A majority of voters support three key provisions of a Senatebill intended to fix part of the Affordable Care Act, according to a survey conducted by the Program for Public Consultation at theUniversity of Maryland, fielded by Nielsen Scarborough and releasedby the Voice of the People.

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After listening to arguments for and against each proposal inthe bill co-authored by Senator Lamar Alexander (R-Tenn.) and PattyMurray (D-Wash.), 2,511 registered voters were asked how swayed theirwere, and whether they supported or opposed the provision.

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One provision would allow Americans age 30 and up to have“copperplans,” which have lower premiums, but require patients to paynearly all of the medical costs until they meet the high deductibleof $7,150 (younger Americans can already have such plans).

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A majority (85 percent) of Republican respondents, 68.9 percentof Democrat respondents and 77.3 percent of Independents find thepro argument for copper plans convincing: “The government shouldnot be telling people what kind of insurance plan to have. Ifpeople want to have a copper plan with a high deductible theyshould be able to do so. They may feel that they’re healthy enoughand they can financially handle the first $7,150 of an illness orand an accident. In the event of a very costly illness or accidentthey would still be covered. We should let people make thatdecision for themselves. Furthermore, it might encourage people toget cove rage who do not have it now, because they feel they cannotafford the premiums of a bronze plan.”

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On the other hand, 49.5 percent of Republicans, 63.7 percent ofDemocrats and 54.3 percent of Independents find the argumentagainst copper plans convincing: “Copper plans are a bad idea.They’ll always look like a better deal on the surface than theyreally are. The very people attracted to those plans are ones withlow incomes who cannot afford the $7,150 deductible, especiallywhen they get sick and are less able to work. Also, research showsthat people on plans with very high deductibles tend to avoidvisiting the doctor. They wait until illness or accident forcesthem to. Often they end up going to the emergency room, which isinefficient; since many cannot afford to pay, the hospital ofteneats the cost. The ACA exchanges should not be offering theseplans, which are bad for lowincome people and for society.”

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After listening to both arguments, 68.2 percent of Republicans,53.9 percent of Democrats and 57.2 percent of Independents say theysupport the bill’s copper plan provision.

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Another provision would restore the cost-sharing reductionpayments to insurers – though those terms were not provided to thesurvey respondents. Instead, they were told that the provisionpertains to subsidies that have been paid directly to the insurancecompanies to reimburse them for covering the outofpocket costs oflowincome people over and above their maximum.

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Less than half (45.5 percent) of Republicans, 87.4 percent ofDemocrats and 61 percent of Independents find the pro argument forthis provision convincing: “By ending the subsidies for out ofpocket costs for lowincome people the government has only createddisruption and uncertainty. Middleincome people are paying higherpremiums. And the government will pay more in premium subsidies forlowincome people. The CBO says the government is not savingany money and even losing money in the short run. We need torestabilize the individual healthcare market by restoring thesubsidies that have been highly effective in bringing healthcarecoverage to millions of people.”

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On the other hand, 82.8 percent of Republicans, 30 percent ofDemocrats and 56.3 percent of Independents find the argumentagainst this provision convincing: “These subsidies are a giveawayto the insurance companies that has to stop. This bill is simply aneffort to shore up a system that is not working. The advocates ofthe ACA told us that premiums would stop going up and up, but thathas clearly not happened. Going back to paying subsidies so thatsome lowincome people make little or no copayments removes theirincentives to keep their medical costs low and makes them dependenton the government.”

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Afterward, 29 percent of Republicans, 84.4 percent of Democratsand 55.3 percent of Independents say they support thatprovision.

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The respondents were also asked about the bill’s provision torestore funding for services that help familiarize people with theACA's insurance exchanges, including advertising, education,training “navigators” to help people find their way to a healthplan, and notifying people if there is a problem with theircoverage. The Trump administration reduced funding for outreach byover 70 percent.

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A third (35.5 percent) of Republicans, 83.2 percent of Democratsand 64.2 percent of Independents find the pro argument to restoreoutreach funding convincing: “It is the responsibility ofgovernment to do its best to maximize the number of citizens withhealth insurance. When people do not have health insurance iscreates many costs for society as well as the person

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without insurance. We know from experience that if we cut backon outreach efforts fewer people will sign up. For example, someonewho lost the insurance they previously got from an employer may notknow that they need to sign up for insurance during a specificperiod in the year and that if they miss it will have to go withoutinsurance until the next year. Cutting back spending on outreachefforts is pennywise and poundfoolish.”

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On the other hand, 85.2 percent of Republicans, 20.9 percent ofDemocrats and 46.1 percent of Independents find the argumentagainst restoring outreach funding convincing: “In its work to geta grip on the overspending going on everywhere in government, theadministration is scrutinizing all budgets, including spending topromote Affordable Care Act. This reduction is reasonable: itlowers this spending to a level similar to what the governmentspends on publicizing Medicare’s drug benefit. Government shouldnot be expected to always take people by the hand and tell themwhat they need to do. Furthermore, it is clear that the ACA is afailing program and it makes no sense to prop it up withtaxpayerfinanced advertising.”

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Afterward, 29.3 percent of Republicans, 85.1 percent ofDemocrats and 55.4 percent of Independents say they supportrestoring outreach funding.

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Katie Kuehner-Hebert

Katie Kuehner-Hebert is a freelance writer based in Running Springs, Calif. She has more than three decades of journalism experience, with particular expertise in employee benefits and other human resource topics.