Health care reform

52 Percent Favor Health Care Law's Community Rating; 76 Percent Oppose When Cuts to Quality Considered

Data suggest community rating is popular when considered in isolation of costs; support declines when increased wait times to see a physician, increased premiums, increased taxes, or decreased health care quality are considered.

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New findings from the Reason-Rupe poll demonstrate weak support of the new health care law, which is likely driven by opposition to the individual mandate. However, other provisions in the law do enjoy majority support.

For instance, 52 percent favor the community rating provision, which prohibits health insurance companies from charging some customers higher premiums based on medical history or pre-existing conditions. However, when potential cuts to quality are considered, support flips and 76 percent oppose the provision.

The Reason-Rupe poll sought to provide realistic potential costs associated with the community rating provision to understand what costs Americans might be willing to accept in exchange for community rating.

Although a majority of Americans favor a community rating provision, support drops to 41 percent if increased wait times result, 38 percent if increased premiums result, and 37 percent if increased taxes result. Most strikingly though, opposition skyrockets to 76 percent if decreased health care quality results from the community rating provision.

Among those who favor the community rating provision, a majority continue to favor it if increased wait times result, 47 percent continue to favor if increased taxes result, and 46 percent continue to favor if increased premiums result. However, opposition also soars to 76 percent if decreased health care quality results from the community rating provision.

Polls typically ask about explicit provisions in the new health care law, such as the individual mandatethe employer mandatecommunity ratingguaranteed issue, and the medical loss ratio. However, they often fail to provide realistic potential costs associated with these provisions. This is essentially asking a person if they want a benefit without suggesting there is any associated cost.

When potential unintended costs are considered, favorability toward the Affordable Care Act's provisions becomes more nuanced. These data suggest community rating's benefits are popular when considered in isolation of costs. However, support declines when increased wait times to see a physician, increased premiums, increased taxes, or decreased health care quality are considered.

Reason-Rupe Question Wording

30. The new health care law has a provision that prohibits health insurance companies from charging some customers higher premiums based on pre-existing conditions or medical history. Do you favor or oppose this provision?

31. Suppose the effect of this pre-existing conditions provision were to increase taxes. Would you be willing to pay higher taxes in order for health insurance companies to not charge higher premiums based on medical history?

32. Suppose the effect of this pre-existing conditions provision were to increase wait times to see your doctor or specialist. Would you be willing to wait longer to see a doctor or specialist in order for health insurance companies to not charge higher premiums based on medical history?

33. Suppose the effect of this pre-existing conditions provision were to increase premiums. Would you be willing to pay higher premiums in order for health insurance companies to not charge higher premiums based on medical history?

34. Suppose the effect of this pre-existing conditions provision were to lower health care quality. Would you be willing to have lower quality health care in order for health insurance companies to not charge higher premiums based on medical history?

Full poll results found here.

Nationwide telephone poll conducted March 10th-20th of both mobile and landline phones, 1200 adults, margin of error +/- 3 percent. Columns may not add up to 100 percent due to rounding. Full methodology can be found here