As Obamacare debate rages, most in N.J. say health insurance system 'on wrong track'

Just eight percent of New Jersey residents do not have health coverage, and the majority receive it through their job, according to a poll by the Eagleton Center for Public Interest Polling at Rutgers University. (Dreamstime)

The Affordable Care Act helped dramatically reduce the number of people who lack health coverage in New Jersey, but those who signed up are least satisfied with their coverage because of cost, according to a poll released Monday.

People who bought their coverage through the Obamacare health exchange were the most likely to say cost drove their decision -- not because they liked the network of doctors or they wanted to maintain the same coverage from the prior year, according to the findings by the Eagleton Center for Public Interest Polling and the New Jersey Health Care Quality Institute.

"This group is the least satisfied about current costs and thus considers cost most when it comes to choosing a plan," said Ashley Koning, assistant research professor and director of the Eagleton Center at Rutgers University-New Brunswick. "They are the only group to cite this as their top reason and do so by a 3-to-1 margin or more over every other demographic."

But when all 1,203 people who participated in the poll were asked whether the health care and insurance systems were "going in the wrong direction" or were "on the right track," 52 percent responded negatively, 37 positively and 12 percent said they did not know.

Linda Schwimmer, president & CEO of the New Jersey Health Care Quality Institute, said the poll "confirmed what we're hearing on the ground - affordability and the value of available plans remain major issues among residents purchasing in certain markets."

"The Affordable Care Act was effective in increasing coverage, but there's more to be done to make that coverage affordable. This is especially true for small businesses and individuals above 400 percent of the federal poverty level who are purchasing insurance on their own and not receiving subsidies. They are feeling the brunt of a health care system's costs that are ever increasing," Schwimmer said.

The fate of the landmark health care law is in the hands of the Trump administration and the Republican-led Congress, which have repeatedly attempted to repeal the ACA.

The tax cuts President Trump signed into law last year included the repeal of the individual mandate -- the requirement that all people must be insured or face a penalty at tax time. Without the mandate, experts predict the health exchange will be dominated by sick or older policy holders, which could drive up costs even further.

On Sunday, Gov. Phil Murphy issued an executive order that directs all state agencies to promote enrollment in the Affordable Care Act marketplace.

"President Trump has attempted to undermine access to affordable health care at every turn," Murphy said in his announcement.

"By stepping in at the state level, better advertising ACA enrollment periods, and properly coordinating efforts to raise awareness at our state agencies, we can help combat those efforts and make sure that New Jersey residents don't miss out on registering for vital health insurance."

Interest in enrollment has been strong.

Just 560,000 out of the 7 million adults who call New Jersey home lack health insurance, the poll said. Three times as many people lacked coverage before the landmark health care law took effect in 2014. About 550,000 enrolled in the Medicaid program who had not been eligible before; 268,000 enrolled through the exchange.

But the people who reported the most satisfaction with their insurance plan received coverage through their jobs, which represent 56 percent of all adults, followed by Medicare, the program for senior citizens that covered about one in five residents, the survey found.

Eight percent have Medicaid, the program for the poor and people with disabilities, and 10 percent purchased a plan themselves either from an insurance company or marketplace.

The findings are based on the responses from 1,203 adults interviewed by phone from Nov. 15-27, 2017. The margin of error is 2.8 percentage points.

Susan K. Livio may be reached at slivio@njadvancemedia.com. Follow her on Twitter @SusanKLivio. Find NJ.com Politics on Facebook.

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