WASHINGTON (AP) — With a bright look to its rebuilt website, version 2.0 of President Barack Obama’s health insurance overhaul represents another chance to win over a skeptical public.
But more than possible computer woes lurk as HealthCare.gov’s second open enrollment season begins Nov. 15.
The risks include an unproven system for those renewing coverage and a tax hit that could sting millions of people. Those tax issues are the result of complications between the health care law and income taxes, and they will emerge during next year’s filing season.
“Things will not be perfect,” said Health and Human Services Secretary Sylvia M. Burwell, trying to set expectations. “We are aiming for a strong consumer experience, and it will be better.”
The Obama administration cannot afford to repeat last year’s online meltdown. Congress will be entirely in Republican hands in 2015, and GOP lawmakers will be itching to build the case for repeal. The Supreme Court’s decision Friday to hear another challenge to the law is also casting a shadow.
The health insurance exchanges offer taxpayer-subsidized private coverage to people who do not have access on the job. HealthCare.gov will serve 37 states, while the rest run their own markets.
This new sign-up period will be the first time that renewal has been tried for current customers, and also overlaps with the first tax-filing season that the law’s requirements are in effect.
On the plus side, premium increases are expected to be modest in many, though not all, states. New insurers have come into the market, promoting competition, and regulators now take a close look at anything above a 10 percent increase.
The online application for most new customers is down to 16 screens from 76. Website security is better, thanks to aggressive monitoring. The government and insurers have added call center staff.
The administration had said last week that consumers would be able to get an early peek at 2015 plans and premiums this weekend. It looked like that early goal was slipping. Officials said Sunday that window shopping would be available overnight, without giving a specific time.
This year, the bar will be higher.
The Congressional Budget Office has projected that 13 million people will be covered through federal and state insurance markets in 2015. That means retaining most of the 7 million people now covered and adding 6 million more. Many are skeptics who sat out last year’s campaign.
One potential motivator: The law’s tax penalty for remaining uninsured is rising, to a minimum of $325 for 2015.
“We have some momentum built up,” said Rachel Klein, enrollment strategist for Families USA, an advocacy group supporting the law. “We can build on that, but it is a somewhat higher bar to find all the people we need to help, because by definition, they are harder to reach.”
An Associated Press-GfK poll found that 31 percent of those questioned expect the health insurance exchanges to work better, while 49 percent think they will work about the same. Also, 18 percent expect version 2.0 to be worse.
Some of the potential enrollment pitfalls:
—For those already signed up, coverage will renew automatically if you do nothing. Sounds good, but maybe not. You could miss out on lower premium options and get stuck with an outdated and possibly incorrect subsidy. Shop around, but don’t dally. You have until Dec. 15 to update your income information or change plans if you want to have everything in place by Jan. 1.
—New customers, be advised: The Nov. 15-Feb. 15 open enrollment is half as long as last time, and it overlaps with the holidays. Try to get familiar with some of the basic health insurance trade-offs. A low-premium silver or bronze plan may not make sense if you’ll wind up with high out-of-pocket costs for the deductible and copayments. In that case, you might be better off going for the gold.
Some of the tax complications lurking:
—Most current customers are getting a tax credit to help with premiums. Those subsidies are tied to income, so you’ll have to file new forms with your 2014 taxes to prove you got the right amount. Too much subsidy and your tax refund will get dinged. Too little, and the government owes you. It’s bound to cause anxiety because many people depend on their tax refunds to pay bills.
—If you remained uninsured in 2014, you risk a penalty that will be deducted from your tax refund. It starts at $95 for those uninsured all year. Millions of people may qualify for penalty waivers, but getting exemptions could be an ordeal. Some appear simple, but for others you’ll have to mail in an application and supporting documents.
Melissa Dresler of Lexington, Kentucky, said she’s lucky that she got covered, but she also learned some lessons that should make her a better shopper this year. The climate change researcher unexpectedly found herself in need of a delicate operation. She woke up one day and something was wrong with her right eye. It turned out to be a detached retina.
Her surgery cost well into five figures, and she paid about $1,000. The problem came when she had to go out-of-network because of a complication. To keep premiums in check, many plans restrict a patient’s choice. The follow-up corrective surgery cost her about $6,000.
“I may gripe once in a while, but I am so happy with Obamacare,” said Dresler. “I feel so lucky I was covered.”
She adds: “If I had known that I was going to have a major emergency then I would have certainly invested more in a better plan.”
DENVER (AP) — As a season of campaigning enters its final, intense weekend, a new Associated Press-GfK poll illustrates the challenge ahead for candidates and their allies trying to rally voters around traditional wedge issues such as abortion and gay marriage. This fall, voters just have other matters on their minds.
Social issues are eclipsed by concerns about the economy, health care, the Islamic State group and Ebola, the poll finds. And hovering over each of these individual issues is a broad dissatisfaction with President Barack Obama and Republican leaders in Congress.
Only 32 percent of likely voters called gay marriage an important issue, compared with 91 percent ranking the economy important, 78 percent with similar concerns about health care and 74 percent naming Ebola important. The issue that some Democrats have emphasized most of all — abortion rights — also has been a relatively low priority, with only 43 percent of likely voters in a September poll ranking it important.
Yet women’s health and reproductive rights have been at the center of campaigns for U.S. Senate in Alaska, Iowa, North Carolina and especially Colorado. There, half of the ads aired by Democratic Sen. Mark Udall and those backing his re-election have criticized his GOP opponent, Rep. Cory Gardner, on women’s health issues. They include a contention the 40-year-old congressman from eastern Colorado wants to ban some forms of birth control.
“Democrats this year clearly think that all that you need is that silver bullet of social issues,” said Katy Atkinson, a GOP political official in Denver. “It’s not. You need more.”
Gardner may have been able to parry the offensive by proposing that birth control pills be sold over-the-counter, without a prescription. After he began airing an ad on his proposal last month — as security concerns rose amid U.S. military action against the Islamic State group in the Middle East and the West Africa outbreak of the Ebola virus — Gardner moved ahead in public polls.
Gardner isn’t the only Republican to propose the sale of birth control over-the-counter. So, too, have Republicans running for Senate in North Carolina, Virginia and Minnesota.
The issue of access to birth control has also found its way into the Senate race in Iowa, where Democratic Rep. Bruce Braley has hammered his Republican opponent, state Sen. Joni Ernst, for her support of bestowing personhood status on a fetus. He says that would outlaw abortion, in-vitro fertilization and most kinds of contraception; she says she supports access to birth control and abortion in some circumstances.
Some voters have scoffed at the emphasis.
“They do a lot of yapping about how contraceptives have to do a lot with women’s health, which is a load of crap,” said Donald Johnson, 82, a staunch Republican in Clinton, Iowa. “If they want contraception, they can go and get it. It doesn’t cost that much. There’s no reason the government should be paying for it.”
On both abortion and same-sex marriage, recent AP-GfK polling has found likely voters more apt to trust Democrats than Republicans. But on issues that have captured more of voters’ attention this midterm season, such as the economy and protecting the country, Republicans have the advantage.
Republicans have emphasized terrorism and Ebola threats in the campaign’s closing days, though the poll suggests Ebola inspires less of a partisan preference than other issues.
Cindy Nath, a 59-year-old high school teacher in Colorado Springs, is most worried about economic inequality but also has concerns about reproductive freedom. A Democrat, she’s already cast an early ballot for Udall. But the issues her students discuss are very different — the Islamic State group and Ebola. “That’s what they’re talking about,” she said. “ISIS comes up every day.”
Women’s votes have shifted sharply between presidential years and midterm elections in recent contests, according to exit polling conducted for the AP and ABC, CBS, CNN, Fox and NBC. In 2012, women broke for Obama by an 11-point margin, while in 2010, when few candidates raised social issues as a major campaign theme, they split evenly between Democratic and Republican House candidates.
Atkinson noted that social issues usually poll low in priority but can be effective in defining candidates as too extreme. That’s how Democrats have won recently in Colorado. Although polling shows Udall slightly behind, his campaign believes he can win with a superior get-out-the-vote operation and by continuing to use women’s health issues to motivate key voting groups. Democrats are particularly targeting single women, whose participation dips in midterm elections.
The model is Sen. Michael Bennet’s 2010 come-from-behind win, where he similarly focused on women’s health. Still, a gender gap cuts both ways. Several recent polls in Colorado have shown Gardner’s advantage among men outpaces Udall’s among women.
But Jill Hanauer, a Denver-based Democratic strategist, said people should not mistake a temporary issue advantage for something permanent.
“Republicans have immediate issues to run on and Democrats have much broader, long-term ones like climate change and reproductive rights,” Hanauer said. “This election is one point in time, not a long-term trend.”
The AP-GfK Poll was conducted Oct. 16-20, using KnowledgePanel, GfK’s probability-based panel designed to be representative of the U.S. population. It involved online interviews with 1,608 adults and has a margin of sampling error of plus or minus 2.8 percentage points for all respondents.
Respondents were first selected randomly using phone or mail survey methods and later interviewed online. People selected for KnowledgePanel who didn’t otherwise have access to the Internet were provided with the ability to access the Internet at no cost to them.
Agiesta, AP’s director of polling, reported from Washington. Associated Press writers Stacy A. Anderson and Emily Swanson contributed to this report.
AP-GfK Poll: http://www.ap-gfkpoll.com
By DEB RIECHMANN and EMILY SWANSON, Associated Press
WASHINGTON (AP) — Sixty-five percent of Americans now say the threat from the Islamic State group is very or even extremely important, and nearly half think the U.S. military response in Iraq and Syria has not gone far enough, according to an Associated Press-GfK poll. Most want to see America’s partners step up their contribution to the fight,
Less than half, 43 percent, approve of the way President Barack Obama is handling the danger posed by the extremist militants.
Greg Franke, 24, of Columbia, South Carolina, was among the 55 percent of those who disapproved. Franke, a 24-year-old assistant editor at a research library, said he thought Obama was too hesitant in responding to the militants, who have employed brutal tactics to swiftly seize territory.
“I understand the need to be hesitant, but this was a group that was marching across parts of the Middle East, which is already unstable,” Franke said. “I think it warranted a swift and more decisive response.”
“I also think that his declaration that U.S. troops would not be involved was premature,” he said. “I don’t want U.S. troops involved. But I don’t think we need to close doors.”
A majority, 66 percent, favor the airstrikes the United States has been launching against the militants, yet 65 percent of those surveyed say Obama has not clearly explained America’s goal in fighting the Islamic State group. The president met with his national security team on Friday to discuss the Islamic State and talk via video teleconference with U.S. officials at the American Embassy in Baghdad and consulates in Irbil and Basra.
Here’s a look at the poll:
IS ENOUGH BEING DONE?
Forty-six percent said the U.S. military response has not gone far enough — up from 40 percent in September. Fifty-six percent said the military response from countries that have joined the U.S. in the fight against Islamic State militants has not gone far enough. The U.S. and partner countries, including Qatar, Saudi Arabia and the United Arab Emirates, have been bombing Islamic State targets since August.
“It shouldn’t just be us. It shouldn’t just be ‘Oh, the United States is policing.’ It should be everyone is there policing and everybody believes this is wrong and everyone — worldwide — is trying to stop this,” said Kathy Robinson, 24, a Sterling, Virginia, woman who works at an information technology company.
At the same time, she thinks the United States eventually will put troops on the ground in the region “just to make sure nothing starts back up — to keep the peace.”
Only 32 percent think Obama has done a good job in clearly stating U.S. policy against the IS group. More than six in 10 of them think it’s either not likely or only moderately likely that the U.S. and its partners will achieve their goal in fighting IS.
ARE AMERICANS FOLLOWING DEVELOPMENTS IN IRAQ, SYRIA?
While 47 percent of those surveyed said there’s a very or extremely high risk of another terror attack inside the United States, just a third said they have been keenly following the news about the U.S. military action against IS. An additional 38 percent said they were following the action somewhat closely, and 31 percent said they were keeping up not too closely or not closely at all.
DO PEOPLE SUPPORT THE AIRSTRIKES?
While Americans support the airstrike, when it comes to supporting the idea of deploying U.S. ground troops, respondents were more guarded.
Thirty-seven percent said they opposed putting American forces on the ground, 33 percent favored the idea and 28 percent said they were neither for nor against it.
Obama has said repeatedly that he has no plans to send ground troops to Iraq or Syria. However, 28 percent thought it was very or extremely likely that he would, and an additional 45 percent thought it was moderately likely. Just 24 percent said it was not likely.
Michael Rainwater, 64, of Sammanish, Washington, doesn’t particularly want to see U.S. troops sent in, but thinks they might be deployed at some point.
“I think all of these things tend to escalate,” he said. “You can’t keep pouring fuel on the fire and expect the fire to get smaller. So every time we bomb or send in armed drones, you are creating more terrorists.”
He does not think, though, that the Islamic State is in a position to mount a 9/11-style attack against the U.S.
Said Rainwater, a retired software company owner: “It is more of a criminal entity because basically what they are doing is kidnapping people for ransom, taking over oil refineries for the income.”
The AP-GfK Poll was conducted Oct. 16-20 using KnowledgePanel, GfK’s probability-based panel designed to be representative of the U.S. population. It involved online interviews with 1,608 adults, and had a margin of sampling error of plus or minus 2.8 percentage points for all respondents. Respondents were selected randomly using phone or mail survey methods, and later interviewed. People selected for KnowledgePanel who didn’t otherwise have access to the Internet were given free access.
By LAURAN NEERGAARD and EMILY SWANSON
WASHINGTON (AP) — Americans have at least some confidence that the U.S. health care system will prevent Ebola from spreading in this country but generally disapprove of the way President Barack Obama and the Centers for Disease Control and Prevention have handled the crisis so far.
Most disapprove of Obama’s handling of the Ebola outbreak, according to an Associated Press-GfK Poll. Just 1 in 5 approve of the CDC’s work on Ebola so far, and only 3 in 10 say they trust that public health officials are sharing complete and accurate information about the virus. And only 18 percent have deep confidence that local hospitals could safely treat a patient with Ebola.
Amid worry here, most Americans say the U.S. also should be doing more to stop Ebola in West Africa. Health authorities have been clear: Until that epidemic ends, travelers could unknowingly carry the virus anywhere.
“It seems to me we have a crisis of two things. We have a crisis of science, and either people don’t understand it or … they don’t believe it,” said Dr. Joseph McCormick, an Ebola expert at the University of Texas School of Public Health. And, “we have a crisis in confidence in government.”
Some findings from the AP-GfK poll:
HEALTH CARE GETS MIXED REVIEWS
Nearly a quarter of Americans are very confident the U.S. health care system could prevent Ebola from spreading widely, and 40 percent are moderately confident.
But nearly half don’t think their local hospital could safely treat an Ebola case, and 31 percent are only moderately confident that it could.
After all, Thomas Eric Duncan, the first Ebola patient diagnosed in the U.S., at first was mistakenly sent home by a Dallas emergency room, only to return far sicker a few days later. Then, two nurses caring for him somehow became infected. The family of one of the nurses, Amber Vinson, said Wednesday doctors no longer could detect Ebola in her as of Tuesday evening.
Asked how the Centers for Disease Control and Prevention handled those cases, 42 percent of people disapprove and 22 percent approve.
FEAR VS. KNOWLEDGE
Despite months of headlines about Ebola, nearly a quarter of Americans acknowledge they don’t really understand how it spreads. Another 36 percent say they understand it only moderately well.
Ebola doesn’t spread through the air or by casual contact, and patients aren’t contagious until symptoms begin. Ebola spreads through close contact with a symptomatic person’s bodily fluids, such as blood, vomit, feces, urine, saliva, semen or sweat.
People who say they do understand are less concerned about Ebola spreading widely in this country. Among those who feel they have a good grasp on how it spreads, 46 percent are deeply concerned; that rises to 58 percent among those who don’t understand it as well.
Likewise, a third of those with more knowledge of Ebola are confident in the health system’s ability to stem an outbreak, and 27 percent think their local hospital could safely treat it. Among those who don’t understand Ebola, fewer than 1 in 5 shares either confidence.
WHAT SHOULD BE DONE
A whopping 93 percent of people think training of doctors and nurses at local hospitals is necessary to deal with Ebola, with nearly all of them, 78 percent, deeming it a definite need.
Nine out of 10 also think it’s necessary to tighten screening of people entering the U.S. from the outbreak zone, including 69 percent who say that’s definitely needed.
Some would go even further: Almost half say it’s definitely necessary to prevent everyone traveling from places affected by Ebola from entering the U.S. Another 29 percent say it’s probably necessary to do so.
More than 8 in 10 favor sending medical aid to Ebola-stricken countries and increasing government funding to develop vaccines and treatments.
SOME NEW STEPS
The CDC had issued safe-care guidelines to hospitals long before Duncan arrived last month, and it made some changes this week after the unexpected nurse infections. Now, the CDC says hospitals should use full-body garb and hoods and follow rigorous rules in removing the equipment to avoid contamination, with a site manager supervising. Possibly more important, workers should repeatedly practice the donning and doffing and prove they can do it correctly before being allowed near any future patients.
While Duncan wasn’t contagious during his flight, his arrival spurred U.S. officials to begin checking passengers arriving from Liberia, Sierra Leone and Guinea for fever, an early Ebola symptom, just like they’re checked before leaving those countries.
Wednesday, the CDC moved to fill a gap in that screening: Starting next week, all of those travelers must be monitored for symptoms for 21 days, the Ebola incubation period. They’ll be told to take their temperature twice a day and must report the readings to state or local health officials.
That’s not just for West African visitors. It includes U.S. government employees, who had been doing their own 21-day fever watches upon return from fighting the epidemic, as well as doctors and other workers for aid organizations and journalists.
The AP-GfK Poll was conducted Oct. 16-20, using KnowledgePanel, GfK’s probability-based panel designed to be representative of the U.S. population. It involved online interviews with 1,608 adults and has a margin of sampling error of plus or minus 2.8 percentage points for all respondents. Respondents were first selected randomly using phone or mail survey methods and later interviewed online. People selected for KnowledgePanel who didn’t otherwise have access to the Internet were provided with the ability to access the Internet at no cost to them.
AP-GfK Poll: http://www.ap-gfkpoll.com