Insurance costs dominate public worries about healthcare, survey finds

Though President Obama's Affordable Care Act continues to animate political debate in Washington and on the campaign trail, Americans are more concerned with basic healthcare issues such as the cost of their health insurance, a new national poll shows.

The health law ranked eighth among issues voters identified as most likely to be extremely important to their vote for president this year, with 23% identifying the 2010 legislation, commonly called Obamacare.

Concern about how much people were paying personally for healthcare and health insurance tied for third, with 28% of voters saying the issue would be very important.

The top two issues were terrorism, cited by 38% of voters, and the economy and jobs, picked by 34%, according to the survey by the nonprofit Kaiser Family Foundation.

The findings underscore a transition underway in the national healthcare debate, nearly six years after the Affordable Care Act was enacted.

While the public remains deeply divided over the law, particularly along partisan lines, Americans increasingly point to pocketbook concerns including drug prices and surprise medical bills as issues they want elected officials to tackle.

At the same time, Americans also remain generally satisfied with their own health insurance and medical care, a sentiment illustrated again by the latest Kaiser poll.

These complex public sentiments are helping drive contrasting healthcare platforms from the 2016 presidential candidates.

The Republican contenders all pledge to repeal the health law, amid pledges to replace it with something that will further reduce costs.

Vermont Sen. Bernie Sanders is advocating an even more sweeping healthcare proposal that would move all Americans into a single government-run health insurance plan that he claims would lower their premiums.

Former Secretary of State Hillary Clinton, Sanders' rival for the Democratic nomination, has offered a more incremental platform that would build on the current law by imposing new regulations on drug makers and insurance companies.

"There has always been a bit of a disconnect between people's views of the overall healthcare system and their own personal experiences with medical care and health insurance," said Mollyann Brodie, who directs Kaiser’s polls.

Nearly three quarters of non-elderly adults with health coverage say they believe their insurance is worth the amount it costs, and more than 6 in 10 say their health plan is either an “excellent” or “good” value.

The Kaiser survey also picked up limited concern about narrowing insurance networks, even though health plans' moves to restrict the number of doctors and hospitals in their networks have gained increasing attention in the news media and among policymakers.

Just 12% of non-elderly Americans with insurance said they were “very dissatisfied” or “somewhat dissatisfied” with the choice of doctors in their health plan, while 87% said they were “very satisfied or somewhat satisfied."

Only 12% said they had needed to switch doctors in the previous 12 months because their doctor wasn’t in their health plan network; 5% said the change had been a big problem for them.

The poll was conducted Jan. 13-19 among a nationally representative sample of 1,204 American adults. The margin of sampling error is plus or minus 3 percentage points for the full sample.

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