Three out of four Americans concerned about potential health care policy changes

Eighty-one percent of Americans are aware of the health care debates in Washington, D.C. and of those, 92 percent are concerned about those changes and 59 percent are very or extremely concerned, according to a recent survey from the Transamerica Center for Health Studies (TCHS). The study, Healthcare Consumers in a Time of Uncertainty, an online survey of more than 4,600 Americans, ages 18-64, found that the three biggest fears among Americans include:

1. Loss of coverage for those with pre-existing conditions (42 percent);
2. Reduction in Medicare coverage for seniors (31 percent); and
3. No employer mandate to offer health care coverage (30 percent).

The survey also found that more than two-thirds (67 percent) of Americans reported having at least one chronic health condition, and 19 percent cited managing a chronic illness/condition (e.g., heart disease, diabetes, high blood pressure) as one of their top two most important health-related priorities right now.

“With such high rates of chronic health conditions, it is not surprising that so many Americans are concerned about losing coverage due to their pre-existing conditions,” said Hector De La Torre, executive director of TCHS. “This concern is reflected by a substantial 56 percent of Americans who think health insurance should cover people with pre-existing conditions. This strong consensus is counter to the ongoing split over the Patient Protection and Affordable Care Act (ACA), with 43 percent having a positive view and 32 percent having a negative view of the ACA (and 26 percent neutral on the ACA compared to 51 percent in 2016).”


When asked about the most important characteristics of the health care system, the most common response was “being able to pay for the care I need” (36 percent). Consistent with previous years, affordability remains a top concern, with nearly one in five (19 percent) saying they are currently not able to afford routine health care expenses (i.e., health insurance copayments, deductibles, out-of-pocket expenses, etc.). Only about one in 10 Americans (13 percent) say their access to affordable health care coverage has increased in the past one to two years.

Interestingly, the survey found variations in increased access to affordable coverage among racial and generational segments, with Latino adults (19 percent) more likely than White (12 percent), African American (11 percent), and Asian/Pacific Islander (10 percent) adults to say access to affordable coverage has increased. In addition, Millennials (18 percent) are more likely than Generation X (10 percent) and Baby Boomers (6 percent) to say access to affordable coverage has increased.

“Year after year, we have found that affordability is top of mind for Americans and yet few say they are currently saving for health care expenses, and a substantial proportion of employed adults are not sure they are taking advantage of the health care savings offered by their employer,” said De La Torre. “As we approach open enrollment in the Exchanges, employer-based coverage and Medicare, it is crucial that individuals understand their health care options and comparison shop so they can make the most informed decisions for their situation.”

Other key findings include:

  • Fifty-seven percent do not feel the government (state or federal) should require individuals to purchase health coverage.
  • Twenty-eight percent believe that the ACA has directly impacted their health insurance choices in 2017 in a positive way.
  • Fifty-one percent of employed Americans feel they must stay at their current job because they need the health insurance.
  • Sixty-two percent say health care costs are a very/somewhat significant source of stress, more than family responsibilities, work and housing costs. Only money and the economy are more commonly mentioned as sources of stress.
  • Almost half (47 percent) of rural Americans have a negative impression of the ACA, compared to a 19 percent of urban Americans and 34 of suburban Americans.

The uninsured and newly insured.

The survey found that 12 percent of adults are uninsured, which is down from 15 percent in 2014 and 21 percent in 2013. One in four Latinos (23 percent) are uninsured, the highest rate among racial groups, compared to 15 percent among African Americans, 8 percent among Whites, and 6 percent among Asian/Pacific Islanders. Most commonly, the uninsured say paying their health expenses and the penalty is less expensive than the health coverage options available to them (29 percent). About one in six (18 percent) uninsured adults still claim they are unaware of the ACA’s insurance mandate for individuals. Thirty-nine percent of uninsured adults did not obtain coverage before the ACA mandate because they were unaware of it, did not know how to apply, did not know the mandate applied to them, or were not informed about the ACA.

Finally, 40 percent of the uninsured have a negative impression of the ACA (with 30 percent positive), compared to 31 percent negative and 44 percent positive for the insured.

SOURCE: Transamerica Center for Health Studies.
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