The uninsured, which along with those with existing conditions, would seem to be the clearest beneficiaries of Obamacare, and were thus assumed by many to favor it. But a new poll shows that on the whole far more distrustful that the Administration likely expected.
The New York Times gives the results of a new 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.
Mind you, disliking the law is not necessarily the same as not signing up:
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….. 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 have to tell you, having done lots of marketing surveys, asking people whether they will or won’t buy a product is a highly unreliable way of gauging purchase intent. First, with polls in general, subtle differences in wording produce large differences in results. Second, and more important, consumer questionnaires and polls generally produce statements of willingness/intention to buy that are much higher than what actually happens. Survey respondents seem to have a a bias to please the interviewer by signaling willingness to make a purchase (that may not be operative here) and impress the interviewer with their economic status (as in saying they’d buy is a marker of being better off). So it’s reasonable to assume that actual results are more likely to be worse than what this poll finds rather than better.
Cost was the big reasons for expecting not to sign up; nearly half of the ones who gave negative signals cited it as the reason. And across all uninsured, only 10% expected Obamacare to make insurance cheaper (notice the confusion of insurance with health care, since the ACA almost assuredly will give them access to lower-cost insurance. But the question remains whether their all in health care costs are lower or not, given the typical high deductibles with low premium plans). Mind you, some of the people who are finding they can’t afford the plans are distraught. Michael Olenick provided this Facebook posting from a friend in her 50s, Roxanne:
Broke down crying during conversation with insurance agent, who confirmed my situation… as I un-enrolled in the only hope, a plan that I cannot afford… wondering what the hell I’m going to do if I get sick, how to get my prescription for Metropolol filled… feeling extremely small and insignificant… I couldn’t hold back tears. The poor guy couldn’t wait to hang up. The house was so big and quiet then. When you feel so low, it’s like even the walls are strangers… I am not alone, though. There’s many others with less, I know that for sure….
I don’t know, I guess I just fucked up, and now can’t afford insurance. It’s not like I committed a crime! Maybe it won’t be that bad. If I have to go to the doctor, I will pay them when I can. And if I get too sick and die? It has to happen someday anyway! Look at all the joy and love I have in my life. Maybe if I share my story others will calm down about it, too. We are so much more than this messed up system. How’s that song go… “Those not busy being born are busy dying.” I choose the former. . . So, as I head into the next chapter, I will go with a strong heart, knowing we’re all only here a short time anyway.
The uninsured also overwhelmingly resent being required to buy insurance, with 77% disapproving (and this resentment being the reason nearly 30% of the time for expecting not to sign up). And the poll restricted the range of focus to health insurance, not health care. For instance:
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.
But another factor that is clearly important, but apparently not included in the survey questions, is the complexity:
Mr. [David] 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.
This matters due to the fact that the uninsured skew less educated, and one would also assume that many have limited access to the Internet (2011 Census data shows that members of households with $25,000 to $49,999 in income, only 64% have access to the Internet from “some location”). Given the time it takes to shop for plans, that’s going to be a significant obstacle for quite a few (the Administration perversely is trying to discourage paper-based signups).
And the uninsured may have picked up on the narrow networks issue:
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.
And the poll findings are consistent with enrollment data: so far, fewer people eligible for subsidies than expected have signed up, although the ratio was higher in November than October.
When I read the lack of enthusiasm overall from one of its intended beneficiary groups, I can’t help thinking of one of the early Obamacare promotional videos (I’ve looked but there are so many I can’t locate it). It showed a flat cutout figure of a woman, with the entire segment in bright flat colors, the sort you see in children’s books. The video described how shopping for healthcare would be easy, and showed the cartoon woman scurrying with a cart through a store, putting different products in it, and then showed her shopping for insurance in the same manner (as in picking a policy off a shelf and putting it in her cart).
I found the imagery horrifying. Citizens aren’t just reduced to “consumers”: they were depicted in an infantilized manner, imaged as obedient puppets scurrying through the Administration’s shopping “experience.” If this is what the Administration really thinks of voters (and women), one might wonder if its target audience is picking up on its not-too-well-formulated marketing messages, as well as the defects in the product itself.