When it comes to last year's Affordable Care Act, there's not much people agree on. Except, says Kaiser Family Foundation President and CEO Drew Altman, this one thing: "It really does help the uninsured; 32 million uninsured people will get coverage."
But according to the foundation's latest monthly tracking poll, it appears that only about half of uninsured people have any idea that help is on the way. And fewer than a third (31 percent) say they think the law will help them obtain health insurance.
Those two things are clearly linked. Among those lacking insurance, 41 percent incorrectly think the law lacks provisions to help those with modest means pay for health insurance (7 percent said they didn't know) and 37 percent incorrectly said the law doesn't include an expansion of the Medicaid program to low-income, able-bodied adults (16 percent weren't sure).
The logical conclusion, Altman wrote in an accompanying column, is an apparent "communications failure" on the part of the law's supporters to explain how the measure will actually work. But in that column and a subsequent interview, Altman said there's more to it than that.
"What's going on here is people who are uninsured are busy just trying to make it through the week, paycheck to paycheck," he says. Meanwhile, he adds, "they're listening to a confusing political debate."
But the bottom line, he says, is that the health overhaul will probably start to sink in in 2014, "when there are benefits out there, real coverage out there that people can look at — and can get...."
That's when people without insurance will really make a judgment about whether they can afford insurance or they like the law or it helps them. "Until then," Altman says, "it's just a political debate."
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