Obamacare still divides Kentuckians, but opinion has firmed up; view of its personal impact on them is now even

By Melissa Patrick and Al Cross
Kentucky Health News

Kentuckians still have a marginally unfavorable opinion of the federal health-reform law, and their views about it have firmed up, according to the latest Kentucky Health Issues Poll.

However, the opinion of those who say the law has had an effect on their family has improved to the point that they are evenly divided on the controversial topic.

"Although many still report they do not have enough information to understand the impact of the law on themselves, and opinions remain split, the numbers reporting positive personal and family impacts have increased as provisions of the law have gone into effect," said Susan Zepeda, CEO of the Foundation for a Healthy Kentucky, which sponsors the survey.

The poll has asked the same question of Kentucky adults since 2010: "Given what you know about the health reform law, do you have a generally favorable or generally unfavorable opinion of it?"

Last year, opinion was almost evenly split, with 41 percent unfavorable and 39 percent favorable. This year, 46 percent were unfavorable and 41 percent favorable. Because the poll's error margin is plus or minus 2.4 percentage points, which applies to each number, there is little or no statistical difference in the two years' results.

The significant change was in the share of people who said they didn't have an opinion about the law. That dropped to 14 percent this year from 20 percent last year.

Political affiliation continues to be reflected in opinions of the law. The survey found that 61 percent of Democrats had favorable views of it and 66 percent of Republicans had unfavorable views. Among independents, 42 percent had unfavorable views and 43 percent were favorable.

Kentuckians' opinions are virtually the same as those found in a national survey taken at about the same time. The September 2015 Kaiser Health Tracking Poll found that 45 percent of U.S. adults had unfavorable views of the law; 41 percent were favorable; and 14 percent did not know or refused to answer.

The number of Kentucky adults who reported the law had a positive effect on their family increased to 23 percent, up from 18 percent in 2014. The percentage who said the law had negatively affected them or their family remained steady at 23 percent.

Kentucky's adoption of the law expanded eligibility for the Medicaid program to households with incomes up to 138 percent the federal poverty level. Among such people, 37 percent said the law had affected them positively.

People with incomes from 138 to 400 percent of the poverty level are eligible for private-insurance subsidies. Among those with incomes between 138 and 200 percent of the FPL, 27 percent said the law had positively affected them; it was 12 percent among above 200 percent of the FPL.

As for Kynect, the state's online marketplace for health insurance, 35 percent said they had heard a lot about it; 22 percent had heard "something" about it; and 43 percent had heard only a little or nothing at all.

The poll was conducted among a random sample of 1,608 Kentucky adults Sept. 17 through Oct. 7 for the foundation and Interact for Health, formerly the Health Foundation of Greater Cincinnati, by the Institute for Policy Research at the University of Cincinnati. It used landlines and cell phones.