SACRAMENTO, Calif. -- Health care reform -- enshrined in the 2010 Affordable Care Act (ACA) -- enjoys widespread support in California among African American voters (88 percent) and about two-thirds of Korean and Latino voters support the law, according to a Field Poll voters released this week.
The poll indicates that overall, "Californian voters have been consistently supportive," observed Mark DiCamillo, director of the Field Poll, who released the findings at the Capitol. Statewide, he said, 54 percent of voters support the law, while 37 percent are opposed.
"The only difference is that this year, 13 percent of them strongly support it; last year it was 31 percent," he said.
Many Face "Dire Situation"
Carmela Castellano-Garcia, president and chief executive officer of the California Primary Care Association (CPCA), which represents over 800 community-based clinics, said she was not surprised to see so much support from Latino voters given that one in three of them is uninsured. "Their support is mired in the dire situation they face," she said. More than half of that patients in CPCA clinics are Latino.
Almost half (45 percent) of Chinese Americans support the law, versus 31 percent who don't. The margin of support is narrower for Filipino Americans surveyed (39 percent to 33 percent), with large proportions undecided.
"Groups that are going to benefit in 18 months -- (in 2014, when the ACA goes into full effect) – are strongly supportive," noted Gerald Kominski, professor of health policy and management and director or the UCLA Center for Health Policy Research. "I find that encouraging."
This is the third multilingual survey conducted by Field Poll in as many years. Field plans two more on a wider range of issues in September and October.
The new poll, funded by the California Wellness Foundation, was conducted by telephone in English, Spanish, Cantonese, Mandarin, Tagalog, Korean and Vietnamese. The Field Poll surveyed a total of 1,579 voters, 407 of them from ethnic communities.
The poll shows there is low awareness among voters (17 percent) about the state's new Health Care Exchange, the online health-insurance marketplace mandated by ACA where individuals and small businesses can purchase coverage. California is far ahead of the rest of the nation in developing it. States can chose whether to create their own exchange or have the federal government operate one for them.
Exchanges—Online Malls to Buy Insurance
Promising to be a virtual health-insurance shopping mall for consumers, the exchange is gearing up to be full active when it begins on Jan. 1, 2014. The state is developing the tools consumers will need for comparison shopping – including standards insurers must meet to participate – and aims to many as many Californians as possible signed up when the pram goes live.
That current public awareness is low "is somewhat to be expected," said DiCamillo, "given that they haven't done any outreach or marketing yet." He added, "What will really be interesting is how much we see that change over time, whether there is greater awareness among certain subgroups later, as the exchange gets closer to actual operation."
DiCamillo continued that about one-quarter of those surveyed were potential users of the exchange – Medi-Cal beneficiaries, uninsured people or those with insurance in the individual market outside of group health plans.
When asked if they would be interested in shopping for insurance coverage through the exchange in 2014, DiCamillo said, three of four said yes. Exchanges promise to give consumers tool for comparison shopping among health plans on benefits and price.
"That's a sizable segment," DiCamillo said. "And we're excluding pretty much the Medicare population." He noted that this large proportion does not factor in additional numbers of people who learn that ACA will give them subsidies to purchase health insurance through an exchange. This includes many lower and middle-income people, who earn too much to qualify for Medi-Cal but still find buying insurance unaffordable.
Peter Lee, executive director of California's exchange, said he believes "misinformation and misrepresentation" about the exchange by those who oppose it has diminished public awareness of the service.
Even so, he said he was heartened that nearly 74 percent of those polled were interested in buying health insurance from it, when it is up and running January 1, 2014. The Exchange's target audience includes individuals currently uninsured, on Medi-Cal or covered through the high-cost individual market.
Although people can go online and do their shopping, California will also "have human beings who'll speak many languages" to assist them, Lee said.
Between 42 and 44 percent of Latino, African American and Asian American voters say they will shop online when it becomes available. In contrast, only 29 percent of white non-Hispanic voters said they would shop on the exchange.
Generally, DiCamillo said, opinions about the exchange and reform is "highly related to political party affiliation." Favorable opinions about health care reform tend to run higher in California, where the majority of voters are Democrats.
Previous Debate Less Partisan
Before ACA was enacted, when the state debated health care reform, "it wasn't this partisan," asserted Diana S. Dooley, secretary of California's Department of Health and Human Services. "Now what we think about the ACA is what we think about politics."
Most Californians – 51 percent -- felt Congress should halt any efforts to repeal the law, the poll found. By a nearly two-to-one margin, voters disapproved attempting to cut off funding of the law as a way to stop its implementation.
Journalist and author Emil Guillermo, currently with the Asian American Legal Defense and Education Fund, said the one shortcoming about the poll was that it lacked the views of South Asians, an increasingly politically active segment on the U.S. scene, as well as those of such Asian sub-groups as the Hmong.
"Everything has been diversified in the state, except the polls," Guillermo pointed out. "With the kind of diversity we have in the state, how can we not drill down and say with certainty how these [other] groups think," before Sacramento develops policy.
DiCamillio conceded that a number of groups, including Native Americans, were not surveyed because "it was a matter of resources. We had a smaller budget and a smaller time frame. There's always going to be a group that's not going to be included."