In Profile

A Conversation With Laura Adams

Undercurrents of Health Reform

by PE Kelley

Mr. Kelley is managing editor of this magazine. Connect with him by e-mail: [email protected]

A recent survey of consumer opinions about the Affordable Care Act, conducted by the insurance marketing website InsuranceQuotes, revealed that while overall support for the ACA has varied since the law was introduced in 2010 (highest after President Obama took office and lowest a year before the 2016 presidential election), the election has not changed overall sentiment.

One possible explanation for why Americans feel the same toward health care laws since the election may be because health care situations have not changed yet. Until now…An announcement last month by Anthem Health, the nation’s second largest health insurer, that it is pulling out of the California individual market because of uncertainty about ACA, has sparked an avalanche of inquiries from Americans now faced with the very real, and grim, possibility of losing their health care.

We spoke with Laura Adams, Senior Insurance Analyst for insuranceQuotes.com, about the size and scope of the conversation about healthcare reform, and what it may portend for Americans, as the market and political forces behind it continue to advance agendas that threaten hundreds of thousands of policy holders nationwide.

PEK: Generally speaking, just how important is the topic of Health Care reform to Americans, and what are the key issues about reform that they’re now revealing?
LA: In a recent insuranceQuotes survey, 38% of Americans said health care reform should be the top priority for President Trump and Congress this year. When asked to think ahead 12 months, here’s what respondents said will happen to the Affordable Care Act:
• 31% said it will be repealed and replaced with a new law.
• 27% said it will still be in place, but updated.
• 24% said it will be the same as it is today.
• 8% said it will be repealed but not replaced with a new law.

PEK: What have you learned about the demographics of health care reform opinions, considering Age, Gender, Income, Party affiliation and Race, to name only a few?
LA: Of the 38% of survey respondents who want health care reform to be a top priority, here are their demographics:
• Most are over age 65 (40%).
• Most are women (45% versus 32% men).
• Most have annual incomes below $75,000.
• Political party affiliation is divided almost equally among Independents (39%), Democrats (38%), and Republicans (34%).
• Most are white, non-Hispanics (39%).
• Community type is split almost equally among Urban (39%), Sub-urban (37%) and Rural (38%).

PEK: Opinion about ‘Pre-existing conditions’ appears to resonate loudest across the entire spectrum. What does your survey reveal about this?
LA: When asked about various aspects of the health care system, 87% said they either strongly or somewhat favor requiring health insurance companies to cover people with pre-existing medical conditions. Older Americans showed slightly more favor for this regulation than younger respondents.

Instability in the health insurance market makes it more difficult for insurers to stay in business

PEK: Does Anthem Health’s announcement that they will pull out of the California individual market serve as a barometer for the rest of the country, and what are the implications following that?
LA: Instability in the health insurance market makes it more difficult for insurers to stay in business. If they don’t believe a geographic region will be profitable, they must charge higher premiums or leave the market altogether. Unfortunately fewer health insurance carriers means fewer choices for consumers.

PEK: What are the differences and similarities in opinions about reform between generations?
LA: When asked what issue should be a national priority, older Americans were the most likely to choose health care reform:

  • 40% are age 73 or above, in the Silent generation
  • 42% are age 53 to 71, Baby Boomers
  • 35% are age 37 to 52, Gen X
  • 35% are age 18 to 36, Millennials

PEK: If the underlying sentiment about health care centers around ‘choice’ what do consumers say that they want the most from their healthcare plans?
LA: When asked about various aspects of the health care system, 87% said they either strongly or somewhat favor requiring health insurance companies to cover people with pre-existing medical conditions. The next most favorable choices were:

  • Allowing states to offer health insurance through Medicaid to more low-income people (79%)
  • Allowing young adults to stay on their parents’ health insurance plans until age 26 (78%)
  • Providing financial assistance to low-income Americans so they can afford health insurance (78%)
  • Requiring nearly all Americans to have health insurance or else pay a fine (40%)

PEK: What are the prevailing sentiments about the individual mandate?
LA: The individual mandate is the least popular aspect of the health care law. The insuranceQuotes survey found that 57% strongly or somewhat oppose this measure.

PEK: At the time of the 2016 election, ACA was a much debated topic from both ends of the discussion, but your research reveals that attitudes about reform have not really changed much after the election. What does this imply?
LA: Our survey results may imply that Americans’ attitudes about heath care haven’t changed because their health status or coverage situations haven’t changed. For instance, if you had group health insurance through an employer before the 2016 presidential election and you still have that same coverage, your opinion about the ACA may be the same.

PEK: If the administration does let ACA implode, what will be the most likely result and how will the industry respond in that aftermath?
LA: If the administration doesn’t stabilize the health insurance market, carriers and consumers would suffer. It’s estimated that 18 million people would lose health insurance coverage and premiums would rise by 20% to 25% within the first year after repeal.

PEK: Do consumers believe that the government should be more or less involved in the administration of healthcare plans?
LA: The insuranceQuotes survey found that 79% favor the federal government providing financial assistance to low-income Americans so they can afford health insurance. And 79% also favor allowing states to offer health insurance through Medicaid to more low-income people. ◊