By RICARDO ALONSO-ZALDIVAR and JENNIFER AGIESTA, Associated Press

 WASHINGTON (AP) — They may not like it, but they don’t see it going away. About 7 in 10 Americans think President Barack Obama’s health care law will go fully into effect with some changes, ranging from minor to major alterations, an Associated Press-GfK poll finds.

 Just 12 percent say they expect the Affordable Care Act — “Obamacare” to dismissive opponents — to be repealed completely.

 The law — covering 30 million uninsured, requiring virtually every legal U.S. resident to carry health insurance and forbidding insurers from turning away the sick — remains as divisive as the day it passed more than two years ago. After surviving a Supreme Court challenge in June, its fate will probably be settled by the November election, with Republican Mitt Romney vowing to begin repealing it on Day One and Obama pledging to diligently carry it out.

 That’s what the candidates say. But the poll found Americans are converging on the idea that the overhaul will be part of their lives in some form, although probably not down to its last clause and comma.

 Forty-one percent said they expect it to be fully implemented with minor changes, while 31 percent said they expect to see it take effect with major changes. Only 11 percent said they think it will be implemented as passed.

 Americans also prefer that states have a strong say in carrying out the overhaul. The poll found that 63 percent want states to run new health insurance markets called “exchanges.” They would open for business in 2014, signing up individuals and small businesses for taxpayer-subsidized private coverage. With many GOP governors still on the sidelines, the federal government may wind up operating the exchanges in half or more of the states, an outcome only 32 percent of Americans want to see, according to the poll, which was developed with researchers from Stanford University and the University of Michigan.

 Finally, the poll found an enduring generation gap, with people 65 and older most likely to oppose the bill and those younger than 45 less likely to be against it.

 ”People are sort of averaging out the candidates’ positions,” said Harvard School of Public Health professor Robert Blendon, who tracks polling on health care issues. “The presidential candidates are saying there’s a stark choice, but when you ask the voters, they don’t believe that the whole bill will be repealed or implemented as it is today in law.”

 Republicans remain overwhelmingly opposed to the overhaul and in favor of repeal. But only 21 percent said they think that will actually come about.

 Romney supporter Toni Gardner, 69, a retired school system nurse from Louisville, Ky., said that until a few weeks ago she was sure her candidate fully supported repeal, as she does.

But then Romney said in an interview there are a number of things he likes in the law that he would put into practice, including making sure that people with pre-existing medical problems can get coverage. The Romney campaign quickly qualified that, but the candidate’s statement still resonates.

 ”If Romney gets in, he’ll go with parts of it,” Gardner said, “and there are parts of that he won’t go with.”

 Gardner thinks expanding coverage will cost too much and may make it harder to get an appointment with a doctor. Besides, she doesn’t believe the government can handle the job. She’s covered by Medicare — a government-run health system — but says “that wasn’t a choice that I had.”

 At 26, Santa Monica, Calif., web developer Vyki Englert has only bare-bones health insurance coverage. Her parents, a preschool teacher and a self-employed photographer, are uninsured. Englert says she thinks the law will largely go into effect as passed. (Among 18- to 29-year-olds, 60 percent think it will be implemented with only minor changes or none at all.)

 Englert says that she supports guaranteeing coverage to people with health problems and that provisions such as broader coverage for birth control will help younger women such as her.

 ”I kind of see a day-to-day way where this law could benefit me,” she said. Englert says the health care law dovetails with a trend toward consumerism in her generation. Older Americans “don’t have the context of the young people,” she added. “They are looking more at the theoretical impact on the budget and the country.”

 Overall, the poll found Americans divided on the question of repeal, with neither side able to claim a majority. Forty-nine percent said the health care law should be repealed completely, while 44 percent said it should be implemented as written.

 The notion that the law will be implemented with changes, captured in the poll, mirrors a discussion going on behind the scenes in Washington, particularly among some Republicans.

 ”Whoever wins the election, the (health care law) is going to be modified,” Mark McClellan, who ran Medicare under former President George W. Bush, said in a recent interview.

Congressional Republicans say if tax increases are on the table in a budget negotiation with a re-elected Obama next year, changes to the health care law — including possible delays in implementation — also must be considered. For now, White House officials refuse to be drawn in on that question.

 Some parts of the law already are in effect; its big coverage expansion for the uninsured doesn’t come until 2014.

 Public opinion about the law itself has barely budged since the summer of 2010, soon after it passed. At the time, 30 percent supported the law. It’s now 32 percent. And 40 percent opposed the overhaul. That’s now 36 percent.

 And misconceptions about the law that reigned two years ago continue to live on, including former Alaska Gov. Sarah Palin’s widely debunked charge that it would create “death panels” to decide on care for the elderly and disabled. In 2010, 39 percent believed the law would set up committees to review individual medical records and decide who gets care paid for by the government. Forty-one percent currently hold that view, according to the poll.

 The poll asked people to say whether 18 different items were in the law or not and to rate how certain they were about their answers. Just 14 percent were right most of the time and sure of it.

Still, knowledge about what the law actually does is growing. More people are aware of provisions that allow adult children to stay on their parents’ coverage until age 26, impose insurance mandates on individuals and businesses, and protect those with pre-existing medical conditions.

 The poll was conducted Aug. 3-13 and involved interviews with 1,334 randomly chosen adults nationwide. It has a margin of sampling error of plus or minus 3.4 percentage points.

The survey was conducted online by GfK using its KnowledgePanel sample, which first chose people for the study using randomly generated telephone numbers and home addresses. Once people were selected to participate, they were interviewed online. Participants without Internet access were provided it for free.

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AP News Survey Specialist Dennis Junius contributed to this report.

 

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Topline results are available at http://www.ap-gfkpoll.com and http://surveys.ap.org.

Online:

http://www.ap-gfkpoll.com

AP-GfK Poll: End game: No immigration deal, just divisions

WASHINGTON (AP) — A Congress that began with bright hopes for immigration legislation is ending in bitter divisions on the issue even as some Republicans warn that the political imperative for acting is stronger than ever for the GOP.

In place of a legislative solution, President Barack Obama’s recent executive action to curb deportations for millions here illegally stands as the only federal response to what all lawmakers agree is a dysfunctional immigration system. Many Democrats are convinced Latino voters will reward them for Obama’s move in the 2016 presidential and Senate elections, while some Republicans fear they will have a price to pay.

“If we don’t make some down payment toward a rational solution on immigration in 2015, early 2016, good luck winning the White House,” said Republican Sen. Lindsey Graham of South Carolina, an author of the comprehensive immigration bill that passed the Senate last year with bipartisan support, but stalled in the GOP-led House.

With the expiration of the 113th Congress this month, that bill will officially die, along with its path to citizenship for the 11 million immigrants in this country illegally.

Immigration is certain to be a focus for the new, fully Republican-led Congress when it convenes in January — but there’s little expectation the GOP will make another attempt at comprehensive reforms.

Instead, GOP leaders in the House and Senate have pledged to take action to block Obama’s executive moves, setting up a battle for late February when funding expires for the Department of Homeland Security, which oversees immigration matters. House Speaker John Boehner, R-Ohio, has promised action on a border security bill as part of that.

Whether Congress can do anything to stop Obama remains unclear, since he’s certain to veto any effort to undo his executive moves. It’s also not clear lawmakers could pass a border bill, or that Obama would sign it if they did.

While some congressional Republicans are arguing for action on piecemeal reforms, most advocates are resigned to waiting until a new president takes office in 2017 for lawmakers to make another attempt at a comprehensive overhaul that resolves the central immigration dilemma — the status of the millions here illegally.

“They had the best chance in a generation and they couldn’t get enough support from the Republican caucus,” said Frank Sharry, executive director of America’s Voice, an immigrant advocacy group. “It may well be that they’re going to have to lose the White House and both chambers of Congress for us to get comprehensive immigration reform.”

When Obama won a second term in 2012 with strong Hispanic and Asian support, many national Republican leaders decided they needed to support policies that would attract those growing blocs of voters. The Republican National Committee formally embraced support for comprehensive immigration reform as a guiding principle for the GOP.

But legislative efforts stalled in the House as conservative Republicans balked at Boehner’s efforts to advance the issue. Last summer’s crisis over an influx of unaccompanied Central American minors arriving at the border caused shelter overloads and case backlogs, straining resources and creating the impression that the border was out of control — further souring political prospects for reform legislation.

In absence of congressional efforts, Obama promised he would act on his own, and he made good on that shortly after last month’s midterm elections, announcing an array of changes that will include work permits and three-year deportation stays for some 4 million immigrants here illegally. It mostly applies to those who’ve been here more than five years and have kids who are U.S. citizens or legal permanent residents.

The move inflamed Republicans, who have been fighting about it ever since, including a failed effort by Sen. Ted Cruz, R-Texas, to block Obama in a Senate floor vote this past weekend. On Tuesday the dispute spilled over into debate on Obama’s nominee to lead the Immigration and Customs Enforcement agency, Sarah Saldana, the U.S. attorney in Dallas. She was confirmed 55-39 by the Senate over objections from Republicans who had initially supported her but turned against her because of her support for Obama’s executive actions.

Meanwhile, some immigration advocates complained that the steps didn’t go far enough as Obama faced criticism from both sides of the political divide.

A new Associated Press-GfK poll found that most Americans support allowing immigrants living in the country illegally a way to stay here lawfully. But only 43 percent of them think Obama was right to take executive action to make those changes, while 54 percent of them say he should have kept trying to make a deal with Republicans. Still, the poll also showed little sign of blowback for Obama. Although 57 percent disapprove of Obama’s handling of the immigration issue, that was down slightly from 63 percent in October.

A group of 24 states joined in a federal lawsuit filed in Texas alleging that Obama overstepped his constitutional powers in a way that will only worsen the humanitarian problems along the southern U.S. border. And Arizona Sheriff Joe Arpaio is in federal court in Washington, contending that the policy is a magnet for more illegal entries into the country that will impose a burden on law enforcement.

In a court filing late Monday, the Justice Department argued for dismissal of Arpaio’s case, saying he has failed to substantiate his claims.

Congressional Republicans say that Obama’s actions created an even tougher climate for immigration legislation, but many Democrats and advocates contend that Republicans were terminally stalled on the issue anyway. Some Republicans question whether immigration legislation really is a political imperative for the GOP. “It’s really mixed out there — some people want a big immigration bill, others don’t,” said Sen. Orrin Hatch, R-Utah, a supporter of reform efforts.

And two years after a “Gang of Eight” senators launched an immigration overhaul drive on Capitol Hill, some of those same players say they have no plans to initiate another such effort.

“I’m not going to start it in the Senate,” said Sen. John McCain, R-Ariz. “We’ve tried that.”

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Associated Press News Survey Specialist Emily Swanson and writer Pete Yost contributed to this report.


AP-GfK Poll: Crunch time again for health insurance sign-ups

By Ricardo Alonso-Zaldivar

WASHINGTON (AP) – President Barack Obama’s push to cover America’s uninsured faces another big test Monday.

 

This time, it’s not only how the website functions, but how well the program itself works for millions who are starting to count on it.

 

Midnight Monday, Pacific time is the deadline for new customers to pick a health plan that will take effect Jan. 1, and for current enrollees to make changes that could reduce premium increases ahead of the new year.

 

HealthCare.gov and state insurance websites are preparing for heavy online traffic before the deadline, which gives consumers in the East three hours into Tuesday to enroll.

 

Wait times at the federal call center started creeping up around the middle of last week, mainly due to a surge of current customers with questions about their coverage for next year. Many will face higher premiums, although they could ease the hit by shopping online for a better deal. Counselors reported hold times of 20 minutes or longer for the telephone help line.

 

About 6.7 million people now have coverage through Obama’s signature law, which offers subsidized private insurance. The administration wants to increase that to 9.1 million in 2015. To do that, the program will have to keep most of its current enrollees while signing up more than 2 million new paying customers.

 

People no longer can be turned down because of health problems, but picking insurance still is daunting for many consumers. They also have to navigate the process of applying for or updating federal subsidies, which can be complex for certain people, including immigrants. Many returning customers are contending with premium increases generally in the mid-to-high single digits, but much more in some cases.

 

Consumers “understand it’s complicated but they appreciate the ability to get health insurance,” said Elizabeth Colvin of Foundation Communities, an Austin, Texas, nonprofit that is helping sign up low-income residents. “People who haven’t gone through the process don’t understand how complicated it is.”

 

Last year’s open enrollment season turned into a race to salvage the reputation of the White House by fixing numerous technical bugs that crippled HealthCare.gov from its first day. With the website now working fairly well, sign-up season this year is a test of whether the program itself is practical for the people it is intended to serve.

 

New wrinkles have kept popping up, even with seemingly simple features of the Affordable Care Act.

 

For example, most current customers who do nothing will be automatically renewed Jan. 1 in the plan they now are in. At this point, it looks like that is what a majority intends to do.

 

While that may sound straightforward, it’s not.

 

By staying in their current plans, people can get locked into a premium increase and miss out on lower-priced plans for 2015. Not only that, they also will keep their 2014 subsidies, which may be less than what they legally would be entitled to for next year.

 

Doing nothing appears to be a particularly bad idea for people who turned 21 this year, according to the Center on Budget and Policy Priorities, a Washington group that advocates for low-income people.

 

Researchers at the center estimate that 21-year-olds will see a 58 percent increase in the sticker price for their premiums just because they’re a year older. An age-adjustment factor used to compute premiums jumps substantially when a person turns 21. A 20-year-old whose premium was $130 per month in 2014 will see the premium climb to $205 a month in 2015, solely because of that year’s difference.

 

Tax-credit subsidies can cancel out much or even all of the impact. But if consumers default to automatic renewal, their tax credits will not be updated and they will get the same subsidy as this year.

 

“Even in the best possible scenario of how many people we can expect to come in, we will still see a substantial number of people defaulting,” said Judy Solomon, a health care policy expert at the center. She worries that some young adults may get discouraged and drop out.

 

Reviews of HealthCare.gov and state health insurance exchanges are mixed.

 

An Associated Press-GfK poll this month found that 11 percent of Americans said they or someone else in their household tried to sign up since open enrollment began Nov. 15. Overall, 9 percent said the insurance markets are working extremely well or very well. Twenty-six percent said the exchanges are working somewhat well, and 39 percent said they were not working well. The remaining 24 percent said they didn’t know enough to rate performance.

 

So far it has been a frustrating experience for Marie Bagot, of Fort Lauderdale, Florida. She and her husband are in their 60s, but not yet old enough for Medicare. The husband, who works as a chef, will turn 65 around the middle of next year and qualify for Medicare. Bagot said they were happy with their insurance this year under Obama’s law.

 

“As you get older, you worry about your health,” she said. “I was very pleased with the price we got.”

 

But Bagot said she received a notice from her insurer that her current plan will not be available next year in her community. The closest alternative would involve a premium increase of more than $350 a month, even with their tax credit subsidy. After days of trying to find a comparable plan through the federal call center and after visiting a counselor, Bagot said she opted to keep their current coverage, while hoping costs go down after her husband joins Medicare.

 

“I cannot afford it, but I’m going to try to,” she said.

 

Monday is not the last chance for consumers like Bagot. Open enrollment doesn’t end until Feb. 15.

 

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Associated Press Director of Polling Jennifer Agiesta contributed to this report.