Republicans and Democrats have made their political and ideological stance on President Obama's health care law a key part of their respective campaigns. But recent data suggests that Americans are preoccupied with the more practical matter of how much it will cost them to get the care they need.
Experts say the focus on pocketbook issues reflects both the nation’s preoccupation with household finances amid the difficult economy, and the fact that the Affordable Care Act is poorly understood.
“People don’t think about the nation’s health care costs,” said Mollyann Brodie, senior vice president for public opinion and survey research for the Kaiser Family Foundation. “They’re not thinking about the total amount the nation is spending on health care. What they think about is the price they pay, the price coming out of their paycheck.”
Brodie noted that it’s been hard for either opponents or proponents of the Affordable Care Act to explain how the big health care reform program will affect people’s individual health care costs.
That's partly because the effect will be very different depending on what kind of health insurance, and health care needs, you have. And it's made more complicated because many provisions of the law aren’t set to take effect until 2014 or later.
Also, although people may have deep partisan feelings about whether such a plan is necessary, in their everyday lives they’re more concerned with how they can afford the health care they need.
“When you ask them what bothers me, what bothers me is I can’t afford the premium,” she said.
A Kaiser Family Foundation survey conducted this month finds that even among Republicans, health care costs are a bigger health-related concern than any issues they might have with "Obamacare."
The Kaiser survey of about 1,200 Americans found that 67 percent of Republicans said the cost of health care and health insurance was either extremely or very important when choosing a president, while 61 percent said Medicare was the top health care issue in choosing a president.
A smaller number of Republicans, 54 percent, said the 2010 health care law that has been such a hot topic of political debate was extremely or very important to their decision. Romney, the Republican presidential candidate, has vowed to undo many aspects of the law if elected.
Among Americans of all political affiliations, health care cost also ranked as the most second worrisome economic issue, right after jobs, in the Kaiser survey.
A separate Gallup survey also showed that health care costs remain a top worry among American workers as well. It found that American workers are more worried about getting their benefits cut than about having their job eliminated, despite an unemployment rate that is above 8 percent.
The Gallup poll of about 500 working adult Americans, which also was conducted in early August, found that 40 percent were worried that their benefits will be cut, while 28 percent were worried about losing their job.
Paul Fronstin, director of the Employment Benefit Research Institute’s health research and education program, said it’s no surprise that Americans are so concerned about the cost and availability of benefits. Fronstin noted that health care costs have been rising for years. That’s left many employees either being asked to contribute more toward the cost of their care, or finding that their employer simply doesn’t offer a plan they can afford.
“Benefits have been eroding. We have seen deductibles going up, and we have seen copayments going up,” he said.
The Gallup survey has for years shown that Americans are most worried about benefit cuts. But the concern spiked when the economy began to falter. Perhaps surprisingly, it has continued to outpace fears of a job loss even as millions of Americans have lost their jobs.
These days, Fronstin said many people may feel like they made it through the recession and therefore don’t have to be as worried that they will lose their job. Yet they still may worry that their employer will continue to ask them to pay more for health care, and they may wonder how they will swing that added cost.
“People are starting to get over that (fear that) they’re going to lose their job because the unemployment rate has been coming down, even slightly,” he said. “But it doesn’t make them feel better about their benefits.”