Gallup poll shows potential ObamaCare downside in the fall

So far, the victory lap taken by Barack Obama after the end of ObamaCare open enrollment hasn’t impressed anyone, at least according to the latest Gallup survey.  Approval of the law ticked up within the margin of error since the last survey in March, but disapproval remains near its peak:

With the open enrollment period for obtaining health insurance through a federal government exchange now over, Americans’ views on the broader healthcare law remain more negative than positive. Currently, 43% approve and 54% disapprove of the law, commonly known as “Obamacare.” The approval figure is a bit higher than Gallup’s estimates since last November, but disapproval is essentially unchanged. …

Americans’ overall approval of the law and expectations for its long-term effects on the healthcare system continue to be strongly related to their party affiliation. A vast majority of Democrats, 79%, approve of the law, and 69% think it will make the healthcare situation better. In contrast, 87% of Republicans disapprove of the law, and 77% think it will make the healthcare situation worse.

Independents are more negative than positive toward the law. They disapprove of the law by 65% to 32%, and 53% believe the law will make the healthcare situation worse compared with 26% who say better.

Basically, we still see stasis despite the self-congratulation of last week, which preceded the survey dates (April 7-8). The departure of Kathleen Sebelius isn’t likely to impact this one way or the other. Republicans dislike the law as much as ever, while Democrats may be rallying around it a little bit. The view among independents appears to have worsened slightly, as only 17% think it will make their own lives and those of their family better, as opposed to 39% who think it will make it worse, after a 20/38 reading from the beginning of March.

Otherwise, nothing much has changed. A couple of points should be noted, though, about the potential downside as the 2015 mandates and premiums approach. So far, most of the impact of ObamaCare has been on the individual market, with the employer market shielded from much of the churn and turmoil. That’s why the percentage of those claiming that ObamaCare had no effect on them remains in the mid-60s (64%) as it has since the rollout. Before ObamaCare, only 15% of the US was uninsured, and that’s still the percentage that claims ObamaCare has helped them. Another 18% claim to have been hurt by ObamaCare, outstripping those boosted by the law.

What happens when ObamaCare’s employer mandates hit? Most of that 64% will get some sort of impact, and it’s not likely to be overwhelmingly positive, either. They will either lose their current plans and get forced into higher deductibles and higher premiums, or get pushed out of employer-subsidized coverage altogether. It won’t just be the mandates that drive those pricing changes, either. As I wrote in my column for The Fiscal Times, a new study of exchange consumers from Express Scripts makes it pretty clear that the risk pools got sicker and not healthier in this first round:

Moreover, those who did enroll through the state exchanges didn’t provide the demographic lift and risk-pool support needed to prevent massive increases in either premiums or deductibles, or both, in the near future.  Pharmacy benefit manager Express Scripts, which collected more data from insurers than HHS managed through its own exchanges, determined that the incoming enrollees require more medical attention than the previous risk pools, not less – which means that insurers will need to raise premiums even more than first thought.

Their new study shows, for instance, that the enrollees from state and federal exchanges have a 47 percent higher use of specialty medications than in commercial plans in general. “Increased volume for higher cost specialty drugs can have a significant impact on the cost burden for both plan sponsors and patients,” the report reminds readers. “Despite comprising less than 1 percent of all U.S. prescriptions,” the report continues, “specialty medications now account for more than a quarter of the country’s total pharmacy spend.”

The medications themselves show that the care costs will increase relative to the existing risk pools as well. The rate for HIV medications in Obamacare exchange plans is four times higher than in existing commercial plans. Medication prescriptions are 35 percent higher, and anti-seizure medication increases 27 percent. Ironically, the only category where exchange consumers have lower demand than commercial-plan customers is in contraception – the focus of a big political battle in the employer mandate.

As Express Scripts, which studied changes in pharmacy benefits concludes that the ACA has succeeded in getting coverage to consumers who need it. However, that comes at a high cost for those who had their existing coverage canceled and saw their premiums and deductibles skyrocket as a result of Obamacare.


Insurers will start communicating those new premiums and deductibles this summer, and businesses will start making decisions about coverage by early fall. Employees will experience those shocks well ahead of the midterm elections. Few of them will be pleased with the changes, which means a large amount of the 64% reporting no impact will have their minds changed on that point …. and probably not for the better.

Democrats needed a lot better than stasis coming out of the open-enrollment period in order to compete in the midterms. They may long for it when the ObamaCare churn hits the employer-based market in the fall.

Michael Ramirez had this excellent editorial cartoon about Obama’s victory lap earlier this week at Investors Business Daily:


In this case, though, we don’t really need lookouts in the crow’s nest to see the iceberg ahead.

Also, be sure to check out Ramirez’ terrific collection of his works: Everyone Has the Right to My Opinion, which covers the entire breadth of Ramirez’ career, and it gives fascinating look at political history.  Read my review here, and watch my interviews with Ramirez here and here.  And don’t forget to check out the entire site, which has now incorporated all of the former IBD Editorials, while individual investors still exist.