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Poll: Many Americans uninformed about health care overhaul, some don't know it's law

A Tea Party member reaches for a pamphlet titled "The Impact of Obamacare", at a "Food for Free Minds Tea Party Rally" in Littleton, New Hampshire October 27, 2012. REUTERS/Jessica Rinaldi

President Barack Obama reflects on the status of the Affordable Care Act while speaking Tuesday at the White House.

As the Obama administration girds for “glitches and bumps” along the path to full implementation of the health-care law, a new poll indicates many Americans are still unclear about the details of the new law and, in some cases, unaware it’s actually law of the land.

A whopping 42 percent of Americans do not know that the Affordable Care Act is, in fact, law. Included in that 42 percent -- 12 percent believe it has been repealed by Congress, 7 percent think the U.S. Supreme Court overturned it, and 23 percent are unsure of its status, according to a Kaiser Family Foundation health tracking poll.

For the record, no portion of the law has been repealed; and the Supreme Court upheld it last summer in a 5-4 decision. The law continues to be viewed more negatively than positively, with just 35 percent saying they have a favorable view and 40 percent saying they have an unfavorable one. But the prolonged implementation, complexity of the law, and messaging by opponents has aided in the confusion. The administration is starting to push back, beginning with the president.

“It’s still a big undertaking,” President Barack Obama acknowledged Tuesday in a press conference at the White House. "And what we’re doing is making sure that every single day we are constantly trying to hit our marks so that it will be in place. ... Even if we do everything perfectly, there will still be glitches and bumps. ... And that’s pretty much true of every government program that’s ever been set up."

The poll comes as the administration Tuesday took one step to streamline the application process for health insurance for the uninsured, unveiling a shorter, three-page application form rather than the earlier, 21-page version that was criticized. Enrollment begins Oct. 1 for insurance that would take effect Jan. 1.

Nearly half of all Americans – 49 percent – say they still do not have enough information about the law and how it will impact their families. There are plenty of people happy to try and fill in the gaps.

Republicans, for example, have begun mounting a messaging campaign against the law’s implementation, hoping it can help them in the 2014 midterms and potentially hand over control of the Senate to the GOP, which needs to net six seats to accomplish that goal. 

They have seized, in particular, on retiring Democratic Sen. Max Baucus’ comment at a hearing earlier this month that implementation of the law will not just see “glitches and bumps,” but said it will be a “train wreck.”

“I urge my friends on the other side to join with Republicans and stop this ‘train wreck’ before things get even worse,” Senate Minority Leader Mitch McConnell, up for re-election in 2014, said on the floor of the upper chamber.

Views of the law have gotten worse since the presidential election, sliding from 43 percent favorable to 35 percent. Democrats are mostly responsible for the drop, as pre-election partisanship begins to fade and details of implementation begin to come into focus. 

But on Tuesday, President Obama –  in his most extensive defense of the implementation of the law so far –  said, “Despite all the hue and cry and ‘sky is falling’ predictions about this stuff, if you’ve already got health insurance, then that part of ‘Obamacare’ that affects you, it's pretty much already in place.”

What remains, he added, is getting the 10 percent to 15 percent of Americans who do not have health insurance, and who will face a penalty next year if they choose not to purchase it, to enroll in state or federal exchanges. The federal government’s job is also made more difficult, the president said, because big states like Florida and Texas, both states with Republican governors, have opted against setting up exchanges.

The “only impact” on people who already have insurance “is that their insurance is stronger, better, more secure than it was before,” Obama contended. “Full stop. They don’t have to worry about anything else. The implementation issues come up for those who don’t have health insurance.”

He added, "What we’re doing is we’re setting up a pool, so that they can all pool together and get a better deal from insurance companies. And those who can’t afford it, we’re going to provide them with some subsidies. That’s it." 

But the uninsured, those who will be most affected by the changes in the next year, are undereducated about the law, the Kaiser poll found. Fifty-eight percent of the uninsured said they did not have enough information to know how the law would impact their families.

By a 40 percent to 32 percent margin, more of the uninsured had a favorable view of the law. Nearly three-in-10 did not know or have an opinion on it.

“My assumption is that number starts shrinking,” said Molly Ann Brodie, senior vice president and director for public opinion and survey research for the Kaiser Family Foundation, noting that with more information on what the law actually does and how to sign up for it, the uninsured will begin to look more favorably on the health-care law.

“It’s going to be a difficult and confusing time,” Brodie said, noting the “tight time frame for enrollment.” She added, “Certainly, it’s going to be a messaging challenge and a framing challenge, but all the folks involved in implementation and expansion know that. The key is to focus on the folks who will be affected. … Let the political fight happen in the background.”

While opponents of the law will continue to message against it, Brodie noted that there will also be arguments from proponents highlighting positive stories.

“This will be a case where there are plenty of bumps and challenges to focus on,” she said, “but also some success stories – where people are getting care where they weren’t before. The question is which one wins from a political standpoint.”

Despite those “bumps,” “challenges,” and “glitches,” Obama tried to keep the focus on the big picture, sounding a note from his campaign.

"In a country as wealthy as ours, nobody should go bankrupt if they get sick," he said, adding, "We would rather have people getting regular checkups than going to the emergency room because they don’t have health care — if we keep that in mind, then we’re going to be able to drive down costs; we’re going to be able to improve efficiencies in the system; we’re going to be able to see people benefit from better health care. And that will save the country money as a whole over the long term."

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