the new “high-risk” insurance pools for people with pre-existing medical conditions. Are consumers in those states barred from joining these pools?
More than a dozen states, citing cost concerns, have said they would not operate these federally subsidized programs for uninsured people who have been denied health insurance. “It is creating an unfunded mandate on the states,” says Robert Moffit, director of the Center for Health Policy Studies at the Heritage Foundation. But in those non-participating states, the federal government will step in to run the pools for residents until 2014, when insurers will be barred from discriminating against people with pre-existing conditions. The temporary state pools are expected to begin July 1 and will receive a total of $5 billion in funding, which many experts feel is inadequate to cover their long-range costs.