Fifty-three percent of the uninsured not happy with Obamacare

Rosemary Cabelo looking at health insurance plans on HealthCare.gov last week during a visit to a public library in San Antonio.

By  ABBY GOODNOUGH and ALLISON KOPICKI


The New York Times


WASHINGTON — Americans who lack medical coverage disapprove of President Obama’s health care law at roughly the same rate as the insured, even though most say they struggle to pay for basic care, according to the latest New York Times/CBS News poll.
Fifty-three percent of the uninsured disapprove of the law, the poll found, compared with 51 percent of those who have health coverage. A third of the uninsured say the law will help them personally, but about the same number think it will hurt them, with cost a leading concern.

The widespread skepticism, even among people who are supposed to benefit from the law, underscores the political challenge facing the Obama administration as it tries to persuade millions of Americans to enroll in coverage through new online marketplaces, a crucial element of making the new law financially viable for insurers.

There are several reasons the uninsured appear to be as wary of the law as the insured, including opposition to the requirement that most people have insurance. Still, nearly six in 10 uninsured said having insurance would make their own health better. And 56 percent said they were more likely than not to get insurance by March 31, the deadline to enroll in coverage or face a tax penalty under the law. Thirty-five percent said they were more likely to pay the penalty.



Over all, support for the 2010 health care law has improved since November, when it dropped to an all-time low of 31 percent in a CBS News poll after the flawed rollout of the federal online insurance exchange. The new poll showed approval of the law at 39 percent and disapproval at 50 percent among the general public.

But with the law’s central provisions set to take effect in less than two weeks, uninsured Americans — precisely those it was meant to help — remain confused about it and fearful that it will increase their health care costs. And nearly six in 10 said they had not researched insurance on the online marketplace, even though, based on the demographics of the sample, many probably qualify for free or subsidized coverage.

“I don’t understand it at all,” said Derrick Stapleton, 47, an independent from Peru, Ind., speaking in a follow-up interview. Mr. Stapleton, who is uninsured and out of work, said he planned to sign up for coverage before the March 31 deadline. But he added, “It sounds, from what I understand, that it might not be as affordable as they once thought.”

Even as the insured and uninsured expressed similar misgivings about the law, the uninsured reported starkly different experiences with the health care system. Their responses suggested they were far more likely than the insured to have trouble paying for medical care, to rely more on emergency rooms and community clinics, and to forgo treatment.

Of the uninsured who said they were not likely to sign up by the deadline, fully half said it was because of the high cost. Twenty-nine percent said they planned to go without coverage because they object to the government’s requiring it, and 11 percent said they did not need health insurance.

The poll was conducted among 1,000 adults nationwide by telephone from Dec. 5 to Dec. 8 and among 702 uninsured adults from Dec. 4 to Dec. 15.
The uninsured respondents were generally younger, poorer and less educated than the respondents in the general population. Three-quarters of the uninsured were between 18 and 44, and about one in eight had college degrees. Slightly more than half said they earned less than $30,000 a year.

The requirement to get coverage or pay a penalty remains unpopular among the general public, the poll found, with uninsured Americans voicing disapproval at a higher rate than the insured population. Seventy-seven percent of the uninsured said they disapproved of the mandate, compared with 65 percent of those who already have health insurance.

David Bishop, 46, a Republican from Groton, N.Y., said the mandate was “just taking away your constitutional freedom of choice.” Mr. Bishop, who is caring for his four children while his wife works, said he had looked at New York’s online insurance marketplace but found it difficult to use and did not get the information he needed. He did say, however, that he planned to get insurance through the marketplace, or exchange, before the March deadline.

In the poll, 28 percent of uninsured respondents who said that they planned to sign up for coverage cited the mandate as the main reason. Thirty-eight percent said that they would enroll because having health insurance is good, while 10 percent said that they expected insurance to become more affordable under the law.

“Obamacare made it easier for me to get insurance,” said Rhonda Trask, 60, a Democrat in Welches, Ore., who said she had qualified for Medicaid under the law after going without health insurance for five years. “I haven’t made an appointment yet, but will the week after Christmas because my plan takes effect on Jan. 1. I will be able to see a doctor and get medication.”

In a reflection of how many Americans seem to grapple with conflicting sentiments about the health care law, most respondents — both insured and uninsured — said that it hurts the country when individuals do not have health insurance, even as most voiced opposition to the mandate. In addition, 64 percent of the uninsured and 54 percent of the general public said they thought providing access to affordable health care coverage for all Americans was the responsibility of the federal government.

At the same time, only 37 percent of the general public and 33 percent of the uninsured said the law was so flawed that it should be repealed. That marks a slight shift since the CBS News poll in November, when the federal insurance marketplace was still plagued with technical problems and 43 percent of Americans said the law should be repealed.

The new poll found that most Americans — 55 percent of the general public and 57 percent of the uninsured — disapprove of how President Obama is handling health care. Democrats in Congress got roughly the same rating, with 59 percent of the general public and 58 percent of the uninsured disapproving of their handling of the issue.

Republicans in Congress were judged more harshly, with 73 percent of the general public and 70 percent of the uninsured disapproving of their handling of health care.
The incomes of the uninsured who participated in the poll suggest that many would qualify for Medicaid, which is free, or federal subsidies to help with the cost of private plans. But a widespread lack of understanding about the law — and difficulties using the online exchanges — appear to be keeping many uninsured Americans from even finding out if they qualify for free or subsidized coverage.

Forty-two percent of the uninsured said they had looked into applying for health insurance through the new online marketplaces, compared with 58 percent who said they had not. Only 10 percent of the uninsured said they had actually applied for insurance through one of the marketplaces, including 3 percent who said they had gotten confirmation of coverage.

The poll had a margin of sampling error of plus or minus three percentage points among the general population and among the sample of 895 insured adults; among the uninsured sample, the margin of sampling error was plus or minus five percentage points.
In one of the poll’s more striking findings, 44 percent of the uninsured said the new law would have no effect on the quality of the health care they receive. Thirty percent went so far as to say it would result in them getting worse quality of care, while less than a quarter predicted their care would improve.

Robyn Logan, 55, of Bowie, Md., is an uninsured Democrat who said poor past experiences with the health care system made her skeptical of the law’s potential. “I need to see a doctor and my fear is that even if I get insurance, I won’t be able to find one,” she said. “I was on Medicaid at one point and couldn’t find a doctor because no one would take me.”
Pamela Vinson, 54, an uninsured Republican in Beavercreek, Ohio, said that she, too, worried that there would not be enough health care providers available to treat the newly insured.
“Quality will go down,” Ms. Vinson said, “especially if you’re not healthy and a doctor has to diagnose you in 15 minutes. Doctors won’t have enough time to deal with all the new patients.”