Poor Health Rating

From USA Today:

"Obamacare: 3 years in, it faces steep challenges"

The Affordable Care Act is sure to survive the latest vote scheduled for Thursday by the House of Representatives to repeal it — since the Senate doesn't plan to take it up and President Obama would veto it if it somehow reached his desk — but the administration's signature legislative achievement still faces serious perils ahead. Americans have a dimmer view of the health care law now than they did when Obama triumphantly signed it three years ago, according to monthly tracking polls by the Kaiser Family Foundation. The public's divided view and relentless Republican attacks have made it easier for governors and state legislators to balk at cooperating with the law. It is designed to provide coverage for millions of Americans who haven't qualified for Medicaid in the past and don't get insurance through their employers. That could have a cascading effect: Resistance by the states will make it harder for the law to work as promised when Medicaid expands next year and the health-insurance marketplaces where the uninsured can shop for plans open this fall.  That could fortify the arguments of those who warned the law was a mistake from the start and threaten fundamental provisions of it down the road. Just over a third of Americans, 35%, have a favorable opinion of the health law, according to the Kaiser survey taken last month, down from 46% who had a positive view when it was signed in 2010. Now 40% have an unfavorable opinion — precisely the same as three years ago — and nearly one in four, 24%, say they don't have an opinion.  Uncertainty about the law has risen as time has passed, and confusion about what it does and how it works is especially high among those it is designed to help. In fact, four in 10 Americans don't believe the law is still in place, saying inaccurately that it's been overturned by the Supreme Court or repealed by Congress.  The White House is scrambling to bolster support for and knowledge about the law, in part to encourage younger and healthier Americans who lack health insurance to shop for a plan when the exchanges open Oct. 1. Officials are trying to spotlight popular policies that already have gone into effect, including provisions that provide free preventive care for seniors and allow young adults to stay on their parents' insurance plans. Opposition to Obamacare fueled the rise of the Tea Party and the Republican takeover of the House in the 2010 congressional elections. "Those of us who remember 2009 and the town-hall meetings, we want to be fully prepared now," says Rep. Jan Schakowsky, D-Ill., recalling raucous meetings with constituents who saw the health care plan as an expensive and dangerous government overreach. "People are concerned that we do some better messaging before the August recess."  Meanwhile, Republicans relish the idea of brandishing Obamacare as a political weapon in the midterms. House Speaker John Boehner says the House brought up overall repeal of the law for the third time since it was enacted simply to give Republican freshmen a chance to stand against it. "We've got 70 new members who have not had an opportunity to vote on the president's health care law," he told reporters beforehand. Boehner's office says it is the 37th vote in the House on repealing, curtailing or defunding all or part of the Affordable Care Act. Republicans have failed to repeal the law in its entirety, but seven bills revising particular provisions have been enacted. The GOP also has denied funding requests by the Department of Health and Human Services to help implement the law, including the campaign to boost participation in the insurance exchanges. That's particularly important because if only people with chronic conditions and higher medical bills sign up, premiums would soar and the underpinnings of the system would be undercut. While the law mandates that most of the uninsured get insurance, the annual penalty for failing to do so is low enough ($95 in 2014, rising to $695 in 2016) that some people simply will choose to pay it. The Affordable Care Act envisioned most states establishing and running their own insurance exchanges. But only 17 states and the District of Columbia are moving ahead with plans to do that; another seven are setting up "partnership exchanges" with the federal government. But 26 states, including six of the 10 most populous ones, are leaving the job entirely to the federal government. The administration says one-third of the prime target group nationwide — healthy 18- to 34-year-olds who don't have insurance — live in California, Florida and Texas. Of that trio of states, only California is setting up a state exchange.  The other major part of the Affordable Care Act to cover the uninsured, expanding Medicaid to include more low-income Americans, is opposed by at least 20 governors, according to the Kaiser foundation. The Supreme Court ruling last year upheld the law's controversial individual mandate but gave states the option of choosing not to participate in the Medicaid expansion. In the states that don't, the uninsured who are too poor to afford to buy coverage in the exchanges, even with a federal subsidy, are out of luck.

^ I have written about this before and think it will fall apart sooner rather than later as the average American finally starts to be affected by it. ^

http://www.usatoday.com/story/news/politics/2013/05/16/obamacare-challenges/2166189/