During a Senate Finance hearing, Chair Max Baucus (D-Mont.) warned Health and Human Services (HHS) Secretary Kathleen Sebelius that her department has not adequately informed the public and small businesses about the Affordable Care Act, which he stated could result in a “train wreck” during its implementation.

The Senator cited a March Kaiser Family Foundation poll that found large percentages of respondents believe inaccurate information regarding the ACA’s provisions. In the poll, sixty-seven percent of uninsured respondents under age 65 and 68 percent of respondents with annual household incomes under $40,000 said they have an inadequate understanding of the law.

Few respondents said they knew about their states’ decisions on two key components of the ACA: the creation of health insurance exchanges and the expansion of Medicaid. Forty-eight percent of respondents have heard “nothing at all” about their state’s decision on the online insurance marketplaces, while 78 percent said they are not aware of their state’s position on the Medicaid expansion.

Senator Baucus said, “I’m concerned that a lack of clear information is leading to misconceptions and misinformation, and people generally dislike what they don’t understand,” adding that he would give the administration’s outreach efforts so far a “failing grade.”

Secretary Sebelius responded that the agency takes public education “very, very seriously,” but did not provide specific details on efforts. The Secretary noted that the administration plans to roll out a large-scale public education campaign this summer and that the government is “on track” to begin enrollment in the ACA’s health insurance exchanges this October.

The poll also found:

  • 88% of respondents said they support the idea of providing small businesses with tax credits to offset the cost of health insurance coverage, but just 52% indicated that they know the ACA provides such tax credits; and
  • 74% of respondents are aware of the ACA’s individual mandate, but only 40% said they support the minimum coverage requirement.

The poll also found that misinformation about the ACA still is widespread, with:

  • 57% of respondents stating incorrectly that the law includes a “public option;”
  • 44% stating incorrectly that the law cuts Medicare benefits;
  • 40% stating incorrectly that the law creates a federal “death panel” that will make decisions about end-of-life care;
  • 33% stating incorrectly that the law will not close the Medicare drug prescription coverage gap known as the “doughnut hole;” and
  • 27% stating incorrectly that the law will not raise the Medicare payroll tax for U.S. residents with higher incomes.

Meanwhile, 58 percent of respondents believe the national cost of health care has been increasing at a higher rate than normal in recent years, despite reports indicating a significant deceleration in the growth of health care spending. In terms of overall public opinion about the ACA, 40% hold an unfavorable view of the law and 37 percent a favorable view. Based on party affiliation, 58% of self-identified Democrats and 18% of self-identified Republicans said they support the law.