The knowledge effect: Americans and the Obamacare mandate

It’s well-known that the mandate to have health insurance is the least popular element of the Affordable Care Act. However, some data suggest this lack of support may be related to a lack of knowledge of how it operates.

In general, Americans know less about key provisions of Obamacare since it was first passed. For example, as Kaiser shows, in March 2012, only 51% know the law prohibits insurance companies from denying coverage due to pre-existing medical conditions, down from 70% in June 2010.

Regarding the mandate, not everyone is required to purchase insurance. People who have insurance as a veteran, from one’s job, or from Medicare or Medicaid, don’t need to do so.  The ACA in fact significantly expands Medicaid eligibility.

So all those folks don’t fall under the mandate. Then the people who do have to buy insurance may receive subsidies to do so. These subsidies make a clear difference in how much people support the mandate. This appears to be confusing to some.

Pew Poll, March 26, 2012

Moreover, in asking about the mandate, a new Pew poll provided slightly different question wording, which led to very different levels of support. In neither case does the mandate receive majority support. However, when the availability of “financial help” is mentioned, opinion is essentially split. In contrast, when a penalty is mentioned, opposition is far stronger.

After the Affordable Care Act was passed, the federal government did little publicity about its provisions.

This was in contrast to what happened after the passage of Social Security, when posters like this one were widely circulated.

Whether that would have made a difference in public opinion toward the mandate is hard to know, but they certainly could have.

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Amy Fried

About Amy Fried

Amy Fried loves Maine's sense of community and the wonderful mix of culture and outdoor recreation. She loves politics in three ways: as an analytical political scientist, a devoted political junkie and a citizen who believes politics matters for people's lives. Fried is Professor of Political Science at the University of Maine. Her views do not reflect those of her employer or any group to which she belongs.