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Public Unaware of State's Decisions on Health Reform

A new poll underlines the disconnect between the debate among lawmakers and the public's knowledge about the federal health law's central provisions.

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Though the Affordable Care Act (ACA) has dominated discussions in statehouses and policy circles the last few years, a new poll reveals that the general public still knows very little about their state's decisions on key provisions of the law, including the optional Medicaid expansion and online health insurance marketplaces.

A new Kaiser Family Foundation poll underlines the disconnect between the debate among lawmakers and the public's knowledge about the ACA's central components. 

Nearly half of those polled said they had heard nothing at all about their state's decision to either establish a state-run insurance marketplace, partner with the federal government on one or leave the job to the U.S. Department of Health and Human Services (HHS). Another 29 percent said they knew only a little about the topic.

But in reality, those decisions have already been made, as the last deadline for states to choose their marketplace model passed in February. According to Kaiser Health News, 17 states and the District of Columbia have opted to run their own marketplaces, eight are partnering with the feds, and 25 are letting HHS create and maintain it for them.

Similarly, more than 75 percent said they didn't know enough to say whether their governor had supported or opposed the ACA's Medicaid expansion, even though more than 30 governors have already publicly stated their position.

Other findings from Kaiser could explain this trend: 62 percent of those polled said the law had not personally affected them yet. More than half also said they didn't have enough information to understand how the law would impact them.

Generally speaking, the creation of health insurance marketplaces and the Medicaid expansion appeared popular with the public: 80 percent said they liked the idea of marketplaces, and 71 percent said they approved of the Medicaid expansion.

But while these individual provisions enjoyed broad support, overall opinions on the ACA as it approaches its third anniversay remained sharply divided. Forty percent said they had an unfavorable view of the law, compared to 37 percent who had a favorable view.

Dylan Scott is a GOVERNING staff writer.
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