When it comes to last year's Affordable Care Act, there's not much people agree on. Except, says Kaiser Family Foundation President and CEO Drew Altman, this one thing: "It really does help the uninsured; 32 million uninsured people will get coverage."
But according to the foundation's latest monthly tracking poll, it appears that only about half of uninsured people have any idea that help is on the way. And fewer than a third (31 percent) say they think the law will help them obtain health insurance.
Those two things are clearly linked. Among those lacking insurance, 41 percent incorrectly think the law lacks provisions to help those with modest means pay for health insurance (7 percent said they didn't know) and 37 percent incorrectly said the law doesn't include an expansion of the Medicaid program to low-income, able-bodied adults (16 percent weren't sure).
The logical conclusion, Altman wrote in an accompanying column, is an apparent "communications failure" on the part of the law's supporters to explain how the measure will actually work. But in that column and a subsequent interview, Altman said there's more to it than that.
"What's going on here is people who are uninsured are busy just trying to make it through the week, paycheck to paycheck," he says. Meanwhile, he adds, "they're listening to a confusing political debate."
But the bottom line, he says, is that the health overhaul will probably start to sink in in 2014, "when there are benefits out there, real coverage out there that people can look at — and can get...."
That's when people without insurance will really make a judgment about whether they can afford insurance or they like the law or it helps them. "Until then," Altman says, "it's just a political debate."
STEVE INSKEEP, Host:
And now let's look at a new study of the government's health overhaul. NPR's Julie Rovner reports that many of the people most likely to be helped by it don't know it.
JULIE ROVNER: When it comes to last year's huge health law, there's not much that people agree on, but there is one thing, says Drew Altman of the Kaiser Family Foundation.
DREW ALTMAN: And that's that it really does help the uninsured. Thirty-two million uninsured people will get coverage.
ROVNER: One conclusion, he says, is that the law's supporters have let opponents define the law on their terms.
ALTMAN: That's why it became, in the minds of many, a government takeover.
ROVNER: But Altman thinks there's something else. The uninsured, like everyone else outside of Washington, have so far experienced the health law as little more than a political debate.
ALTMAN: And what it means is this will be real for people when it's real, which is mostly in 2014.
ROVNER: Julie Rovner, NPR News, Washington. Transcript provided by NPR, Copyright NPR.