Skip to main content

Worried about Obamacare? Fear not

By Aaron Carroll, Special to CNN
September 19, 2013 -- Updated 1052 GMT (1852 HKT)
STORY HIGHLIGHTS
  • Polls indicate that many Americans are very confused about what Obamacare is
  • Aaron Carroll: With two weeks before the health exchanges open, here's what it does
  • He says starting in 2014, people without health insurance will get insured in one of two ways
  • Carroll: No one can be denied health insurance; no one can be charged more for being sick

Editor's note: Dr. Aaron E. Carroll is a professor of pediatrics at the Indiana University School of Medicine and the director of its Center for Health Policy and Professionalism Research. He blogs about health policy at The Incidental Economist and tweets at @aaronecarroll.

(CNN) -- With just two weeks before the health care exchanges open and the Affordable Care Act really kicks in, the only thing that's clear about the law is that Americans are totally confused about what it does. Two polls released this week paint a dismal picture for those of us who consider it our job to explain what health care reform means to the public.

The first, from the Wall Street Journal and NBC News, showed that almost 70% of people don't understand what Obamacare is or that they understand only a part of it. While 31% thought it was a good idea, 44% thought it was a bad one. The remaining 25% weren't sure.

It gets worse. When the poll specifically looked at the uninsured -- which Obamacare is specifically designed to help -- more than three-quarters of them said they didn't understand how the law would affect them.

Another poll, from the Pew Research Center and USA Today, found that 53% of Americans disapprove of Obamacare, compared with 42% who approve. In this poll, though, only a third said they had little or no understanding of how the law would affect them. Almost half of people thought that health exchanges would not be available in their state.

Aaron Carroll
Aaron Carroll

While Obamacare is complicated, our understanding of it doesn't have to be so. This is what Obamacare will do:

Most Americans already get health insurance from their jobs, Medicaid, Medicare or the Department of Veterans Affairs. The vast majority of those people will continue to do so.

But starting in 2014, people without health insurance will get insured in one of two ways. If they are very poor -- making less than 133% of the poverty line -- then they will get Medicaid through the expansion of the program. That is, if their state has opted to participate in the program. If their state has not, then they may continue to be uninsured.

The rest of the people without health insurance will go to the exchanges to get it. There, they can choose from plans with different levels of co-payments and deductibles, according to how much they want to spend. If they make less than 400% of the poverty line, they will get a tax credit or subsidy to help with the cost.

Obamacare opposition heats up

No one can be denied health insurance anymore, and no one can be charged more for being sick. All the plans are from private insurance, and they're going to compete for your business.

Complete coverage: Health care in America

There are other bells and whistles, but that's Obamacare in a nutshell.

If you ask me, I think Obamacare will do more good than harm. Many uninsured Americans are unable to get insurance in the market as it exists today, especially if they have chronic conditions. Those who can afford to often pay a fortune for it. Obamacare is a solution to these problems.

While a relatively small number of people will see their rates go up, they're mostly young, healthy people making more than 400% of the poverty line. The vast majority -- more than 90% of people getting their insurance in the exchanges -- will get subsidies to make their insurance more affordable. Plus, now everyone, even if they're young and healthy at the moment, will be protected if they or a member of their family gets sick or when they grow old.

There are places you can go right now to get more information. For instance, you can visit www.healthcare.gov. At that website, by answering a few questions, you can see what options will be available to you starting October 1. After that date, you will be taken to your state's exchange, where you will be able to get actual information about plans and sign up for them. Coverage will start January 1.

Originally, Obamacare was expected to come with more than half a billion dollars to be spent on outreach and education efforts about the exchanges. This money was supposed to be used to help people understand how Obamacare was supposed to work for everyone. But the Republican-led House of Representatives cut the whole implementation budget.

When Health and Human Services Secretary Kathleen Sebelius was further forced to move what little money remained in the PR budget into the Prevention Public Health Fund (which was also cut), Sen. Max Baucus, one of the main architects of Obamacare, got upset. He remarked that the law was complicated and that we would get a "train wreck."

Many leapt on this comment and proclaimed that even Baucus thought the law was a mess. But that's not what he said. He meant that if people didn't understand how it worked, then it would be a mess.

At the moment, his prediction could still come true. The latest polls show that, as he feared, too few people understand how Obamacare functions. But there's still time. It will take a lot of outreach and a lot of elbow grease, but supporters of the law believe they are up to the task.

Time will tell. October 1 is approaching fast.

Follow us on Twitter @CNNOpinion.

Join us on Facebook/CNNOpinion.

The opinions expressed in this commentary are solely those of Aaron Carroll.

ADVERTISEMENT
Part of complete coverage on
October 5, 2013 -- Updated 1609 GMT (0009 HKT)
Ten views on the shutdown, from contributors to CNN Opinion
October 5, 2013 -- Updated 1546 GMT (2346 HKT)
Peggy Drexler says Sinead O'Connor makes good points in her letter to Miley Cyrus, but the manner of delivery matters
October 4, 2013 -- Updated 1956 GMT (0356 HKT)
Sen. Rand Paul says there's no excuse for President Barack Obama to reject any and every attempt at compromise.
October 6, 2013 -- Updated 0822 GMT (1622 HKT)
Amy Stewart says the destruction of hornets' habitats sends them into cities and towns in their search for food
October 4, 2013 -- Updated 2331 GMT (0731 HKT)
John Sutter asks: When will homophobia in the United States start seeming so ridiculous it's laughable?
October 5, 2013 -- Updated 0853 GMT (1653 HKT)
Maurizio Albahari says the Mediterranean chronicle of death cannot end merely as a result of tougher penalties on smugglers, additional resources for search-and-rescue operations, and heightened military surveillance
October 4, 2013 -- Updated 2106 GMT (0506 HKT)
Richard Weinblatt says cops followed a standard of "objective reasonableness" in their split-second reaction to a serious threat, when a woman rammed police barricades near the White House.
October 4, 2013 -- Updated 1130 GMT (1930 HKT)
Ted Galen Carpenter says change of policy should begin with the comprehensive legalization of marijuana.
October 5, 2013 -- Updated 2031 GMT (0431 HKT)
Amardeep Singh: Victims of hate crimes and those convicted of them should work to overcome fear of one another.
October 4, 2013 -- Updated 1044 GMT (1844 HKT)
Meg Urry says a two-week government shutdown could waste $3 million, $5 million, even $8 million of taxpayer investment.
October 3, 2013 -- Updated 1332 GMT (2132 HKT)
Frida Ghitis: Most of the world is mystified by the most powerful country tangled in a web of its own making.
October 3, 2013 -- Updated 1346 GMT (2146 HKT)
Ellen Fitzpatrick and Theda Skocpol say the shutdown is a nearly unprecedented example of a small group using extremist tactics to try to prevent a valid law from taking effect.
October 4, 2013 -- Updated 1911 GMT (0311 HKT)
Danny Cevallos asks, in a potential trial in the driver assault case that pits a young man in a noisy biker rally against a dad in an SUV, can bias be overcome?
October 3, 2013 -- Updated 1410 GMT (2210 HKT)
Ben Cohen and Betty Ahrens say in McCutcheon v. FEC, Supreme Court should keep to the current limit in individual political donation
October 2, 2013 -- Updated 1616 GMT (0016 HKT)
Dean Obeidallah says if you are one of the 10% who think Congress is doing a good job, people in your family need to stage an immediate intervention.
October 2, 2013 -- Updated 1452 GMT (2252 HKT)
Let the two parties fight, but if government isn't providing services, Bob Greene asks, shouldn't taxpayers get a refund?
October 2, 2013 -- Updated 1658 GMT (0058 HKT)
Kevin Sabet says legalization in the U.S. would sweep the causes of drug use under the rug.
September 25, 2013 -- Updated 1359 GMT (2159 HKT)
James Moore says it is time for America to move on to a new generation of leaders.
ADVERTISEMENT