STEVE INSKEEP, HOST:
The Senate overnight voted to approve a budget resolution which amounts to the first step of a repeal of the Affordable Care Act, also known as Obamacare. There's a long, long, long way to go. Republicans and Democrats have yet to agree on a replacement. And this huge national debate is happening amid a cloud of misinformation. That's according to a new NPR Ipsos poll. They asked what people know about the law and found that many of us are misinformed. Joining us this morning is NPR health policy correspondent Alison Kodjak to talk about the survey's findings. Hi, Alison.
ALISON KODJAK, BYLINE: Hi, Steve.
INSKEEP: So what do we think we know that we don't know?
KODJAK: Well, you know, there's just a lot of information that people are slightly or very much misinformed about. The poll is designed to gauge what people know about basic facts. And the biggest surprise, I think, was that more - about half the people - a little bit more - don't even know that the Affordable Care Act has extended insurance to millions of people who didn't have it anymore. The insurance rate - I mean, the rate of uninsured people has gone down to 9 percent which is the lowest in the nation's history, sort of the one basic piece of information that the government probably - the Obama administration probably wants out there and half the people in the country don't know that that's happened.
INSKEEP: I've wondered if this is one of the disadvantages of this law from the beginning. I mean, if you think about Social Security or Medicare, we may be confused about some of it, but we basically get what it is. This is a complicated law, and peace - people from the very beginning didn't basically get what it was.
KODJAK: That's true. And it was, you know, brought in under a huge amount of controversy. People knew that they were going to be, quote, "forced to buy insurance." And then when the law...
INSKEEP: Which is actually true. That part is true, yeah.
KODJAK: It is true. It is true. But what was lost in a lot of the debate was the extension of Medicaid to a lot of people who get Medicaid now who weren't eligible before, so low-income people now are insured who weren't before. And what was lost was some of the ways that the government helps people get insurance. And this law really only applies to a small portion of the population, now 10 million people - but this part of the law.
So most of the people who are thinking about it and talking about it and, perhaps, voting on it, it doesn't affect them directly. Also, the effects of the law happened years after the debate happened. So all this negative info was in the air already, and that sticks with people. I talked to a lot of experts in communication. They say once you get a first impression that's bad, it's really hard to make it good again.
INSKEEP: With that said, is there something real about people's concerns here? They know what they pay for insurance. They know whether they like their insurance or they don't like their insurance, and they're basically expressing a concern. Is that true?
KODJAK: Yes. That's absolutely true. And one of the big concerns is that over time, people who bought insurance on the Affordable Care Act exchanges saw the top-line rates for the insurance go up, and that meant people who don't - aren't eligible for subsidies saw their prices shoot way up. And at the same time generally, some of the insurance benefits on the market overall also were cut back and prices went up, so that people see their insurance rates go up anywhere and they blame it on the Affordable Care Act.
INSKEEP: So the president-elect has made a big promise here along with Republicans in Congress - going to replace it with something that is better and yet cheaper. What's the status of the repeal and the talk at least of replacement?
KODJAK: Well, as you said at the beginning, they're working on the repeal. They're talking about replacement. There's been no replacement plan proposed yet. And so it's unclear what's going to come in in the place of this law.
INSKEEP: And so that's - what? - weeks of debate, months of debate, who knows how much debate?
KODJAK: It looks like it's going to be at least weeks of debate because in the last few days, the Congress has said they want to replace it at the same time as they repeal it. So they're going to have to come up with that plan.
INSKEEP: Well, we'll see what happens. That's NPR's Alison Kodjak. Thanks very much for coming by.
KODJAK: Thanks for having me, Steve.