Health Care 2012 - Knowledge and Favorability
-
Upload
robertclee1234 -
Category
Documents
-
view
218 -
download
0
Transcript of Health Care 2012 - Knowledge and Favorability
7/29/2019 Health Care 2012 - Knowledge and Favorability
http://slidepdf.com/reader/full/health-care-2012-knowledge-and-favorability 1/26
AMERICANS’ATTITUDESTOWARD
THEAFFORDABLECAREACT:WOULDBETTERPUBLIC
UNDERSTANDINGINCREASEOR
DECREASEFAVORABILITY?
WENDY GROSS1
TOBIAS H. STARK2
JON KROSNICK3
JOSH PASEK4
GAURAV SOOD5
TREVOR TOMPSON6
JENNIFER AGIESTA7
DENNIS JUNIUS8
ThisresearchwasconductedwithsupportfromtheRobertWoodJohnsonFoundation,GfK,
StanfordUniversity,andtheAssociatedPress.TheauthorsthankArthurLupiaandMichaelTomz
forhelpfulcommentsonthismanuscript.
1GfK.wendy.gross@gfk.com2StanfordUniversityandUtrechtUniversity.t.h.stark@uu.nl3StanfordUniversity.krosnick@stanford.edu4UniversityofMichigan.jpasek@umich.edu5PrincetonUniversity,[email protected]‐NORCCenterforPublicAffairsResearch.tompson‐[email protected]@[email protected]
7/29/2019 Health Care 2012 - Knowledge and Favorability
http://slidepdf.com/reader/full/health-care-2012-knowledge-and-favorability 2/26
Abstract Nationalsurveysconductedin2010and2012suggestthefollowingconclusions:
‐ AmericanunderstandingofwhatisandisnotintheACAhasbeenfarfromperfect.
‐ Correctunderstandingoftheelementsofthebillweexaminedvariedwithparty
identification:Democratsunderstoodthemost,independentsless,andRepublicansstill
less.
‐ Olderpeopleandmoreeducatedpeoplehaveunderstoodtheelementsofthebillwe
examinedbetterthanhaveyoungerandlesseducatedpeople.
‐ Between2010and2012,publicunderstandingoftheelementsofthebillweexamined
didnotchangenotably.
‐ MostpeoplehavefavoredmostoftheelementsoftheACAthatweexamined,butnot
everyonerecognizedthattheseelementswereallintheplan.
‐ Mostpeopleopposedpoliciesthatweresometimesfalselythoughttobepartsofthe
ACA..
‐ Ifthepublichadperfectunderstandingoftheelementsthatweexamined,the
proportionofAmericanswhofavorthebillmightincreasefromthecurrentlevelof32%
to70%.
Takentogether,allthissuggeststhatifeducationeffortsweretocorrectpublicmisunderstandingofthebill,publicfavorabilitymightincreaseconsiderably.
7/29/2019 Health Care 2012 - Knowledge and Favorability
http://slidepdf.com/reader/full/health-care-2012-knowledge-and-favorability 3/26
1
Introduction
ThePatientProtectionandAffordableCareActof2010(ACA)enactedaseriesofsignificant
changestotheAmericanhealthcaresystem.The900‐page‐longbill,whichelicitedanextremely
partisanreactionandsubstantialnewsmediainterest,amendedtheU.S.codetopreventinsurance
companiesfromdenyingcoverageforpre‐existingconditions,provideforhealthcareexchanges
whereindividualscouldpurchasecaredirectly,requireallindividualstohavehealthinsuranceor
payafine,andmore.InJune,2012,theU.S.SupremeCourtupheldacentralelementofthislaw.
Publicdebateaboutthebillcalledattentiontomanyaspectsofthelawthatwereincluded
intheversionthatCongressapproved.Butduringthecourseofpublicdebate,anumberof
inaccurateclaimsweremade,assertingthatthebillincludedprovisionsthatwerenotincludedin
thefinalversion.Someofthewidelydiscussedcomponentswerepartofthelegislation,suchasthe
plantoallowchildrentostayontheirparents’healthplanthroughage26.Butotherwidely
discussednotionswereneverconsideredforinclusion,suchastheclaimthatapanelofbureaucrats
coulddecidewhencoveragewouldbegiven(theso‐called“deathpanels”).Thelegislationincludedavarietyofless‐oftendiscussedprovisions,suchaschargingafeetoinsurancecompaniesthat
offeredparticulartypesofinsurance.
Manysurveyswereconductedbothbeforethebill’spassageandafteritsenactmentto
gaugetheAmericanpublic’sreactiontoit.Inearly2010,publicopinionwasfairlyevenlysplit.For
example,accordingtoaKaiserFamilyFoundation(KFF)surveyinAprilofthatyear,46%of
Americanssaidtheyhadafavorableopinionofthebill,and40%saidtheyhadanunfavorable
opinion.Ayearlater,inApril2011,KFFreportedthesetwostatisticstobe41%and41%,
respectively.AndinJanuary2012,thefigureswere37%and44%,respectively,perhapssuggesting
aslightshiftintheunfavorabledirectionastimehaspassed.InMay2012,thefigureswere
identical:37%and44%,solidifyingevidenceofthatslightshift.AndinAugust2012,thesefigureswere38%and43%,respectively.
AsimilarportraitwaspaintedbyAP‐GfKpolls.InMay,2010,39%ofrespondentssaidthey
supportedtheACA,and46%saidtheyopposedit.InJune,2012,thosenumberswere33%and
47%,respectively.Thus,asmalldecreaseintheproportionsupporting,andasmallincreaseinthe
proportionopposing.
Surveysdonebyotherorganizationsprovidedsimilar,thoughnotidentical,portraitsofthe
balanceandtrajectoryofopinions.Forexample,aNBCNews/WallStreetJournalpolldoneinMay,
2010,found38%ofrespondentssayingtheythoughttheACAwasagoodidea,and44%saiditwas
abadidea.AsofJune,2012,thatorganizationfoundthesefigurestobe35%and41%.Thus,theproportionexpressingapositiveopiniondroppedslightly,liketheKFFpolls.Buttheproportion
expressinganegativeopinionalsodroppedslightly.
Onlyoneprominentnationalsurveyresearchorganization,ThePewResearchCenter,
reportedresultssuggestingmovementintheoppositedirection.InJanuary,2011,41%oftheir
respondentsapprovedoftheACA,and48%opposed.Theirmostrecentsurvey,inJune‐July,2012,
foundthat47%approved,and43%opposed.
7/29/2019 Health Care 2012 - Knowledge and Favorability
http://slidepdf.com/reader/full/health-care-2012-knowledge-and-favorability 4/26
2
Puttogether,mostnationalsurveysduringthelasttwoyearssupporttwoprincipal
conclusions:(1)publicopinionhasnotmanifestedasizableandconsistentleaningtowardbeing
favorableorunfavorabletowardtheACA,and(2)aslightshiftinthenegativedirectionmayhave
occurredsincethelawwaspassed.
ItwouldbeunderstandabletolookatsuchevidenceasanindicationthattheAmericanpublicdoesnotstronglysupportthispieceoflegislation.Afterall,ifaboutasmanypeoplefavorit
asopposeit,andifwehaveneverseenamajorityfavoringit,thathardlysendsastrongsignalof
support.Furthermore,itiseasytoimaginethatsincepassageofthebill,Americanshavehadtime
toconsiderthebillanditsimplicationsinmoreandmoredepth,andifsuchconsiderationleadstoa
shiftinthenegativedirection,thatcertainlysignalsquitetheoppositeofenthusiasm.Thus,such
datacouldbetakenasasignalthatRepublicaneffortstorepealthebillwouldbewarmlywelcomed
byagrowinggroupofAmericans.
Atthesametime,theverysamepollingevidencecanbeviewedfromtheopposite
viewpoint.AlthoughamajorityofAmericanshavenotfavoredthebill,itisalsotruethatamajority
haveneveropposedit,either.Andevenaftertherecentsmallincreaseinopposition,theproportionopposingitdoesnotexceed50%.Sodirectquestionsaskingaboutpositivevs.negative
evaluationsoftheplanhavenotdocumentedamandatefromthepublictorepealthebill.9Taken
together,allthisevidenceportraystheAmericanpublicinwhatmightseematypicalway:split
aboutevenly,andnotprovidingaclearmandatetoelectedrepresentativesonewayoranother.
Itwouldthereforenotbeunreasonableforthoserepresentativestolookatthispolling
evidence,reachthatconclusion,andproceedtotakeactionsinkeepingwiththeguardianshipview
ofdemocracy:decidingwhattheyfeelisbestforthecountryandtakingaction(ordoingnothing)
accordingly,regardlessofpublicopinion.
Suchignoringofpublicopinionmightalsobejustifiedfromanotherperspectiveaswell.Insomanysurvey‐basedinvestigationsoftheAmericanpublicformanydecades,peoplehavebeen
foundtoperformquitepoorlyonquizzesassessingfactualknowledgeaboutdomainsinwhich
significantlegislationhasbeenconsideredorpassed.Ifmostpeoplelackthefactsneededtotruly
understandtheproblemstobesolvedbyapieceoflegislationandthesolutionsofferedbythat
legislation,whyshouldpublicevaluationsofthelegislationbetakenseriously?Thatis,thepublic
mightfeelverydifferentlyiftheytrulyunderstoodabill,soopinionsbasedonpartialinformation
orsubstantialmisconceptionscancertainlynotbedescribedas“wise”andshouldperhaps
thereforebeignoredbylegislators.
Ofcourse,ignoringpublicopinion,evenuninformedpublicopinion,mayplacelegislatorsat
riskcomeelection‐time.Evenwhenthepublicdoesnotunderstandapieceoflegislation,members
oftheelectoratemaynonethelessholdstrongopinionsaboutit,eitherfavorableorunfavorable,
andthoseopinionsmayshapetheirvotingdowntheroad.Indeed,agreatdealofresearchsuggests
thatpublicopiniononpolicyissuesdoessometimesshapevotechoices(seeAnand&Krosnick,
2003;Krosnick,1988).Soalegislatorwhovotesagainstapieceoflegislationthatvotersfavormay9QuestionsaskingwhetherthebillshouldberepealedhavesometimesshownamajorityofAmericansansweringaffirmatively.
7/29/2019 Health Care 2012 - Knowledge and Favorability
http://slidepdf.com/reader/full/health-care-2012-knowledge-and-favorability 5/26
3
findhimselforherselflaterpayinganelectoralpriceifthatvotebecomeswellpublicizedbythe
legislator’sopponentduringacampaign,evenifpublicunderstandingofthelegislationisseriously
wanting.
Inasituationsuchasthis,legislatorswhowishtoseeapieceoflegislationpassed(oravoid
itsrepeal)alwayshavetheoptionofinformingtheAmericanpublicaboutwhatthelegislationwouldtrulydo,inthehopethatbetterunderstandingwouldleadthepublictoofferastronger
signalofsupporttotheirelectedrepresentatives.Butwouldsucheducationindeedleadtomore
support?Thispresumablydependsonthenatureofthepublic’smisunderstandingsandonthe
public’sevaluationsoftheelementstheybelievecomposethelegislationandoftheelementsthatin
factcomposeit.
Inthispaper,wereportaninvestigationofexactlytheseissueswithregardtotheACA.
Usingdatafromtwosurveys(oneconductedin2010andtheotherin2012),weexplored:
1) HowaccuratelyAmericanshaveunderstoodwhatisintheACAandwhatisnot.
2)
Howtheaccuracyofpeople’sunderstandinghaschangedduringthetwoyearssincethebillwaspassed.
3) HowknowledgeaccuracyisrelatedtofavoringtheACA–thatis,whetherpeoplewho
knowmoreaboutwhat’sintheACAlikeitmoreorlikeitless,
4) HowthepublicwouldfeelabouttheACAifeveryoneunderstoodthataseriesofits
centralelementsareindeedincludedintheACAandthataseriesoffrequently
discussedbutultimatelyomittedelementsarenotinit.
Alongtheway,weinvestigatedtwootherissues:
1) Thepredictorsofaccurateunderstandingoftheplan‐thatis,whichtypesofpeopleare
moreandlesslikelytoscorewellonaquiz.2) Thepopularityofvariousspecificelementsthatwereincludedintheplan,andhow
popularareelementsthatwerenotincludedbutweresometimesclaimedtobe.
Incarryingoutthisinvestigation,weimplementedanewapproachtomeasuringpublic
understandingofapublicpolicyissue.Insurveysdoneduringthelast80years,ithasbeenroutine
totestknowledgebyaskingpeoplefactualquestionsandgradingpeopleaseithercorrector
incorrectbaseduponwhethertheiranswermatchedthefactsornot.Butthisapproachignoresa
simpleandunavoidablefact:thatarespondentsayingtoasurveyinterviewerthatmembersofthe
RepublicanPartyoutnumbermembersoftheDemocraticPartyintheU.S.HouseofRepresentatives
doesnotnecessarilymeanthattherespondentbelievesthistobetrue.Whenaskedwhichparty
holdsmoreseats,arespondentmightsimplyguessandendupgivingthecorrectanswerbychancealone.Thisresponsewouldnotrevealabeliefthattherespondentgenuinelyholds,norwouldthat
purportedbeliefhaveanyimpactonhisorherthinking,becauseheorshedoesnottrulyholdthat
perceptionoftheworld.Guessingseemslikelytoespeciallydistortanswerstoquizquestionsthat
offeronlytworesponsechoices,asweusedhere(isthisincludedintheACAornotincludedinthe
ACA?).
7/29/2019 Health Care 2012 - Knowledge and Favorability
http://slidepdf.com/reader/full/health-care-2012-knowledge-and-favorability 6/26
7/29/2019 Health Care 2012 - Knowledge and Favorability
http://slidepdf.com/reader/full/health-care-2012-knowledge-and-favorability 7/26
5
eitheracomputerorInternetaccesswereprovidedthem.Uponjoiningthepanel,panelistsfirst
completedacoreprofilequestionnairethatcapturedinformationabouttheirrace,gender,age,
income,education,andmore.Foreachsubsequentsurvey,panelmemberswereselectedusinga
probabilityproportionaltosize(PPS)weightedsamplingdesign,producingasamplethatis
representativeoftheAmericanpopulation.
ThefirstsurveyforthisprojectwasconductedbetweenAugust31andSeptember7,2010.
Arandomsampleof1,815adultswasinvitedtoparticipate,and1,271completedthesurvey
(completionrate=70%).Themediantimespentcompletingthequestionnairewas26minutes.
ThesecondsurveywasconductedbetweenAugust3and13,2012.GfKinvited2,344
Americanadultstoparticipate,and1,334completedthequestionnaire,acompletionrateof57%.
Themediantimespentcompletingthequestionnaire(whichwasmuchshorterthanthe
questionnaireusedin2010)was17minutes.
Allanalysesreportedbelowwereconductedusingweightstoadjustforunequalprobability
ofselectionandpost‐stratifyingbasedondemographics.
Table1displaysvariouspercentagesneededforthecalculationofresponseratesforthe
surveyanddisplaysvariousthebreakdownfortheresponseratesforbothsurveys.
Table1:ResponseRates
Rate 2010 2012 A. PanelRecruitment
ResponseRate(AAPORResponse
Rate3)
17.2% 17.2%
B. HouseholdProfileRate
61.5% 61.5%
C. HouseholdRetention
Rate35.0% 35.0%
D. SurveyCompletion
Rate70.0% 57.3%
E. ActiveRate 99.2% 99.2%ORR1(A*B*C*D*E) 2.6% 2.1%ORR2(A*B*D) 7.4% 6.1%ORR3(A*D) 12.0% 9.9%
AppendixBdisplaysthedemographicprofilesofbothsamples.
7/29/2019 Health Care 2012 - Knowledge and Favorability
http://slidepdf.com/reader/full/health-care-2012-knowledge-and-favorability 8/26
6
Measures
KnowledgeandCertainty
Respondentswereasked18knowledgequizquestions,probingwhetherspecificprovisionswerein
thehealthcarebill.Respondentsreadonedescriptionatatimeandindicatedwhetherthey
thoughttheprovisionwas“inthebill”or“notinthebill”thatCongresspassedin2010.
TwelveoftheelementswereprincipalprovisionsoftheACA.Theremainingsixelements
werenotinthebillbuthadbeenfrequentlydiscussedinpublicdebate;theseelementswere
identifiedbyexpertsattheAssociatedPressandresearchersatStanfordUniversity.AppendixA
showstheinstructionsforrespondents,thefulllistofquestions,andthecorrectanswerforeach
item.
Followingeachquizquestion,respondentswereasked,“Howsureareyouaboutthis?”The
answers“extremelysure”and“verysure”werecoded1(certain),andtheanswers“moderately
sure”,“slightlysure”,and“notsureatall”werecoded0(uncertain).
Tomeasureeachrespondent’slevelofknowledge,wefirstcomputedthepercentofthe12
provisionsoftheACAthattherespondentscorrectlyidentifiedassuchwithhighconfidence.Next,
wecomputedthepercentofthe6provisionsnotintheACAthattherespondentcorrectlyidentified
assuchwithhighconfidence.Then,weaveragesthesetwopercentagestoyieldafinalknowledge
scoreforeachrespondent.Consequently,thefactthattwiceasmanyquestionstappedknowledge
aboutprovisionsinthebillastappedprovisionsnotinthebilldidnotcausethefinalindexscoreto
bebasedmoreonunderstandingoftheelementsinthebillthanonunderstandingoftheelements
notinthebill.Thefinalknowledgescorerangedfrom0%forpeoplewhodidnotidentifyany
provisioncorrectlywithhighconfidence,to100%forpeoplewhoproperlyidentifiedallprovisions
withhighconfidence.
Evaluationof the ACA
Inthe2012survey,respondentswereasked,“Ingeneraldoyoufavor,oppose,orneitherfavornor
opposethelawchangingthehealthcaresystemthattheU.S.CongresspassedinMarch2010?”The
responses“favorstrongly”and“favorsomewhat”werecoded1(indicatingfavoring),andthe
responses“neitherfavornoroppose”,“opposesomewhat”,and“opposestrongly”werecodedas0
(notfavoring).
Support for ACAPlanElements
Respondentswerealsoaskedtoindicatewhethertheyfavoredoropposedeachofthe18
provisionsaddressedbythequizquestions.Oneachscreen,respondentswereasked“Doyoufavor
opposethischange?”alongwithastatementdescribingtheprovision.Responseswerecodedinthe
samefashionasforthegeneralfavorabilityquestion,“favor”versus“notfavor”.
PartisanshipTwodummyvariableswerecreatedtodistinguishRepublicansandDemocratsfrompeoplewithout
apartyaffiliation.RespondentswerecodedtobeaDemocratoraRepublicaniftheyanswered
“Democrat”or“Republican”tothequestion“DoyouconsideryourselfaDemocrat,aRepublican,an
7/29/2019 Health Care 2012 - Knowledge and Favorability
http://slidepdf.com/reader/full/health-care-2012-knowledge-and-favorability 9/26
7
independent,ornoneofthese?”Allotherrespondentsweretreatedasindependents.Twenty‐seven
respondentsrefusedtoanswerthisquestionandweretreatedasmissinginanalysesusingthis
variable.
MediaUseRespondentswereasked,“Howoftendoyougetnewsfromeachofthefollowing?”andpresentedwithalistof“LocalTVNews,”“FoxNewscablechannel,”“MSNBCcablenews,”“CNNcablenews,”
“NationaleveningnetworktelevisionnewsonCBS,ABC,orNBC”,“Radionews”,and“newsfromthe
internet.”Responsestothesequestionswerecoded1iftherespondentsanswered“extremely
often”or“veryoften”.Theresponses“moderatelyoften”,“rarely”,and“never”werecoded0.
Demographic InformationAgewascodedtorangefrom0to1.DummyvariablesdistinguishedbetweenWhite,Black,Hispanic
respondentsandthosewhoindicatedtheybelongedtoanotherethnicgroup.Variablesindicating
educationseparatedpeoplewithahigh‐schooldegreeorlessfrompeoplewhoindicatedhaving
attendedsomecollegeeducationbutnodegreeandpeoplewhograduatedfromcollege.Finally,
twodummyvariablesdistinguishedthreeequallylargegroupsofpeoplewhoindicatedhavinglowincome(lessthan$39,999),moderateincome(between$40,000and$84,999),orhighincome
(morethan$85,000).
Results
Favoringvs.Opposingthe ACAin2012
In2012,32%ofrespondentssaidtheyfavoredtheACA,36%saidtheyopposedit,and32%said
theyneitherfavorednoropposedit.Thefactthatnegativeresponsesslightlyoutnumbered
positiveresponsesresemblesresultsproducedbyvariousotherpollingorganizationsinrecent
months.
Notsurprisingly,evaluationsofthebillvariedaccordingtopoliticalpartyidentification.
AmongDemocrats,51%favorthebill;29%ofindependentsexpressedthesameopinion,and8%of
Republicansdidso.Thepartisangapof43percentagepointsisnotatypicalinAmerican
evaluationsofpiecesoflegislationthesedays.
Knowledgeabout the ACAin2012
In2012,whenimplementingthemethodusedinmostpaststudiesofgivingcredittorespondents
whogavecorrectanswersregardlessofcertainty,frequencyofcorrectanswerswasstrikinglyhigh
forsomeelementsoftheplan(seecolumn2ofTable2).Forexample,80%saidthatchildrencouldbecoveredbytheirparents’policy.And80%saidthatcompanieswithmorethan50employees
wererequiredtoprovidehealthinsurancetotheiremployees.Majorities,andoftenlarge
majorities,gavecorrectanswersregardingmostoftheprovisionsinthebill.Foronlytwoofthe
twelveprovisionsweaskedabout(newfeestobechargedtohealthinsurancecompaniesand
pharmaceuticalcompanies)didmajoritiesgivetheincorrectanswer(only44%and37%gave
correctanswers,respectively).
7/29/2019 Health Care 2012 - Knowledge and Favorability
http://slidepdf.com/reader/full/health-care-2012-knowledge-and-favorability 10/26
8
However,thesenumbersshouldbetakenwithagrainofsalt,foratleasttworeasons.First,
becausethesequestionsofferedjusttwoanswerchoices(inthebillvs.notinthebill),random
guessingwouldbeexpectedtoyield50%ofanswerscorrectbychancealone.Andsecond,manyof
thecorrectanswerspeoplegavemayhavebeengivenwithlittleornocertainty,soitmightbe
inappropriatetosaythatthesepeoplepossessedthesebeliefs.
Whentakingintoaccountpeople’scertaintyratings,weobservedmuchlowerlevelsofaccurate
knowledge(seecolumn1ofTable2).Indeed,onlyoneprovisionwascorrectlyidentifiedwithhigh
certaintyasbeingpartoftheACAbyamajorityofrespondents.52%ofrespondentscorrectlysaid
withhighcertaintythatchildrenundertheageof26couldgethealthinsurancebybeingincluded
ontheirparents’healthinsurancepolicies.Allotherprovisionsofthelawwerecorrectlyidentified
withhighcertaintybylessthan40%ofAmericans.Only11%correctlybelievedwithhighcertainty
thatdrugcompanieswouldpaynewfeesunderthelaw,andonly10%correctlybelievedwithhigh
certaintythatinsurancecompanieswouldpaysuchnewfees.
Table 2: Accuracy of Knowledge About Provisions That Were in the ACA– 2012 Data
Policy
% Thinking policy is
in law with high
certainty
% Thinking policy is
in law regardless of
certainty
Children under 26 can be included in parents’
insurance 52.2% 80.1%
Large companies have to provide health insurance to
employees 38.7% 80.1%
U.S. citizens without health insurance have to pay
fine if they don’t have specific reasons 36.3% 69.4%
Insurance
companies
have
to
sell
health
insurance
to
people with preexisting conditions 32.6% 72.2%
Insurance companies have to continue insurance as
long as no rules are broken 28.8% 77.1%
Make insurance for sale for any American 28.7% 69.2%
Prevent limiting amount paid for person’s health care
costs 23.5% 60.5%
Discounts on prescriptions to seniors with high drug
costs 20.0% 68.4%
Federal tax credits for small companies that buy
insurance for their employees 17.5% 66.8%
Subsidize health insurance for U.S. citizens with low
income
16.8%
51.4%
New fees for health insurance companies 11.1% 44.3%
New fees for companies that make drugs 10.2% 37.0%
Asimilarportraitemergedwithregardtothe6provisionsweaskedaboutthatwerenotactuallyin
theACA.Majoritiesgavecorrectanswerstothequizquestionsforallbutoneoftheseprovisions
7/29/2019 Health Care 2012 - Knowledge and Favorability
http://slidepdf.com/reader/full/health-care-2012-knowledge-and-favorability 11/26
9
(seecolumn2ofTable3).Butsomeofthesewereonlyslightmajorities.Forexample,54.3%said
thatso‐called“deathpanels”arenotpartofthelaw.Thisisonlyveryslightlymorethanwouldbe
expectedbychancealone.Andwhencertaintywastakenintoaccount,minorities(andsometimes
verysmallminorities)believedwithhighconfidencethattheywerenotincludedinthelaw(see
column1ofTable3).Forexample,only25.6%wascertainthatjobapplicantswouldnothaveto
disclosepreviousillnessestonewemployers.And“deathpanels”weresaidwithcertaintytonotbepartofthelawbyonly17%oftherespondents.
Table 3: Accuracy of Knowledge About Provisions That Were Not in the ACA– 2012 Data
Policy
% Thinking policy is
NOT in law with high
certainty
% Thinking policy is
NOT in law regardless
of certainty
Job applicants have to disclose previous
illnesses to employer 25.6% 75.3%
Restaurants with unhealthy food must pay fee
to government 23.2% 73.1%
Committees decide whether people get medical
care (“death panels”) 16.8% 54.3%
Smokers have to pay additional $1,000 a year 14.1% 64.0%
Health care ID card needed to get treatment at
hospital 13.3% 56.5%
Require treatment of illegal immigrants for free 10.5% 41.7%
Lookedatfromanothervantagepoint:78%ofrespondentsansweredmorethanhalfofthe18quiz
questionscorrectly(seecolumn4ofTable4),butonly44%answered13ormoreofthe18
questionscorrectly.Andthesefigureswerestrikinglylowerwhentreatingascorrectonlyanswers
providedwithhighcertainty(seecolumn2ofTable4):14%and3%,respectively.Notasingle
respondentansweredeveryquizquestioncorrectlywithhighcertainty.
Table 4: Number of Correctly Answered Quiz Questions With and Without
Taking Certainty into Account (N = 1344) – 2012 Data
Requiring High
Certainty
Regardless of
Certainty
Number of correctly
answered questions
Percent
Cumulative
percent
Percent
Cumulative
percent
All 18 0.0% 0.0% 0.3% 0.3%
17 out of 18 0.0% 0.0% 1.5% 1.8%
16 out of 18 0.1% 0.1% 6.0% 7.8%
15 out of 18 0.8% 1.0% 10.9% 18.8%
14 out of 18 1.3% 2.3% 12.5% 31.3%
13 out of 18 1.1% 3.4% 12.9% 44.1%
7/29/2019 Health Care 2012 - Knowledge and Favorability
http://slidepdf.com/reader/full/health-care-2012-knowledge-and-favorability 12/26
10
12 out of 18 3.2% 6.6% 14.4% 58.5%
11 out of 18 2.7% 9.3% 11.9% 70.4%
10 out of 18 4.2% 13.5% 7.7% 78.1%
9 out of 18 5.4% 18.9% 6.1% 84.2%
8 out of 18 5.6% 24.5% 5.6% 89.7%
7 out
of
18
5.9%
30.4%
3.0%
92.7%
6 out of 18 6.7% 37.1% 2.8% 95.5%
5 out of 18 5.9% 42.9% 0.9% 96.4%
4 out of 18 7.2% 50.1% 0.6% 97.0%
3 out of 18 8.8% 58.9% 0.3% 97.3%
2 out of 18 8.6% 67.5% 0.1% 97.5%
1 out of 18 10.4% 77.9% 0.3% 97.8%
0 out of 18 22.1% 100.0% 2.2% 100.0%
Total 100.0% 100.0% 0.3% 0.3%
PredictingLevelsof Knowledgeabout the ACA
Asshownbytheestimatesofparametersofordinaryleastsquares(OLS)regressionspredictingthe
knowledgescore(computedasdescribedinthemethodsectionabove),levelsofknowledgevaried
systematicallywithsomecharacteristicsofrespondents.Whenusingdemographicsandparty
identificationaspredictors(seecolumn1ofTable5),wefound:
‐ Democratsweresignificantlymoreaccuratethanwereindependents.
‐ IndependentweresignificantlymoreaccuratethanRepublicans.
‐ Accuracyincreasedasrespondentageincreased.
‐ Accuracyincreasedasrespondenteducationincreased,perhapsatleastpartlythe
resultofthefactthatmoreeducatedpeoplegenerallypaymoreattentiontoinformation
aboutpoliticsinthenews.
‐ Sex,race,andincomewerenotsignificantlyrelatedtoknowledgeaccuracy.10
Whenweaddednewssourcesaspredictorsintheregressionequation,weobserveda
seriesofstrikingfindings:
‐ Frequentexposuretowhatmightbecalled“mainstream”newssources(CNN,CBS,ABC,
NBC,andlocaltelevisionnewsprograms)appearstohavehadnosignificanteffecton
theextentofaccurateknowledgepossessedbyrespondents.Thatis,thesenews
organizationsmaynothaveconferredenhancedunderstandingontheirviewers.
10Representingincomeinfivegroupsinsteadofthreedidnotchangetheseresults.
7/29/2019 Health Care 2012 - Knowledge and Favorability
http://slidepdf.com/reader/full/health-care-2012-knowledge-and-favorability 13/26
11
‐ FrequentexposuretoMSNBCmayhaveenhancedaccurateknowledgemorethandid
frequentexposuretoanyothernewssourceweexamined.
FrequentexposuretoFoxNewsmayalsohavehadapositiveeffectonunderstanding
thebill.
‐ Frequentexposuretoradionewsandinternetnewsalsoappeartohavesignificantlyenhancedunderstandingofthebill.
Table 5: OLS Regression Predicting Percent Correct Answers to
Knowledge Quiz Questions with High Certainty – 2012 Data
Predictor Analysis 1 Analysis 2
Democrat 3.90* 3.00
Republican ‐4.69** ‐5.77***
Age 9.18** 5.70
Female ‐1.86 ‐1.85
Black ‐.93 ‐1.11
Hispanic ‐.37 ‐0.41
Other Race 3.22 3.75
Some college education 4.10* 3.59*
College graduate 8.59*** 7.04***
High income 2.11 1.95
Middle income ‐.47 ‐1.05
Fox News exposure ‐ 3.81*
MSNBC exposure ‐ 8.05**
CNN exposure ‐‐1.30
Exposure to
news
on
CBS, ABC, or NBC
‐
1.07
Exposure to local TV
news
‐
1.01
Radio news exposure ‐ 4.40*
Internet news exposure ‐ 3.77*
Intercept 14.94*** 13.42***
N 1316 1222
*** p < 0.001, ** p< 0.01, * p< 0.05
TheRelation
of
Knowledge
to
Favoring
the
ACA
Asrevealedbyestimatesoftheparametersofalogisticregressionequationpredictingopinions
abouttheACAusingknowledgescores,moreknowledgewasassociatedwithahigherprobability
offavoringthebill(seeTable6).Putdifferently,themoreaccurateaperson’sbeliefswereabout
the18elementsthatweaskedabout,themoreheorshelikedtheACA.
7/29/2019 Health Care 2012 - Knowledge and Favorability
http://slidepdf.com/reader/full/health-care-2012-knowledge-and-favorability 14/26
12
AccordingtothecoefficientsinTable6,anindependentwithperfectknowledgeoftheplan
elementsweexaminedhada15.7timeshigherchanceoffavoringthebillthandidsomeonewho
didnotanswerasinglequizquestioncorrectly(log‐odds=.03,odds‐ratiofor100%knowledge
versusnoknowledge=15.73).Whenusingtheparameterestimatesfromanequationexcluding
partyaffiliationasapredictor,ahypotheticalpersonwithperfectknowledgeoftheplanelements
weexaminedhadaalmost21timeshigherchanceoffavoringthebillthandidsomeonewhodidnotanswerasinglequizquestioncorrectly.
Whencontrollingforknowledgelevelandallotherbackgroundvariables,partyidentificationwas
stillsignificantlyrelatedtofavoringtheACA.Democratslikeditmorethanindependents,and
independentslikeditsignificantlymorethanRepublicans.ThechancesthataDemocratwould
favorthebillwasabout2.5timeshigherthanthechanceforanindependent(log‐odds=.94,odds‐
ratio=2.56).AndaRepublican’schancesoffavoringthebillwasonly0.26timesthechancethatan
independentwoulddoso(log‐odds=‐1.36,odds‐ratio=0.26).Thus,althoughthesethreegroups
differedintermsoftheirknowledgelevels,thegapbetweentheminapprovalremainedevenwhen
statisticallyequatingthesegroupsintermsoftheirknowledgelevels.
CollegegraduatesandpeoplewhowerefrequentlyexposedtonewsonCNNhadahigherlikelihood
offavoringtheACAthanothers.Incontrast,peoplewhofrequentlywatchedFoxNewswere
significantlylesslikelytofavorthebillthanothers.Allotherdemographicvariableswerenot
relatedtotheprobabilityoffavoringtheACA.
Table 6: Logistic Regression Predicting Favoring
the ACA – 2012 Data
Predictor Analysis 1
Percent correct answers .03***
Democrat .94***
Republican ‐1.36***
Age .08
Female ‐.23
Black .21
Hispanic .01
Other Race .36
Some college education ‐.08
College graduate .55*
High income .27
Middle income .01
Fox News
exposure
‐1.31***
MSNBC exposure .40
CNN exposure .72**
Exposure to news on
CBS, ABC, or NBC .15
Exposure to local TV
news .11
7/29/2019 Health Care 2012 - Knowledge and Favorability
http://slidepdf.com/reader/full/health-care-2012-knowledge-and-favorability 15/26
13
Radio news exposure ‐.10
Internet news exposure .28
Intercept ‐1.95***
N 1316
*** p < 0.001, ** p< 0.01, * p< 0.05
ProjectingFavorabilitywithPerfect KnowledgeHowwouldthenationhavefeltabouttheACAifeveryonehadunderstoodalltheprovisionswe
askedaboutcorrectlyandwithconfidence?
Weansweredthisquestionintwoways.First,wecalculatedthedegreeoffavorabilityamong
hypotheticalpeopletoillustratehowknowledgeaffectedsupportersofthetwopartiesand
independentsdifferently.Figure1showshowtheprobabilityoffavoringthebillchangedbasedon
theresultsinTable6forahypotheticalwhitefemale,45yearsold,withhighschooleducationorless,ahighincome,andwhodidnotreceiveinformationoftenfromanyofthenewssources.
ThisfigureillustratesthatifthishypotheticalpersonwereaRepublicanwhoanswerednoneofour
knowledgequizquestionscorrectlywithconfidence,shewouldhaveonlya4%probabilityof
favoringthebill.Andisshehadansweredallofourquestionswithhighconfidence,shewould
havehada37%chanceoffavoringtheACA.
IfthepersonwereaDemocratorconsideredherselftobeanindependent,boththeincreaseinthe
probabilityoffavoringthebillwithincreasingknowledgewouldbegreater.Ahypothetical
independentwhogavenocorrectanswerswithhighcertaintywouldhavehada13%chanceof
favoringthebill,andthisnumberwouldincreaseto70%ifsheansweredallquestionsaccuratelywithhighconfidence.ForahypotheticalDemocratwhoansweredallquestionsaccuratelywithhigh
confidence,theprobabilityoffavoringthebillwas86%.
Toapproachthisissueinasecondway,wecalculatedforeveryrespondenttheprobabilitythathe
orshewouldfavortheplanifheorshehadansweredallquestionsaccuratelywithhighconfidence.
Thismethodyieldedthepredictionthat70%ofpeoplewouldfavorthebilliftheyallansweredthe
questionsaccuratelywithhighknowledge.Thiscontrastsdramaticallywiththefactthat32%of
respondentsinthesurveysaidthattheyfavoredthebill,basedontheircurrent,farfromperfect
levelsofcurrentactualunderstandingoftheprovisionsweaskedabout.Thus,thisanalysis
suggeststhatincreasedunderstandingmighthavetransformedthe32%favoringinto70%favoring.
Thismethodsuggestedthatabout88%ofDemocratswouldfavorthebill,74%ofindependents
woulddoso,and40%ofRepublicanswoulddoso.
7/29/2019 Health Care 2012 - Knowledge and Favorability
http://slidepdf.com/reader/full/health-care-2012-knowledge-and-favorability 16/26
14
Figure1:TheRelationof KnowledgetoFavoringthe ACA:Dems,Inds,andRepsSeparately
FavoringtheElementsof the ACA
TheresultsofthissimulationsuggestthateliminatingmisunderstandingsabouttheACAmightlead
tomorefavorableevaluationsofit.Inorderforthistobetrue,itwouldbenecessarythatpeople
generallylikedtheprovisionsthatwereactuallyincludedintheACAbutthattheyoftendidnot
believewithconfidencewere.Then,learningoftheirinclusionwouldincreaseoverallfavorability.
Andlikewise,itmayalsobethecasethatpeoplegenerallydislikedtheprovisionsthatthey
sometimesthoughtincorrectlywereinthebill,solearningthattheywerenotinthebillwouldalso
increaseoverallfavorability.
Infact,directquestionsassessingevaluationsofthespecificplanelementsconformedtothose
guesses.AsshowninTable7,majoritiesofrespondents,andsometimeshugemajorities,favored
theelementsthatwereactuallyincludedintheplan.Onlythreeplanelementswerenotfavoredby
amajorityofAmericans:chargingafeetocitizenswhodonothavehealthinsurance,andcharging
newfeestohealthinsurancecompaniesandpharmaceuticalmanufacturers–werenotfavoredbya
majorityofAmericans
0 20 40 60 80 100
0
2 0
4 0
6 0
8 0
1 0
0
Predicted percentage favoring the bill by knowledge
Percentage correct answers with high certainty
P r e d i c t e d
p e r c e n t a g e
i n
f a v o r
DemocratIndependentRepublican
7/29/2019 Health Care 2012 - Knowledge and Favorability
http://slidepdf.com/reader/full/health-care-2012-knowledge-and-favorability 17/26
15
Table 7: Percent Favoring the Elements of the ACA ‐ 2012 Data
Element
Percent Favoring the
Element
Insurance
companies
have
to
continue
insurance
as
long
as
no rules are broken 81.8%
Discounts on prescriptions to seniors with high drug costs 79.2%
Make insurance for sale for any American 77.9%
Federal tax credits for small companies that buy insurance
for their employees 71.2%
Children under 26 can be included in parents’ insurance 70.4%
Prevent limiting amount paid for person’s health care costs 63.9%
Insurance companies have to sell health insurance to
people with preexisting conditions 62.0%
Large companies have to provide health insurance to
employees
55.3%
Subsidize health insurance for U.S. citizens with low income 47.3%
New fees for companies that make drugs 31.1%
U.S. citizens without health insurance have to pay fine if
they don’t have specific reasons 27.5%
New fees for health insurance companies 24.3%
Evenmorestrikingly,theprovisionsthatwerenotintheACAwerefavoredbyminorities,andoften
smallminorities,ofAmericans(seeTable8).Aminorityof35%favoredtheideathatsmokers
shouldhavetopayanadditional$1,000peryearfortheirinsurance.Notsurprisingly,“death
panels”werefavoredbyfewerthan20%.Thus,thesefiguressuggestthatcorrectingmisunderstandingsabouttheseelementsmightleadtoincreasedpublicfavorabilityabouttheACA.
Table 8: Percent Favoring of Elements That Were NOT in the ACA – 2012 Data
Element
Percent Favoring the
Element
Smokers have to pay additional $1,000 a year 35.1%
Health care ID card needed to get treatment at hospital 27.1%
Restaurants with unhealthy food must pay fee to
government 26.1%
Require treatment of illegal immigrants for free 20.8%
Committees decide
whether
people
get
medical
care
(“death panels”) 19.1%
Job applicants have to disclose previous illnesses to
employer 15.5%
7/29/2019 Health Care 2012 - Knowledge and Favorability
http://slidepdf.com/reader/full/health-care-2012-knowledge-and-favorability 18/26
16
ChangeinKnowledge Accuracybetween2010and2012
DuringthetwoyearssincetheACAwaspassedbyCongress,publicunderstandingofthelawhas
increasedslightlyforsomeplanelementsandhasnotchangedformost.Wewereabletoassess
thisbycomparingtheresultsofour2012knowledgequizwiththeresultsobtainedby
administeringanidenticalquizinour2010survey.
Withregardtothe12elementsthatareincludedintheACA,thepercentofpeoplewho
correctlyrecognizedthatfactwithhighconfidenceincreasedsignificantlyfor5ofthe12elements
(seethelastcolumnofTable9).Thisincreasewasmostsizablefortheplanelementsrequiring
thatcitizenswithoutinsurancepayafine(13.9%increase),allowingchildrenunder26tobe
includedonparentsinsuranceplan(9.5%increase),andrequiringlargecompaniestoprovide
healthinsurancetotheiremployees(8.4%increase).
Correctunderstandingdecreasedsignificantlyforoneplanelement,thoughslightly.
Specifically,fewerpeopleareawareofthefactthatsmallcompaniesthatbuyhealthinsurancefor
theiremployeescangetfederaltaxcredits(decreaseof‐3.4%).Correctunderstandingheldsteady
fortheremaining6elements.
Theratesofaccuracywithregardtoelementsnotintheplanshowedevenless
improvement(seethelastcolumnofTable10).Onlyonesuchelementmanifestedasignificant
increaseinaccuracyfrom2010to2012.Therestshowednochange.Thus,withthepassageof
time,mythsabouttheseelementshavenotbeennotablydiscreditedinthepublic’smind.
Table 9: Change in Accuracy for Policies that are in the ACA Bill between 2010 and 2012
Element
% Thinking the Policy Was
in the
ACA
with
High
Certainty Change
from
2010 to 2012
2010 2012
Children under 26 can be included in parents’
insurance 42.6% 52.2% +9.5%***
Large companies have to provide health insurance
to employees 30.3% 38.7% +8.4%***
U.S. citizens without health insurance have to pay
fine if they don’t have specific reasons 22.4% 36.3% +13.9%***
Insurance companies have to sell health insurance
to people with preexisting conditions 24.8% 32.6% +7.8%***
Insurance companies
have
to
continue
insurance
as
long as no rules are broken 27.0% 28.8% +1.8%
Make insurance for sale for any American 26.7% 28.7% +2.0%
Prevent limiting amount paid for person’s health
care costs 19.5% 23.5% +3.9%*
Discounts on prescriptions to seniors with high drug
costs 21.7% 20.0% ‐1.7%
7/29/2019 Health Care 2012 - Knowledge and Favorability
http://slidepdf.com/reader/full/health-care-2012-knowledge-and-favorability 19/26
17
Federal tax credits for small companies that buy
insurance for their employees 20.8% 17.5% ‐3.4%*
Subsidize health insurance for U.S. citizens with low
income 19.7% 16.8% ‐2.9%
New fees for health insurance companies 11.1% 11.1% +0.0%
New fees
for
companies
that
make
drugs
10.0%
10.2%
+0.2%
*** p < 0.001, ** p< 0.01, * p< 0.05
Table 10: Change in Accuracy for Policies that are NOT in the ACA Bill between 2010 and 2012
Element
% Thinking the Policy Was
NOT in the ACA with High
Certainty
Change
from 2010
to 2012
2010 2012
Job applicants have to disclose previous illnesses to
employer 26.9% 25.6% ‐1.2%
Restaurants with
unhealthy
food
must
pay
fee
to
government 19.6% 23.2% +3.6%*
Committees decide whether people get medical care
(“death panels”) 17.2% 16.8% ‐0.4%
Smokers have to pay additional $1,000 a year 13.9% 14.1% +0.2%
Health care ID card needed to get treatment at
hospital 14.5% 13.3% ‐1.2%
Require treatment of illegal immigrants for free 12.3% 10.5% ‐1.8%
*** p < 0.001, ** p< 0.01, * p< 0.05
Inlinewiththepreviouslydescribedfindings,peoplegavemorecorrectanswerswithhighcertaintyin2012thanin2010.Table11showsthatonly14.9%ofAmericansanswered9quiz
questionscorrectlywithhighconfidencein2010,whereas18.9%didsoin2012.Themedian
numberofcorrectanswersofferedwithhighconfidenceincreasedfrom3to4between2010and
2012,astatisticallysignificantincreasethatwasaccompaniedbyanon‐significantincreaseinthe
percentofpeoplefavoringthehealthcarebill,from29.9%in2010to33.6%in2012
7/29/2019 Health Care 2012 - Knowledge and Favorability
http://slidepdf.com/reader/full/health-care-2012-knowledge-and-favorability 20/26
18
Table 11: Number of Correctly Answered Quiz Questions with High Certainty in
2010 and 2012
2010 2012
Number of
correctly answered
questions
Percent
Cumulative
percent
Percent
Cumulative
percent All 18 0.0% 0.0% 0.0% 0.0%
17 out of 18 0.2% 0.2% 0.0% 0.0%
16 out of 18 0.1% 0.2% 0.1% 0.1%
15 out of 18 0.6% 0.9% 0.8% 1.0%
14 out of 18 0.6% 1.5% 1.3% 2.3%
13 out of 18 1.8% 3.4% 1.1% 3.4%
12 out of 18 2.5% 5.8% 3.2% 6.6%
11 out of 18 2.6% 8.5% 2.7% 9.3%
10 out of 18 2.9% 11.4% 4.2% 13.5%
9 out of 18
3.5%
14.9%
5.4%
18.9%
8 out of 18 5.2% 20.1% 5.6% 24.5%
7 out of 18 5.4% 25.4% 5.9% 30.4%
6 out of 18 5.8% 31.3% 6.7% 37.1%
5 out of 18 7.2% 38.4% 5.9% 42.9%
4 out of 18 8.5% 46.9% 7.2% 50.1%
3 out of 18 8.6% 55.5% 8.8% 58.9%
2 out of 18 8.3% 63.8% 8.6% 67.5%
1 out of 18 12.2% 75.9% 10.4% 77.9%
0 out of 18 24.1% 100.0% 22.1% 100.0%
Total 100.0% 100.0% 100.0% 100.0%
N 1251 1344
ConclusionsTakentogether,thesefindingsreinforcetwomajorconclusions:
‐ AmericanunderstandingofwhatisandisnotintheACAhasbeenfarfromperfect.
‐ Correctunderstandingoftheelementsofthebillthatweaskedaboutvariedwithparty
identification:Democratsunderstoodthemost,independentsless,andRepublicansstillless.
‐ Olderpeopleandmoreeducatedpeoplehaveunderstoodtheelementsweaskedabout
betterthanhaveyoungerandlesseducatedpeople.
‐ Between2010and2012,publicunderstandingofthebilldidnotchangenotably.
7/29/2019 Health Care 2012 - Knowledge and Favorability
http://slidepdf.com/reader/full/health-care-2012-knowledge-and-favorability 21/26
19
‐ MostpeoplehavefavoredmostoftheelementsoftheACAthatweexamined,butnot
everyonerecognizedthattheseelementswereallintheplan.
‐ MostpeopleopposedtheelementsweaskedaboutthatwerenotintheACA,butsome
peoplethoughttheseelementswereintheplan.
‐ Ifthepublichadperfectunderstandingoftheelementsthatweexamined,the
proportionofAmericanswhofavorthebillmightincreasefromthecurrentlevelof32%
to70%.
Takentogether,allthissuggeststhatifeducationeffortsweretocorrectpublicmisunderstanding
ofthebill,publicevaluationsmightincreaseconsiderablyinfavorability.
7/29/2019 Health Care 2012 - Knowledge and Favorability
http://slidepdf.com/reader/full/health-care-2012-knowledge-and-favorability 22/26
20
ReferencesAnand,S.,&Krosnick,J.A.(2003).Theimpactofattitudestowardforeignpolicygoalsonpublic
preferencesamongpresidentialcandidates:Astudyofissuepublicsandtheattentivepublicinthe2000U.S.Presidentialelection.PresidentialStudiesQuarterly,33,31‐71.
Krosnick,J.A.(1988).Theroleofattitudeimportanceinsocialevaluation:Astudyofpolicy
preferences,presidentialcandidateevaluations,andvotingbehavior.JournalofPersonality
andSocialPsychology,55,196‐210.
Krosnick,J.A.(2002).Thecausesofno‐opinionresponsestoattitudemeasuresinsurveys:Theyarerarelywhattheyappeartobe.InR.M.Groves,D.A.Dillman,J.L.Eltinge,&R.J.A.Little(Eds.),Surveynonresponse.NewYork:Wiley.
Petty,R.E.,&Krosnick,J.A.(Eds.).(1995).Attitudestrength:Antecedentsandconsequences.
Hillsdale,NJ:Erlbaum.
7/29/2019 Health Care 2012 - Knowledge and Favorability
http://slidepdf.com/reader/full/health-care-2012-knowledge-and-favorability 23/26
21
Appendix A:QuestionWordingsof KnowledgeQuestions
Respondentswereshownthefollowingtextononescreen:
We’d liketo find out people’simpressionsabout thelaw that theU.S.Congress passed back inMarch 2010tochangetheU.S.healthcaresysteminmany ways.We’d liketo find out people’simpressionsabout what that law sayswill happen.Beforethelaw was passed by theCongress,therewasalot of talk inthenewsabout thingsthat the planmight or might not do.Next, youwill read alist of thesethings,oneat atime.Most thethings you’ll read weretalked about as possibly beinginthelaw.But only someof thethings you’ll read areactually inthelaw that theCongress passed inMarch 2010.We’d liketolearn your best guessesabout whichof thesethingsareinthelaw and whicharenot.Wewill alsoask youhow sure youarethat eachanswer you giveiscorrect.It’s fineif youaresureof ananswer or if youarenot sureof ananswer.We just want to find out your best guesses.Wewant toknow what peoplethink without askingsomeoneelse for theanswersand without lookinguptheanswersontheInternet or inany other way.So pleasedonot doany of thesethings.Please just giveus your best guesses.Onaseriesofscreens,respondentswereasked:
Do youthink that thenew law will or will not dothe followingafter thelaw is fully ineffect? [STATEMENT APPEAREDHERE]How sureare youabout that?
Theorderoftheitemswasrotatedacrossrespondents.Theitemsare:
RequirethatifaU.S.citizendoesNOThavehealthinsurance,thatpersonwillhavetopayafineonhisorherfederalincometaxesunlessheorsheisallowednottohavetheinsuranceforaseriesofspecificreasons,suchashavingaverylowincome.(INTHEPLAN)
Requirecompanieswith50ormoreemployeestoprovidehealthinsurancetotheiremployeesorpayafinetothefederalgovernmentiftheydonot.(INTHEPLAN)
GivemoneytopayforhealthinsurancetopeoplewhoareU.S.citizensandhaveverylowincomes.(INTHEPLAN)
7/29/2019 Health Care 2012 - Knowledge and Favorability
http://slidepdf.com/reader/full/health-care-2012-knowledge-and-favorability 24/26
22
Givefederaltaxcreditstosomeverysmallcompaniesiftheybuyhealthinsurancefortheiremployees.(INTHEPLAN)
Requirecompaniesthatmakedrugstopaynewfeestothefederalgovernmenteachyear.(INTHEPLAN)
Requirecompaniesthatsellhealthinsurancetopaynewfeestothefederalgovernmenteachyear.(INTHEPLAN)
Preventahealthinsurancecompanyfromlimitingtheamountofmoneythatitwillpayforaperson’shealthcarecostsduringhisorherlife.(INTHEPLAN)
RequirehealthinsurancecompaniestosellhealthinsurancetoU.S.citizensandlegalimmigrantswhodon’thavehealthinsuranceandhaveaseriousmedicalproblem.(INTHEPLAN)
Allowyoungadultstogethealthinsurancebybeingincludedintheirparents’healthinsurancepoliciesuntiltheyturn26.(INTHEPLAN)
Requireahealthinsurancecompanytocontinueaperson’shealthinsuranceaslongasheorshepaysforitandhasnotbrokenanyrulesofthehealthinsuranceplan.(INTHEPLAN)
MakehealthinsuranceavailableforsalesothatanyAmericancanbuyifheorshewantsto.(INTHEPLAN)
Providediscountsonprescriptionstoseniorswithhighdrugcosts.(INTHEPLAN)
Requirethatanyoneapplyingforajobmusttelltheemployerifheorshehaseverhadanyseriousdiseases.(NOTINTHEPLAN)
Requirethatfastfoodrestaurantsthatsellunhealthyfoodordrinkstopayafeetothefederalgovernment.(NOTINTHEPLAN)
Requireinsurancecompaniestochargeanadditionalfeeof$1,000yeartoanyonewhobuysinsurancefromthemandsmokescigarettes.(NOTINTHEPLAN)
Createcommitteesofpeoplewhowillreviewthemedicalhistoriesofsomepeopleanddecidewhethertheycangetmedicalcarepaidforbythefederalgovernment.(NOTINTHEPLAN)
RequireeveryAmericantoshowagovernmenthealthcareidentificationcardinordertogetmedicalcareatahospital.(NOTINTHEPLAN)
Requiresomedoctorsandhospitalstotreatillegalimmigrantsfreeofchargeiftheycannotaffordtopay.(NOTINTHEPLAN)
7/29/2019 Health Care 2012 - Knowledge and Favorability
http://slidepdf.com/reader/full/health-care-2012-knowledge-and-favorability 25/26
23
AppendixB:SampleDemographics
2010Sample
Table B.1:
2010
Sample
Demographic
Characteristics
Unweighted(%)
Target (%)
Weighted(%)
Target–Weighted
Age18‐29
30‐44
45‐59
60+
13.228.331.227.3
22.026.127.824.1
21.226.528.226.1
0.8‐0.4‐0.4‐2.0
GenderMaleFemale
50.749.3
48.351.7
48.351.7
0.00.0
Education
Lessthan
high
school
HighschoolSomecollegeBachelorsdegreeorhigher
7.224.430.138.3
13.031.328.027.7
12.031.728.328.0
1.0‐0.4‐0.3‐0.3
Race/EthnicityWhite,Non‐HispanicBlack,Non‐HispanicOther,Non‐HispanicHispanic2+Races,Non‐Hispanic
78.17.83.38.42.5
67.911.55.5
14.01.1
68.511.65.5
13.21.2
‐0.6‐0.10.00.8‐0.1
RegionNortheast Midwest SouthWest
18.022.813.228.3
18.421.822.026.1
18.122.021.226.5
0.3‐0.20.8‐0.4
Note:TargetdataaretakenfromtheJuly, 2010, CurrentPopulationSurvey.
7/29/2019 Health Care 2012 - Knowledge and Favorability
http://slidepdf.com/reader/full/health-care-2012-knowledge-and-favorability 26/26
24
2012SampleTableB.2:2012 Sample Demographic Characteristics
Unweighted(%)
Target (%)
Weighted(%)
Target–Weighted
Age
18‐29
30‐44
45‐59
60+
15.921.628.933.6
21.725.627.425.4
21.325.727.625.4
0.4‐0.2‐0.20.0
GenderMaleFemale
48.951.1
48.251.8
48.251.8
0.00.0
Education
LessthanhighschoolHighschoolSomecollegeBachelorsdegreeorhigher
7.729.529.233.6
12.330.928.728.2
12.230.828.828.3
0.10.1‐0.1‐0.1
Race/Ethnicity
White,Non‐HispanicBlack,Non‐HispanicOther,Non‐HispanicHispanic2+Races,Non‐Hispanic
73.28.85.09.43.6
66.211.56.1
14.91.3
66.711.56.1
14.41.3
‐0.50.00.00.50.0
Region
Northeast Midwest South
West
19.022.735.023.3
18.321.537.023.2
18.321.537.023.1
‐0.10.00.00.1
IncomeUnder$25,000
$25,000‐$49,999
$50,000‐$74,999
$75,000andabove
15.824.119.141.0
19.323.218.938.6
19.323.219.038.5
0.00.0‐0.10.1
Note:TargetdataaretakenfromtheJuly, 2012,CurrentPopulationSurvey (age,gender,education,race/ethnicity,andregion)andtheMarch,2011,CurrentPopulationSurveySupplement(income).