Government shutdown comes over a healthcare plan few understand

October 01, 2013, 8:33 PM GMT+0

A third of Americans want to stop Obamacare even at the cost of causing the shutdown that began today, but many Americans are confused as to what Obamacare actually does.

The Congressional back and forth that resulted in a government shutdown Tuesday morning was a result of debate on a continuing resolution to fund the government that turned into a dispute over the Affordable Care Act – “Obamacare” – passed three years ago and now being implemented. This contentious legislation is poorly understood and seen through a partisan lens – made clear in the latest Economist/YouGov Poll, conducted just before the shutdown began.

The ACA evokes strong feelings and has many objectors: 42% think it should be completely repealed (that figure includes 84% of Republicans). Just over a third (two-thirds of Republicans) would shut down the government to repeal it. A quarter (mostly Democrats) would shut down the government to keep the legislation. A total of 60% of the respondents in the poll see this legislation as worth shutting the government over.

But some of the things Americans may be fighting over are things that aren’t even in the bill.

For example, half or more believe the law will give health care to illegal immigrants and would require the elderly to have consultations about end of life care.

Republicans are especially likely to think these things are true. But neither is. Illegal immigrants will not be able to buy insurance on the newly-created health care exchanges. And the proposal in the original draft bill, which would have allowed doctors to charge for the time they spent with a patient who asked to discuss end-of-life treatment (which became known as the infamous “death panels”) was eliminated before the Affordable Care Act passed Congress.

Majorities also think that there will be limits on care for the elderly and cuts in Medicare spending. 64% of those 65 and older expect cuts in Medicare coverage. Just over half think the bill will result in the rationing of health care.

These changes are not precisely true. While there will be no cuts in Medicare coverage, there will be reductions in reimbursements to doctors and hospitals. It’s unclear whether or how much this will reduce doctors’ willingness to take on new Medicare patients. But there are no direct cuts to Medicare coverage in the Affordable Care act; and no specified limits to care for the elderly and the disabled, or the rationing of specific medical services.

In fact, there are some positive changes in coverage that most people agree will happen once Obamacare is fully implemented. Most agree that you will be able to keep health care coverage even if you become seriously ill, can get cove rage for pre-existing medical conditions, and keep your current doctors if you like.

While Republicans have been harshly critical of Obamacare, three in four agree that the plan will give coverage for pre-existing conditions. And just over half agree that you would be able to keep coverage even if you became seriously ill. But Republicans part company with the majority of Americans when it comes to the question of whether or not you could keep your own doctor when Obamacare was fully implemented. Just 40% of Republicans believe that.

In previous Economist/YouGov Polls, Republicans were far more likely to say they had been affected by the Act, even before it was implemented. In March, 2012, nearly half of Republicans claimed the law had already affected them. Just 19% of Democrats saw a change.

In the current poll, the fear of losing coverage is a partisan fear. More than half of Republicans and 45% of independents say that under the law they might lose their own health care coverage.

The current battle over health care reform is being played out in a confrontation over the budget, and there is a great deal of confusion over the budgetary implications of the law. While the Congressional Budget Office has indicated that the expansion of health care coverage will increase the deficit, but it also reported that other revenue-generating parts of the bill will result in a net budgetary increase and deficit reduction. But most adults, including nearly all Republicans see only the increase.

And less than half think there will be long-term health care savings.

One thing that the recent Congressional battles may have done is increase Americans’ pessimism. Only 24% say the country is headed in the right direction, about the lowest number since before the 2012 election. 63% say the country is off on the wrong track, and that percentage has been rising.

Image: Getty

Full results can be found here.

Economist/YouGov poll archives can be found here.

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