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The Times
  • Uninsured not convinced of health-care law benefits

  • Tammy Gonzalez has her doubts about whether President Barack Obama’s signature legislative achievement –- the Affordable Care Act – will improve the quality of health care, get costs under control or expand access to health insurance.

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  • Tammy Gonzalez has her doubts about whether President Barack Obama’s signature legislative achievement –– the Affordable Care Act –– will improve the quality of health care, get costs under control or expand access to health insurance.
    The 53-year-old resident of Benld, Ill., is like many people without health insurance nationwide. Even though the uninsured are among those who stand to gain the most from the federal health-care reform law, they are far from enthusiastic about it. By many measures, they are no more likely than the insured population to support the law.
    But Gonzalez and some other uninsured residents of central Illinois also don’t want to see the law struck down by the U.S. Supreme Court. The high court is expected to rule this summer on challenges to the law and its requirement that most Americans have health insurance or face tax penalties.
    Gonzalez, an unemployed truck driver, said the court and Congress should allow key provisions of the law to take effect as scheduled in 2014: Expansion of the Medicaid program to all uninsured adults with income below 133 percent of the federal poverty level; and creation of state-level health-insurance exchanges to help people buy affordable insurance, sometimes with federal subsidies.
    “They need to leave it alone, at least for six months to a year, to see what actually comes about,” Gonzalez said while waiting to be treated at a federally subsidized clinic for the poor and the uninsured. “I don’t care if you’re a Republican. I don’t care if you’re a Democrat. We’re all human beings. You need affordable health care.”
    Divided public
    Public opinion about the Affordable Care Act has been divided since the law was passed, according to Mollyann Brodie, a senior vice president at the nonpartisan Kaiser Family Foundation.
    “It’s very much been a case of partisan division,” Brodie said.
    Democrats are much more likely than Republicans to support the law, she said. Among Americans, Kaiser’s most recent poll, in April, indicated that 42 percent favor the law, while 43 percent do not.
    When it comes to the individual mandate, 70 percent oppose the provision, including 53 percent who hold “very unfavorable” views. About half of the public, or 51 percent, want to see the Supreme Court declare the mandate unconstitutional.
    The mandate is the “glue that holds the law together,” said Mike Franc, vice president for government studies at the conservative-leaning Heritage Foundation, which wants to see the law repealed.
    For policy-makers who support the law, public opinion on the insurance mandate is “a pretty big problem to have at the end of the day,” Franc said.
    Page 2 of 3 - Among the uninsured, 43 percent support the overall law, according to Kaiser’s April poll. That’s the same level of support voiced by people who have health insurance, whether through private companies or from programs such as Medicaid or Medicare.
    Thirty-two percent of the uninsured oppose the law, compared with 39 percent of the insured.
    The uninsured were more likely than the insured to say they didn’t know enough about the law to answer the question or refused to answer for some other reason (25 percent of the uninsured versus 7 percent of the insured).
    Uninformed
    Kaiser’s polling indicates people don’t know much about the law’s components, Brodie said. As they are informed about those parts, they are more likely to be supportive, except for the insurance mandate, Brodie said.
    The lack of enthusiasm among the uninsured isn’t surprising, she said.
    “The law isn’t real for most Americans yet,” she said. “They don’t really know what it means for them and their families.”
    Gonzalez –– whose husband is a truck driver but switched employers and doesn’t yet qualify for his new company’s insurance plan –– said she is grateful for the Maple Street Clinic in Gillespie, Ill., which is operated by the local health department and where she pays $28 for an office visit with a nurse practitioner she said is “awesome.”
    Gonzalez was recently diagnosed with fibromyalgia and hopes the reform law will give her access to affordable private insurance so she doesn’t have to worry about going bankrupt because of medical bills.
    “I had insurance for years,” she said.
    She said she has heard that the law would result in “putting the elderly out to pasture.” Brodie said only one-third of senior citizens support the law, possibly because of negative and, in some cases, incorrect claims by opponents about “death panels” and a lack of awareness about how the law is moving to close the Medicare Part D “doughnut hole.”
    Gonzalez said she wishes politicians on both sides of the health-care law would tone down their rhetoric.
    “Somebody’s always trying to put a bad spin on every little bit,” she said.
    Playing politics
    Melissa Pieper, an unemployed mother of two from Auburn, Ill., agreed.
    “I don’t think you should play politics with people’s lives in a presidential election,” said Pieper, 39, a breast-cancer survivor who lost her insurance in 2009 when she and her former husband divorced.
    She said she has been turned down for private coverage because of her cancer history and can’t afford insurance from Illinois’ federally funded high-risk pool.
    Pieper, whose two daughters receive health coverage through their father, said she is worried that the Supreme Court will throw out the reform law and allow insurers to jack up rates and deny coverage based on pre-existing conditions.
    Page 3 of 3 - “I need the help,” Pieper said. She was laid off from her contract job with the state of Ilinois in November.
    Pieper has received medical care through Springfield’s Capitol Community Health Center, the same federally subsidized clinic that has served Jim Sherwood, 63, of Auburn, since he was laid off from his job a year ago in January.
    Sherwood said he will be 65 and qualify for Medicare in 2014, but he said the new law could do some good for the country.
    “I don’t see how insurance costs can get any higher,” he said.
    But he said he will be pessimistic about the future of the law, and the solvency of Medicare, until the economy improves.
    “It all comes down to the economy,” he said. “Unless people go back to work, the money is not going to be there.”
    Americans younger than 65 with no health insurance: U.S. 45.3 million 17.2
    Sources: U.S. Census Bureau
    Follow Dean Olsen at twitter.com/deanolsen.
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