Obamacare News That Should Make Conservatives Happy, But Won't

House Speaker John Boehner of Ohio, left, joined House Majority Whip Kevin McCarthy of Calif., and Rep. Keith Rothfus, R-Pa.,
House Speaker John Boehner of Ohio, left, joined House Majority Whip Kevin McCarthy of Calif., and Rep. Keith Rothfus, R-Pa., right, meets with reporters on Capitol Hill in Washington, Tuesday, Nov. 19, 2013, following a GOP strategy session. The Republicans kept up their their criticism of the Affordable Care Act, focusing on President Barack Obama’s promise to Americans that they could keep their private health care plans if they preferred them over Obamacare. (AP Photo/J. Scott Applewhite)

A new survey released on Thursday suggests that Affordable Care Act consumers are relatively happy with the insurance that they have purchased. And it's partly for reasons that conservatives would be celebrating -- if only that didn't also mean celebrating “Obamacare.”

The survey comes from the research firm J.D. Power and Associates. More than 3,000 people who purchased private insurance through one of the Affordable Care Act marketplaces last year participated, representing 11 states. The questions covered a variety of issues -- from quality of customer service to the adequacy of doctor and hospital networks. The survey also solicited opinions about the benefits of the plans and the costs.

The answers were surprisingly positive, at least by the standards of health insurance in America. J.D. Power uses a numerical index, from zero (low) to 1,000 (high), to measure consumer satisfaction. The figure for Affordable Care Act consumers was 696. To put that in perspective, the figure for people with employer-sponsored insurance -- the source of coverage for most working-age Americans -- was 670.

The survey found that people who were buying plans for the second consecutive year were more satisfied than those buying for the first time. Those buying plans through marketplaces that the federal government operates, rather than marketplaces that the states run, also tended to be happier.

The J.D. Power study is not the first to suggest that the majority of Obamacare consumers are content with what they are getting for their money. One year ago, the Commonwealth Fund published another survey of people who had received coverage through the Affordable Care Act.

Like the J.D. Power study, the Commonwealth survey included respondents who bought insurance through the marketplaces and frequently benefitted from generous federal tax credits. But it also polled people who got their insurance through Medicaid, the government program available in participating states to anybody with income below or just above the poverty line.

The results were still very positive. Nearly 8 in 10 respondents said they were “somewhat satisfied” or “very satisfied” with their health plans.

A previous survey by the Kaiser Family Foundation came to a similar conclusion -- that Obamacare consumers were generally happy with their coverage -- although many still struggled with the price of their insurance, and those who'd lost old plans were less happy than those getting insurance for the first time.

Of course, surveys aren't always the most reliable reflection of reality, since so much depends factors like the way pollsters word questions. And public sentiment itself can mask serious problems. At any moment, only a relatively small number of people have serious medical problems, which means only a relatively small number of people are relying on their coverage to get the medical care they need -- and protect them from financial duress. An insurance system popular with the vast majority of healthy people might leave a small minority of unhealthy Americans in trouble.

Even most supporters of the Affordable Care Act would concede that its protection from high co-payments and deductibles are not as strong as they’d like. Of particular concern these days are reports via Elizabeth Rosenthal of The New York Times that describe consumers discovering huge, unexpected co-payments because physicians at emergency rooms weren’t part of their hospital networks.

But the best available evidence suggests that, on net, the Affordable Care Act has resulted in more protection for more people. It has also contributed -- almost certainly in a small way and maybe in a big way -- to a historic slowdown in health care costs. This reality is wildly at odds with the rhetoric of Republicans and their supporters, who continue to throw around terms like “train wreck” to describe the law and promise that their first act if elected will be to repeal it.

The irony is that the J.D. Power survey actually reinforces an argument that, in other contexts, conservatives love to make. As Sarah Kliff noted at Vox, one likely reason for the high consumer satisfaction is that people buying coverage on the marketplaces are enjoying the chance to shop around -- comparing plan offerings and finding the best price. This is consistent with a ton of polling data in which respondents consistently say they value lower premiums over things like broad networks of doctors and hospitals.

This isn’t necessarily comfort to liberals -- who worry, again, that limits on access could harm the small minority of people with serious illnesses. But conservatives frequently talk about the virtues of increasing choice. In fact, the ideal world for many conservatives is one in which everybody, even people now on government-provided Medicare, would be shopping aggressively and choosing among multiple, competing private insurance plans.

That would seem like a reason for the right to talk up the J.D. Power results -- if only it didn’t mean admitting that perhaps Obamacare isn’t such a disaster after all.



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