Last in a five-part series

Young Mainers – those in the 18-34 age demographic – are most critical of the Affordable Care Act, according to a new Portland Press Herald/Maine Sunday Telegram poll.

Overall, the poll shows Mainers are still deeply divided in their opinions of the six-year-old law, with 40 percent in favor of the ACA and 41 percent opposed, according to 609 randomly selected Maine adults in a survey conducted June 15-21 by the University of New Hampshire Survey Center.

Mainers still have a slightly more favorable view of the ACA than the nation as a whole, according to a Kaiser Family Foundation tracking poll. In monthly tracking polls over the past year, national opposition to the law has run 5 percentage points to 7 percentage points ahead of support for it. As of April, the national poll showed 49 percent of adults had an unfavorable view of the law, compared with 38 percent who support it.

“Clearly, the ACA is still a really partisan issue,” said Emily Brostek, executive director of Consumers for Affordable Health Care, an Augusta-based health advocacy group.

The ACA provides subsidized individual insurance for those earning between 100 percent and 400 percent of the federal poverty limit, up to $97,200 for a family of four. It has helped reduce the number of Americans without health insurance from 17 percent six years ago to 11 percent, according to the most recent Gallup poll.

“Do you favor or oppose the Affordable Care Act?”

But among Mainers ages 18-34 and with incomes less than $30,000 per year, the law that President Obama signed on March 23, 2010, is still deeply unpopular. Those two groups are the most likely to be affected by the ACA, according to health experts, because they are more likely to be purchasing individual insurance on the ACA’s health insurance marketplace.

For those who are least likely to be affected, such as seniors covered by Medicare and those earning $100,000 or more, the law is relatively popular, with 52 percent support among Mainers earning in the six figures or more.

PAYING PREMIUMS ON TIGHT BUDGETS

While the ACA has many components, the individual mandate – the requirement that people either must have employer-based coverage, purchase individual marketplace insurance or pay a penalty – has been controversial, with some arguing that the mandate impinges on personal freedoms.

Those in the 18-34 demographic have been slow to sign up for the ACA in Maine and nationally, despite the individual mandate.

Before the ACA became law, many young single people working in jobs that don’t offer health insurance, such as in the service industry, would go without insurance. But the law requires people to purchase insurance or pay a fine, while offering subsidies to help pay the costs.

“Have your medical costs increased, decreased or remained the same?”

Jake Acheson, 26, of Scarborough, who works as a bartender and server in the Old Port, purchased marketplace insurance for the first time this year because he could no longer stay on his parents’ health plan. The ACA allows people to stay on their parents’ health plan up to age 26.

“It feels good to have insurance,” Acheson said. “But it’s annoying to pay that bill every month.”

Acheson is not surprised that people in his age group tend to oppose the ACA, because they’re generally healthy and may not see the value of health insurance, but he believes having coverage is important.

“My parents always instilled in me the idea that when you’re sick, you go to the doctor,” said Acheson, an avid snowboarder.

Acheson, who earns about $20,000 per year, said he pays $167 per month in premiums for a midrange plan.

Brostek said that, based on Acheson’s income, he likely filled out the forms incorrectly, because people in his income category should be paying only about $25 to $50 per month in premiums, once the subsidies kick in. Brostek said if someone fills out incorrect information, they can get reimbursed upon doing taxes the following year.

SPREADING WORD ON AVA BENEFITS

Dr. Wendy Wolf, president and CEO of the Maine Health Access Foundation, an Augusta health advocacy group, said that especially for younger people, the value of insurance may seem remote.

“People do not feel the love for health insurance unless they need it,” Wolf said.

But as people age, health insurance becomes more important, and Wolf said that’s why the higher level of support among seniors is not surprising.

“Have you and your family been better off or worse off under the Affordable Care Act?”

“They’re seeing their friends have heart disease or cancer, and they realize that might be them next time,” she said.

Wolf said the law is complex and confusing to people, even though it benefits millions.

Brostek said she’s seen national polls indicating that when individual parts of the ACA are asked about, support for the law increases. For instance, people are generally supportive of the ban on insurance companies denying coverage of pre-existing conditions – which was routine before the ACA was passed – and that children can stay on their parents’ health plans through age 26.

Lisa Letourneau, executive director of Maine Quality Counts, a group that advocates on a variety of health issues, said supporters of the ACA still have work to do to show how the law is improving the health care system and protecting people from financial difficulties when they fall ill.

“We need to do a better job letting people know about the benefits,” she said.

The Portland Press Herald/Maine Sunday Telegram Poll was conducted by the University of New Hampshire Survey Center from June 15-21, 2016. Results are based on landline and cellular telephone interviews with 609 randomly selected Maine adults and 475 randomly selected likely Maine voters. The poll has a margin of error of plus or minus 4 percentage points for all adults and plus or minus 4.5 percentage points for likely voters.