October 4, 2013
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New Jersey Divided on Impact of Obamacare

By Monmouth University Polling Institute

The Monmouth University Polling Institute and the New Jersey Health Care Quality Institute has released the very first “Health Matters Poll,” a periodic survey of Garden State attitudes regarding healthcare related issues.

The first poll gauges New Jersey residents’ opinion of the Affordable Care Act (ACA) and the impending individual mandate. Garden State views are either in line or slightly more positive than national attitudes about the law in general. But when it comes to actual knowledge of the individual mandate, Garden State residents are less informed than the rest of the country.

“We are excited about this new collaboration with the Monmouth University Polling Institute,” said David L. Knowlton, president and CEO of the New Jersey Health Care Quality Institute. “In the health care quality world, it is an important axiom that patients – the health-care consumer – comes first. This new survey will take much of the guesswork out of understanding what they are thinking on important health-care concerns.”

“Most New Jerseyans appear to be fine with upcoming implementation of the new health-care law, but they are much less aware than other Americans about the individual mandate. Many uninsured New Jerseyans could be in for a surprise if they elect not to get health-care coverage and later find they have to pay a fine on their 2014 taxes,” said Patrick Murray, director of the Monmouth University Polling Institute.

Just under half (45 percent) of New Jersey residents have a favorable opinion of the ACA health-reform law, also known as Obamacare, while 40 percent have an unfavorable view and 16 percent express no opinion. This is somewhat more positive than national opinion as measured by a recent Kaiser Health Tracking Survey. That August poll found 37 percent of Americans with a favorable opinion of the ACA and 42 percent with an unfavorable view.

About half (49 percent) of the state thinks the quality of their own health care will not be affected by implementation of the ACA, although 30 percent think it will get worse and just 13 percent think it will get better. This is nearly identical to a national Kaiser poll taken in March, when 48 percent of Americans believed their health care quality would stay the same under the ACA; 34 percent said it would get worse, and 15 percent said it would get better.

There are more concerns about the ACA’s impact on health care costs than on quality. More than 4-in-10 New Jerseyans (42 percent) predict their own costs will get worse under the ACA, compared to 37 percent who say their costs will stay about the same, and just 14 percent who say they will improve. Nationally, the March Kaiser poll found that nearly half (49 percent) of Americans felt that the ACA would negatively impact their own health care costs – a number that is somewhat more negative than the New Jersey result. One-third (33 percent) of Americans said their own costs would stay the same and just 15 percent said they would get better.

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New Jerseyans who purchase their own coverage (48 percent) are as likely as those who have employer coverage for either their families (45 percent) or just themselves (44 percent) to say that their health-care costs will worsen under the ACA.

“In my view, just as is true with elections, as we get closer and closer to the date that people will have to be concerned with this historic new law, they will pay more attention and gain a better and more accurate understanding of it,” Knowlton said. “I am not at all surprised by the level of understanding at this point.”

Most New Jerseyans feel they understand the health-care reforms either very (18 percent) or somewhat (49 percent) well. Only 3-in-10 say they understand the ACA not too well (19 percent) or not well at all (12 percent). However, Garden State residents’ self-reported awareness of the reforms doesn’t necessarily correlate with their knowledge of specific aspects of the law.

Just 1-in-3 New Jerseyans have heard a lot (11 percent) or some (23 percent) regarding the new health-care exchanges, or marketplaces, which opened Oct. 1. Another 31 percent have heard only a little and 33 percent have heard nothing at all. These state numbers are nearly identical to a national poll taken by Kaiser in August (12 percent a lot, 21 percent some, 34 percent a little and 33 percent nothing).

New Jersey is significantly less informed than the nation, though, when it comes to the ACA’s individual mandate. Just over half (56 percent) of the state is aware that the new law requires nearly all Americans to have health insurance by next year or pay a fine. Another 24 percent erroneously say there is no such mandate in the law, and 21 percent admit they do not know if such a provision exists. Among New Jerseyans who do not currently have health coverage, 58 percent are aware of the mandate. Among those who currently purchase their own coverage and could potentially be impacted if they drop that coverage, 64 percent are aware of the mandate.

New Jerseyans’ knowledge of the individual mandate is significantly lower than national awareness. A March poll by Kaiser found that 74 percent of Americans said the ACA requires individuals to purchase health coverage or pay a fine. This awareness level is 18 points higher than the comparable New Jersey number and suggests that a lack of a statewide public awareness campaign could have an impact on residents’ compliance with the mandate.

Just over 1-in-10 (11 percent) New Jersey adults report that they currently do not have health-care coverage. Among this group 62 percent say will probably obtain health coverage for 2014 after learning of the individual mandate. Another 24 percent say they will remain uninsured despite the mandate’s fines, while 13 percent are uncertain about what they will do.

These results are similar to a national Kaiser poll from August, when 58 percent of uninsured American adults said they would obtain coverage under the mandate.

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New Jerseyans who pay for their own health coverage or do not have coverage express mixed interest in shopping for better or lower cost coverage on the new health care exchanges.

Nearly half say they are very (27 percent) or somewhat (19 percent) interested in seeing what options the exchanges would provide for them compared to half who say they are only a little (14 percent) or not at all (36 percent) interested in exploring what the ACA marketplace has to offer.

Among the uninsured, 70 percent are interested in shopping on the exchange. A majority (58 percent) of those who purchase coverage on their own also express interest in exploring the exchange. New Jerseyans with employer provided coverage for their families (42 percent) or just themselves (37 percent) are less likely to be interested.

The poll also presented nongovernment insured respondents with a possible premium scenario for exchange coverage, based on early estimates of a potential $1,000 monthly unsubsidized premium for a family plan that includes an average 30 percent co-pay. Just 19 percent of respondents would be at least somewhat interested in exploring family coverage for this cost.

Of course, the exchange is geared toward those who do not have access to employer-provided coverage. Among New Jerseyans who are currently without insurance – the group who the exchange is initially designed to serve – just 22 percent would be interested in family coverage at $1,000 per month. However, more than 9-in-10 of these uninsured respondents report annual income levels that would potentially qualify them for federal subsidies to lower this cost. This means the amounts presented in the poll are markedly higher than the net cost that will be available to most residents who are currently uninsured.

Among New Jerseyans who currently purchase their own coverage, 32 percent are interested in looking into the exchange for alternate family coverage at $1,000 per month. The poll results suggest that most of those who currently purchase insurance on their own would not be eligible for the lower subsidized premium because less than half report even being in an income bracket that could potentially qualify for federal subsidies.


This survey was conducted by the Monmouth University Polling Institute in West Long Branch in partnership with the New Jersey Health Care Quality Institute from Sept. 6 – 10 with a statewide random sample of 783 adult New Jersey residents, including 580 via live interview on a landline telephone and 203 via live interview on a cellphone.


Two River Moment


This undated photo was taken in Red Bank on West Front Street, looking west, with Riverside Avenue on the right. Where the gas station had been located is now the triangular, vest-pocket Veterans Park.

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