My healthcare plan is fine. But yours is probably lousy.
That seems to be the way Americans evaluate the convoluted U.S. healthcare system these days, according to new data published by the Employee Benefit Research Institute. In its annual survey of workers, EBRI found a majority consider the healthcare system overall to be poor or fair, a notable deterioration compared with the numbers from 2013. There was a corresponding drop in the portion saying the system is good, very good or excellent.
Yet the number of Americans satisfied with their own healthcare plan has been going up, the opposite of what you’d expect if the broader system were actually getting worse. The percentage of Americans rating overall healthcare as fair or poor has risen from 49% in 1998 to 61% in 2014. Yet the portion saying they're satisfied with their own plan has ticked up from 87% to 88% during the same time. Here’s a chart showing the trends:
So why, when it seems the vast majority of Americans are satisfied with their own health plan, would they also feel the overall healthcare system is getting worse?
Oh. Right. Obamacare went into effect this year. It started out as an administrative disaster, with Healthcare.gov on the fritz for months. Instead of getting a better deal on healthcare, some people lost their insurance. Costly penalties are coming for people who don’t comply with Obamacare, even if they don’t know what they’re supposed to do. And the whole law is so problematic that half of Congress wants to repeal it.
Those are the grim impressions you’re likely to have if you’ve been sporadically following the news on the Affordable Care Act, the official name for President Obama’s health reform law. But the actual healthcare ordinary Americans get may end up changing far less than the hyperventilating over Obamacare suggests. It’s possible changes brought by the law might even do some good, even though Obamacare remains unpopular and its supporters are arguably losing the PR battle.
It’s still too early to tell whether Obamacare will succeed in the long term, but here are a few changes during the past year or two that might explain why ordinary Americans are satisfied with their own care yet disdainful toward the system as a whole:
Costs are still going up. The rate of increase has been slowing, which is good news, but that doesn’t seem to be putting money into anybody’s pocket just yet. The EBRI survey, for instance, shows a slight increase in the portion of people satisfied with the cost of health insurance. But the portion satisfied with the cost of care not covered by insurance is just 29%, down 14 percentage points from two years ago, and the lowest number on record. That could be because the ACA cut back on some Medicare spending, which would slow the growth of overall healthcare costs but not help ordinary consumers, since the spending comes from the government. Meanwhile, other data show workers are paying a higher share of insurance premiums and taking out more high-deductible plans that force them to pay a larger share of routine costs.
More people have healthcare coverage. About 7.3 million people seem to have enrolled in Obamacare, paid the premiums and kept the coverage. Other data show the number of uninsured Americans dropped by at least 3.8 million early in 2014. That might help people feel better about their own coverage — especially if you didn’t have it before but now do. Yet those same people may have hit snags with Obamacare or had other problems suggesting the overall system is a mess.
Some people are worse off under Obamacare. These would be the people who were happy with a “bare-bones” health plan insurers had to cancel because it didn’t comply with new Obamacare requirements. This was a relatively small group, compared with the 42 million Americans who lacked health insurance in 2013, yet it became a high-visibility problem because of Obama’s earlier promise that anybody who liked their plan would be able to keep it. Many people with stable health insurance were nonetheless appalled at the news of others losing their policies with virtually no warning, which made Obamacare seem arbitrary and punitive.
The healthcare system is getting increasingly complicated. Obamacare will probably succeed in extending health coverage to significantly more people. But it’s also a devilishly complex program with subsidies based on income not yet earned, penalties that are sure to be unpopular and workarounds meant to assure a “single-payer” (government-funded) healthcare system doesn't take root. Healthcare was complicated before Obamacare, and it sure hasn’t gotten simpler.
The 2014 midterm elections are coming. The upcoming midterms have given a dedicated band of Obamacare haters a fresh platform for highlighting everything wrong with the law, sustaining a drumbeat of negativity that amped up even before the law passed in 2010. At the same time, however, the majority of Americans are discovering that a law vilified as the second coming of communism affects them very little or not at all, as Gallup polls reveal. If the worst problems with Obamacare fade away, as seems likely, complaints about the law will start to seem hollow. And your coverage may appear to be just as good as mine.
Rick Newman’s latest book is Rebounders: How Winners Pivot From Setback To Success. Follow him on Twitter: @rickjnewman.
