How do people feel about the Affordable Care Act? It’s a common question, one that has been asked by pollsters countless times since the controversial law’s start almost seven years ago
“But here’s the problem with those polls,” said Emily Ekins, chief pollster for the libertarian Cato Institute. “Public polling almost never takes cost into account.”
“Public polling almost never takes cost into account.”
Speaking to an audience at Cato last week, Ekins said this frustrating reality has irked her to no end over the past few years. It would be akin to asking a group of people if they would each like to own a fancy sports car. The vast majority would immediately answer in the affirmative — who doesn’t like to have nice things? Ask that same group if they would like to purchase a fancy sports car, however, the results would be far different.
Everybody wants nice things, but nobody wants to pay for them.
“We see questions that ask people if they like prohibiting insurers from charging some people higher rates because of their medical history,” Ekins said. “And people think that’s a great idea. But what they don’t offer people is any idea of what the cost might be and then see if some people might be willing to make certain trade-offs.”
“People simply aren’t asked that question, so we asked it ourselves.”
“People simply aren’t asked that question,” Ekins added, “so we asked it ourselves.”
In two separate surveys, Cato broke down how the public viewed certain aspects of the Affordable Care Act — and then qualified that by asking respondents if they liked the full picture of what those provisions would actually mean.
The first survey asked if people supported the ACA’s community rating, which requires insurance companies to provide equitable insurance rates everyone within a given community. About 63 percent of respondents said they supported that provision, which is in line with the results of polls recently conducted by the Kaiser Family Foundation .
But when those same people were asked if they supported the provision if taxes increased, only 40 percent said yes. When asked if they would support the provision if premiums went up, only 39 percent were in favor. And most remarkably, when asked if they would support the provisions if it limited access to medical tests and treatments, only 27 percent were in favor, while 66 percent were opposed — a total flip of the results.
But when those same people were asked if they supported the provision if taxes increased, only 40 percent said yes.
When the Cato poll asked whether people supported the ACA’s provision barring insurance companies from denying coverage based on preexisting conditions, the vast majority (77 percent) were supportive. But when told the provision would lead to tax hikes, support dropped to just 40 percent.
Moreover, if that provision would lead to increased premiums, support dropped even further to 35 percent. Finally if the pre-existing conditions rule would lead to lower quality of care, support plummeted to just 20 percent, while opposition rose to 75 percent — another total flip of the results.
“What I take away from this is that people care about taxes, yes, and people care about premiums, yes, but what people really care about is the quality of their health care,” Ekins said. “And that is the issue that we’re not talking quite enough about. We’re either talking about cost or premiums or access. But we need to keep in mind the quality of health care, because, at the end of the day, that’s what this whole conversation is really all about.”
Head over to the Cato Institute for the full speech.
Evan Smith is a Staff Writer for Opportunity Lives. You can follow him on Twitter @Evansmithreport.