The Affordable Care Act Doesn't Rank Highly As an Issue for Voters in the Presidential Primaries

Despite Anecdotal Reports about Narrow Networks, 87% of Working-Age Adults with Insurance Are Satisfied With Their Plan's Choice of Doctors; 12% Say They Had to Change Doctors in Past Year

As the ACA's Open Enrollment Nears End, Most of Those Who Remain Uninsured Are Disengaged

While this month Congress passed and President Obama vetoed legislation to repeal the Affordable Care Act, voters nationally aren't focused on the law in this year's presidential election, the latest Kaiser Health Tracking Poll finds.

Terrorism (38%) and the economy and jobs (34%) are the issues that voters are most likely to say will be extremely important to their presidential vote. In contrast, nearly a quarter (23%) say the ACA will be extremely important to their vote, ranking eighth. Among the issues ranking somewhat higher is the personal cost of health care and health insurance, which 28 percent of voters describe as extremely important to their vote.

When asked to choose the single most important issue to their vote, just 4 percent of voters choose the ACA, ranking behind the economy (12%) and terrorism (10%), dissatisfaction with government (9%), gun control (7%), the cost of their health care (6%), climate change (5%), and tied with immigration (4%) and the federal budget deficit (4%). For voters across parties, the ACA ranks no higher than fourth.

A minority of the public (39%) was aware of President Obama's veto of legislation to repeal the ACA, the survey finds. Overall public opinion on the law did not change significantly this month and is closely split, with 44 percent holding an unfavorable view and 41 percent holding a favorable one.

With recent media and political attention focused on concerns about narrow provider networks that limit choices for people with insurance, this month's tracking poll examines the experiences of working-age adults with insurance and finds the vast majority (87%) say they are "very" or "somewhat" satisfied with the choice of doctors in their plan's network and 4 percent who say they are “very dissatisfied." (The poll captures experiences of all insured Americans ages 18-64, not just those in ACA marketplace plans).

Among this group, one in eight (12%) say they had to change doctors in the past 12 months because their doctor wasn’t covered by their health insurance plan. This includes 5 percent who say the change was a big problem for them, 5 percent who say it was a small problem, and 1 percent who say it was not a problem.

With the Affordable Care Act’s third open enrollment period ending Jan. 31, the survey finds people who remain uninsured are largely disengaged from the ongoing enrollment process.

Most of those without health insurance say they have not been contacted about signing up for coverage (67%) or that they have not tried to get more information on their own (57%). Most also say they have not taken steps in the past six months to figure out if they are eligible for either Medicaid (72%) or financial assistance to purchase health insurance through the healthcare marketplaces (79%).

Just 15 percent of the uninsured can correctly say when the enrollment deadline is. Most (61%) also do not know what the fine will be for people who do not get insurance in 2016, and just 1 percent cite the correct amount ($695 per person or 2.5% of household income).

At the same time, two-thirds (65%) say they plan to get health insurance in the next few months, even though nearly half (46%) say they have been without coverage for at least the past two years.

The poll was designed and analyzed by public opinion researchers at the Kaiser Family Foundation and was conducted from Jan. 13 to 19, 2016 among a nationally representative random digit dial telephone sample of 1,204. Interviews were conducted in English and Spanish by landline (481) and cell phone (723). The margin of sampling error is plus or minus 3 percentage points for the full sample. For results based on subgroups, the margin of sampling error may be higher.

Filling the need for trusted information on national health issues, the Kaiser Family Foundation is a nonprofit organization based in Menlo Park, California.