Health Insurance

They want those Obamacare subsidies, no matter what: Poll

They break it? You need to fix it.

A strong majority of Americans would want officials to restore often-significant financial aid given to Obamacare customers in much of the United States if the Supreme Court rules the assistance is illegal, a new survey shows.

The Kaiser Family Foundation poll released Wednesday underscores the potential political peril Obamacare foes may face if the high court case goes in their favor, and subsidies for millions of insurance customers are ended by summer.

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The poll reflects the fact that even as the Affordable Care Act continues to be viewed negatively by more Americans than those who view it positively—46 percent to 40 percent—there is stronger reluctance among the public to see those who have been helped by the ACA lose its benefits.

The U.S. Supreme Court
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The survey found that 56 percent said they knew "nothing at all" about the high court challenge, which targets subsidies issued to most customers of HealthCare.gov. The federal health insurance marketplace serves 37 states, and so far this year has seen sign-ups by more than 6 million people who qualify for subsidies.

Just 14 percent of respondents said they knew "some" or "a lot" about the case targeting the aid, which is available to Obamacare customers with low or moderate incomes.

But 64 percent agreed that "Congress should pass a law" to restore the HealthCare.gov subsidies if the Supreme Court said the ACA as written does not allow them. While Democrats and self-described independents were the most supportive of that view, 40 percent of Republican respondents said Congress should pass a remedy.

In states served by HealthCare.gov, 59 percent said they would want their state to create its own Obamacare exchange in the face of a high court decision ruling the federal exchange subsidies are illegal. And a slight majority of Republicans in those states, 51 percent, agreed that their state should take such action.

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The vast majority of people who buy Obamacare plans on government-run exchanges qualify for tax credits to help them pay their monthly insurance premiums. If those subsidies are not available, there is widespread agreement among insurance experts that enrollment in Obamacare plans would plummet because many people would find their retail prices unaffordable.

In the pending court case, plaintiffs argue that the ACA allows the subsidies to be issued only to customers of one of the 14 insurance exchanges established by individual states and the District of Columbia. Plaintiffs say the aid is not an option for HealthCare.gov customers because the ACA only explicitly authorizes subsidies to customers of an exchange established by a "state."

The Obama administration disputes that, and has said it is confident the subsidies will continue for HealthCare.gov customers.

The Supreme Court is due to hear arguments March 4, and is likely to rule in June.

Fixes may be difficult

Because Republican opponents of Obamacare are in control of Congress, it may prove difficult, at best, for the administration to get a law passed that would allow subsidies to be issued to federal exchange customers if the Supreme Court rules for the plaintiffs.

And while some HealthCare.gov states may be inclined to set up their own exchanges in the face of such a decision, not all would do so.

Other findings by the Kaiser poll point to persistent lack of awareness about elements of Obamacare among uninsured people, the group that the ACA is specifically designed to help.

The survey found that only 17 percent of the uninsured know that Feb. 15 is the deadline to enroll in plans sold on Obamacare exchanges or to get health coverage to avoid a tax penalty for failing to have insurance.

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Sixty percent of the uninsured said they did not know the deadline, 11 percent gave a date "outside of the enrollment period and 13 percent say the deadline has passed or there is no deadline."

Less than half of the uninsured—42 percent—know that subsidies are available to help people with low and moderate incomes, and a mere 22 percent said they know "at least something" about the Obamacare exchanges.

Little support for changing 'employer mandate'

The poll also found relatively weak support for a move by congressional Republicans tweak the ACA in order to reduce the burden on employers from the so-called "employer mandate."

Starting this year, that mandate requires employers with 100 or more employees working at least 30 hours per week to offer them health insurance or face a potential fine.

The House voted this month in favor of raising the mandate threshold to at least 40 hours per week.

Just 26 percent of people in the poll supported that idea; 40 percent said they were opposed.

But the poll also found that people's opinions on that question could be swayed after being given additional information.

Just 13 percent still agreed with boosting the work-week threshold and 51 percent were opposed after being told such a move would increase the federal deficit and lead more employers to cut hours for some full-time workers to avoid the requirement to offer them insurance.

But when respondents were told that subsidies for Obamacare-exchange plans would be available to low- and middle-income workers who did not work enough hours to qualify for work-based insurance, support for increasing the work-week limit rose to 41 percent, compared with just 22 percent who remained opposed to that idea.