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Public warms up to ACA's employer mandate


A majority of Americans now have a favorable view of the ACA's provision that employers with at least 50 employees provide healthcare coverage. But a great deal of misinformation about the ACA remains.

Weeks ahead of its implementation, 6 in 10 Americans now have a favorable view of the Affordable Care Act’s employer mandate, which will require companies with 100 or more employees to offer health coverage or pay a penalty.

But opinions still have time to shift ahead of when the provision takes effect later this month, and a new poll from the Kaiser Family Foundation finds that public view of the provision depends greatly on how companies react to the mandate.

Public approval of the provision rises from 60% to 76% when told that most employers with 100 or more workers already offer health insurance and therefore won’t  face fines. But when faced with the prospect of companies moving workers from full-time to part-time to avoid paying a penalty, approval drops to nearly 30%.

Approval also depends on party affiliation, with 34% of Republicans viewing the provision favorably compared with 78% of Democrats, according to the poll. But a barrier to effectively gauging public opinion of the ACA is the disinterest in news of healthcare coverage. Eighty-four percent of poll respondents knew little or nothing about an upcoming U.S. Supreme Court case addressing whether low- and moderate-income Americans using insurance exchanges will be eligible for subsidies in paying for health insurance.

The public was also in the dark when it comes to how many states are using the federally-operated insurance marketplace. Only one third of poll respondents said they paid attention to news stories about marketplace enrollment. But the public was a bit more interested when it came to a suit brought against President Obama designed to halt implementation of the ACA. While nearly half of those polled were aware of the lawsuit, roughly half of those attributed the suit to political grandstanding.

Overall, the poll indicates that public opinion is split over the ACA, with 46% viewing the law unfavorably and 41% approving of it. Those favoring the law approve of the creation of insurance exchanges, financial assistance for the needy in paying for marketplace plans, and state Medicaid expansion.

A great deal of misinformation about the ACA also remains in the public realm. For example, the Kaiser poll found that only 5% of uninsured respondents know the correct deadline for signing up for plans in the marketplaces, and nearly all (97%) of the uninsured didn’t know the correct amount of the fine for failing to secure coverage in 2015-even though 37% of them expect to be paying that fine.


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Jennifer N. Lee, MD, FAAFP
© National Institute for Occupational Safety and Health
© National Institute for Occupational Safety and Health
© National Institute for Occupational Safety and Health
© National Institute for Occupational Safety and Health
© National Institute for Occupational Safety and Health
© National Institute for Occupational Safety and Health