AP-GfK poll: Health law seen as eroding coverage

WASHINGTON (AP) — Americans who already have health insurance are blaming President Barack Obama's health care overhaul for raising the costs of their policies while making them pay a larger share of their medical bills out of pocket, and overall 3 in 4 say the rollout of coverage for the uninsured has gone poorly.

An Associated Press-GfK poll finds that health care remains politically charged going into next year's elections when control of both houses of Congress will be at stake. Keeping the refurbished HealthCare.gov website running smoothly is just one of Obama's challenges, maybe not the biggest.

The poll found a striking level of unease about the law among people who have already have health insurance and aren't looking to take advantage of the new law. Those are the 85 percent of Americans who the White House says don't have to be worried about the president's historic push to expand coverage for the uninsured. Most Americans get their health insurance coverage through plans offered through their employer, or from government programs covering the elderly, poor, disabled, and active duty military and veterans. The U.S. has been the only leading industrial country without universal health care coverage.

Obama's Affordable Care Act is intended to provide coverage for millions of uninsured Americans by raising income levels to qualify for Medicaid — the government program that covers the poor — and creating state and national exchanges through websites that offer the uninsured an opportunity to obtain lower-cost coverage at group rates — with many qualifying for government subsidies to make their rates more affordable. The United States is the only major industrial country without a universal health care system.

But the survey showed that nearly half of those who already have job-based or other private coverage say their policies will be changing next year — mostly for the worse. Nearly 4 in 5 (77 percent) blame the changes on the Affordable Care Act, even though the trend toward leaner coverage predates the law's passage in 2010.

Sixty-nine percent say they will have to pay more for their insurance policies, while 59 percent say they will have to pay more out of pocket for their medical care.

Only 21 percent of those with private coverage said their plan is expanding to cover more types of medical care, though coverage of preventive care at no charge to the patient has been required by the law for the past couple of years.

Fourteen percent said coverage for spouses is being restricted or eliminated, and 11 percent said their plan is being discontinued.

"Rightly or wrongly, people with private insurance looking at next year are really worried about what is going to happen," said Robert Blendon, a professor at the Harvard School of Public Health, who tracks public opinion on health care issues. "The website is not the whole story."

Employers trying to control their health insurance bills have been shifting costs to workers for years, but now those changes are blamed increasingly on "Obamacare" instead of the economy or insurance companies.

Political leanings seemed to affect perceptions of eroding coverage, with larger majorities of Republicans and independents saying their coverage will be affected.

The White House had hoped that the Oct. 1 launch of open enrollment season for the uninsured on the exchanges would become a teaching moment, a showcase of the president's philosophy that government can help smooth out the rough edges of life in the modern economy for working people.

Instead, the dysfunctional website became a parable for Republicans and others skeptical of government.

At the same time, a cresting wave of cancellation notices hit millions who buy their policy directly from an insurer. That undercut one of Obama's central promises — that you can keep the coverage you have if you like it. The White House never clearly communicated the many caveats to that promise.

Disapproval of Obama's handling of health care topped 60 percent in the poll.

With the website working better and enrollments picking up, Democrats are hoping negative impressions will quickly fade in the rearview mirror. The poll found that Democrats still have an edge over Republicans, by 32 percent to 22 percent, when it comes to whom the public trusts to handle health care. Republicans have called for repealing the Affordable Care Act, but have yet to offer a plan to replace it.

Other potential bumps are just ahead for Obama's law.

It is unclear whether everyone who wants and needs coverage by Jan. 1 will be able to get it through the new online insurance markets. Some people who have to switch plans because their policies were cancelled may find that their new insurance covers different drugs, or that they have to look for other doctors.

In the poll, taken just after the revamped federal website was unveiled, 11 percent of Americans said they or someone in their household had tried to sign up for health insurance in the new marketplaces.

Sixty-two percent of those said they or the person in their household ran into problems. About one-fourth of all who tried managed to enroll. Half said they were not able to buy insurance, and the remaining quarter said they weren't sure.

The AP-GfK Poll was conducted Dec. 5-9 and involved online interviews with 1,367 adults. The survey has a margin of sampling error of plus or minus 3.5 percentage points for all respondents.

The survey was conducted using KnowledgePanel, a probability-based Internet panel designed to be representative of the U.S. population. Respondents to the survey were first selected randomly using phone or mail survey methods, and were later interviewed online. People selected for KnowledgePanel who didn't otherwise have access to the Internet were provided with the ability to access the Internet at no cost to them.