Americans Are Still in the Dark About Health Reform

Americans are not sure how the health reform law will affect them and few are paying attention to state-level decisions about implementation, according to the latest Kaiser Health Tracking Poll.

Though opinion on the law remains nearly evenly divided, opponents’ attacks seem to have taken a toll on the public’s expectations. Americans are now more likely to say the law will make things worse rather than better for their families. While most of the law’s individual provisions remain popular, many of the most well-liked elements are the least well-known among the public. Public knowledge of the ACA’s provisions has not increased since 2010. In fact, awareness of some key provisions has declined since the law’s passage when media attention was at its height.

The public hasn’t been paying much attention to the decisions of state and federal policymakers about Medicaid expansion and health insurance exchanges. Forty-eight percent have hear nothing about their state’s decision on whether to create a state run exchange; 15% have heard some; and 7% have heard a lot about it.

While health care cost growth has slowed in recent years, a majority of the public perceives that the country’s health costs have been going up faster than usual. While health care cost growth continues to outpace inflation, the rate of growth in national health expenditures has slowed markedly in recent years. The public’s perception is quite different, however. Fifty-eight percent say that, the cost of health care for the nation has been going up faster than usual over the past few years.

Thirty-four percent say that their own family’s health care costs have been going up faster than usual while 24% say the costs been going up about the same amount as usual, and 32% say their costs have held steady in recent years. Only 2% say their costs have been going up more slowly than usual or have come down. For more information, visit,

Last Updated 05/25/2022

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