The effect of the Obamacare subsidies mirrors, to a certain extent, the position of people who get health coverage through an employer-based insurance plan. Employers tend to pay the majority of the premium costs for employees, and the health coverage that workers and their families get is tax-exempt.
For many Obamacare customers with low and moderate incomes, the federal subsidies they get put them on the same footing financially with people who have job-based coverage.
The Commonwealth Fund survey found that 66 percent of Obamacare exchange customers with incomes of below $30,000 said they paid either no premiums for their coverage or less than $125 per month. That compares to 60 percent of such people in employer plans.
But the picture is different for Obamacare customers with incomes higher than $30,000. Among them, 58 percent told Commonwealth researchers that they paid more than $125 in monthly premiums, compared to 34 percent with employer-sponsored insurance.
Overall, 49 percent of Obamacare customers viewed their health plans as being affordable. That compares to 75 percent of people with employer-based insurance. Commonwealth's report noted that the difference in view is at least partly due to the fact that Obamacare customers tend to have lower incomes than people in employer plans, meaning a bigger share of their incomes are devoted to health coverage.
But Commonwealth also noted that higher-income Obamacare consumers are spending more on coverage, as a share of their income, than people who have job-based coverage.
When it comes to out-of-pocket health costs, there is also a big gap between Obamacare customers of different income groups, the survey found. That spread results from the fact that people who earn above 250 percent of the poverty level do not get any financial aid with their deductibles, copayments or coinsurance.
Commonwealth's survey found that 68 percent of customers who earn above that threshold have plan deductibles of $1,000 or more. But just 30 percent of customers who fell below the 250 percent cutoff have deductibles that top $1,000.
The report said that "cost-sharing reductions [in Obamacare plans] have made deductibles similar to those incurred in employer plans."
"The share of lower-income adults with high deductibles is similar in marketplace plans and in employer plans," the report said. "At higher incomes, however, marketplace enrollees were significantly more likely than employer plan enrollees to have a high-deductible plan."
In other survey findings, about 40 percent of respondents said they had selected a so-called narrow network plan that has fewer covered doctors and hospitals than other plans. Those plans tend to have lower costs for customers than broader network plans.
Nearly 80 percent of Obamacare customers said they were either very or somewhat satisfied with the doctors in their plans' networks, and 64 percent said their plans included some or all of the doctors they wanted.