The Kentucky Health Issues Poll has asked Kentucky adults their opinions about the health care reform law, called the Patient Protection and Affordable Care Act (ACA), since it passed in 2010.
The ACA allows children to remain on their parents’ health insurance policy until they are 26 years old; prohibits insurance companies from denying coverage or charging more because of pre-existing health problems; and requires preventive services such as flu vaccines and cancer screenings to be provided at no cost.1 It also permits states to expand Medicaid coverage to low-income adults. Kentucky did this in 2014.2
The law originally required that adults had to have health insurance or pay a tax penalty. In 2017, Congress eliminated the penalty, effective Jan. 1, 2019.
Kentucky received approval from the Centers for Medicare and Medicaid Services for an 1115 Medicaid waiver that includes premiums, community engagement and other requirements for the ACA expansion population. The requirements are set to start April 1, 2019.3
KHIP is sponsored jointly by Interact for Health and the Foundation for a Healthy Kentucky.
Opinion about the ACA was unchanged from 2017. More than 4 in 10 Kentucky adults (44%) held favorable opinions and more than 3 in 10 (33%) held unfavorable opinions. About 2 in 10 Kentucky adults (22%) said they don’t know. The percentage of adults with a favorable opinion of the health law had increased from 2010 to 2017.
In 2018, nearly 6 in 10 Kentucky adults (56%) reported having enough information about the health reform law to understand how it would impact them personally.4 Four in 10 Kentucky adults (41%) reported not having enough information. Three percent reported that they don’t know. The percentage of Kentucky adults who feel they have enough information about the law has gradually increased since the question was first asked in 2010.
KHIP asked Kentucky adults whether the health reform law had an impact on them or their families.5
More than 5 in 10 Kentucky adults (53%) reported no impact on themselves or their families. About 2 in 10 Kentucky adults (18%) reported positive impacts. Another 2 in 10 Kentucky adults (21%) reported negative impacts.
Democrats and Republicans differed in their reports about the impact of the law on them personally. Three in 10 Democrats (31%) reported the law had positively affected them and their families, while only about 1 in 10 Republicans (11%) reported being positively affected. Conversely, 3 in 10 Republicans (29%) reported that the law had negatively affected them and their families, while 1 in 10 Democrats (9%) reported being negatively affected. A slim majority of Democrats (53%) and Republicans (53%) and 6 in 10 Independents (63%) reported that the health reform law had not had an impact on them.
1. U.S. Department of Health &Human Services. About the ACA. Accessed Dec. 8, 2018, from https://www.hhs.gov/healthcare/about-theaca/index.html.
2. Kaiser Family Foundation. Medicaid Waiver Tracker: Approved and Pending Section 1115 Waivers by State. Accessed Dec. 8, 2018, from
3. Centers for Medicare and Medicaid Services. Accessed Dec. 17, 2018 from https://www.medicaid.gov/medicaid/section-1115-demo/demonstration-and-waiver-list/?entry=39258.
4. KHIP asked, “As you may know, a health reform bill called the Affordable Care Act was signed into law in 2010. Do you feel you have enough information about the health reform law to understand how it will impact you personally, or not?”
5. KHIP asked, “Overall, which of the following statements would you say best describes the impact of the health reform law on you and your family personally: the health reform law has positively affected me and my family; the health reform law has negatively affected me and my family; or the health reform law has not had an impact on me and my family.”
Interact for Health regularly conducts research and collects data in order to monitor and evaluate our region’s health status and to measure public opinions about health policy.
Our Health in Action stories highlight the innovative work our grantees are doing to help reduce tobacco use, address the opioid epidemic and ensure that children can access health care through school-based health centers. We also interview people working on those issues at other organizations across the country to learn what works for them.
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