Americans Weigh in on the 2010 Health Care Law

March 29^th marks the completion of the final day of the Supreme Court’s health care hearings.  The Court is expected to make its ruling in late June.  In conjunction with the final day of arguments, The New York Times released its polling data on the public’s support and comprehension of the Affordable Care Act and its implications.  The poll finds that 47% of Americans disapprove of the legislation, while 36% approve.  In addition, while the public can only speculate on the outcome of the health care hearings, the American people have specific opinions on how the Supreme Court should handle the case.  26% believe the law should remain intact, 29% favor overturning the individual mandate, and 38% would prefer the Court to find the entire law unconstitutional.  Americans are much more favorable of the law’s specific provisions.  

Aside from the individual mandate (51% of Americans disapprove of the Affordable Care Act’s requirement that Americans purchase health insurance), the majority of Americans support: (1) the Act’s requirement that health insurance companies cover those possessing existing medical conditions, (2) The provision permitting children to remain on their parents’ policies until age 26, and (3) the Affordable Care Act’s attempt to close the prescription drug coverage gap, commonly known as the “doughnut hole.” 

In terms of the personal effects of the 2010 health care law, most Americans believe the legislation will not have much effect on their overall health care benefits or the quality of care they receive, but they do expect their health care costs to increase as a result of the legislation.

Lastly, it appears that many Americans are confused with how the Affordable Care Act will affect them and their families.  48% of the public does not understand the 2,700-page act and the effects it will have on their families, while 47% say they do understand the law.  

Employer-Sponsored Health Insurance On the Decline

Paul Krugman and Reed Abelson, writing with the New York Times, recently highlighted a study displaying the trends within the sources of health insurance for nonelderly Americans.  The study, carried out by the National Institute for Health Care Reform (NIHCR), looked at the form of health insurance coverage for Americans from 2001 to 2010.  The study found that the share of Americans under 65 who receive coverage from Medicaid has risen over 8 percent, up from 9.5 percent in 2001 to 17.6 percent in 2010.  This trend illustrates the paradox of government-sponsored insurance in times of a recession; as people begin to lose their jobs and income, they are more likely to fall under the umbrella of Medicaid.  With the diminishing revenue from income tax, however, the state and federal governments have less funds to support Medicaid.  When a recession hits, more people need Medicaid, but there is less money to fund the program.  The NIHCR data displays this trend, but it also shows the rapidly declining percentage of nonelderly Americans who receive health insurance from their employer.  The share of Americans under 65 who receive employer-sponsored coverage is down from 69.8 percent in 2001 to 53.5 percent in 2010.  This severe drop in employer-sponsored coverage can be attributed to the rise in unemployment over the past decade in conjunction with the decline of employers willing and/or able to provide coverage to employees.  The final notable trend illustrated in the NIHCR study was the growing number of uninsured nonelderly Americans.  The share of Americans under 65 who remain uninsured rose from 14.1 percent in 2001 to 19.5 percent in 2010.  The recession clearly had notable impacts on health insurance coverage, but it will be interesting to see how the recently passed Affordable Care Act, which will not be fully implemented until the beginning of 2015, will affect the NIHCR’s numbers in the future.  In addition, the constitutionality of the Affordable Care Act (specifically, the individual mandate) is currently under review by the Supreme Court, so the outcome of the case will also have significant implications for health insurance coverage.

Unemployment By Industry

In one of the New York Time’s Economix blog posts, Motoko Rich discusses changes in the unemployment rate by industry from February 2011 to February 2012, as reported by the Bureau of Labor Statistics.  While unemployment remained relatively unchanged at 8.3 percent in February “mainly because more people started – or resumed – looking for work,” the data released by the Bureau of Labor Statistics shows quite a bit of variability in unemployment between industries.  For example, as the table from the Bureau of Labor Statistics above shows, construction experienced a 4.7% decrease (from 21.8 % to 17.1%). Agriculture; information; and mining, quarrying, and oil and gas extraction all saw increases in unemployment of 1.1%, 1.7% and 1.6% respectively.  In addition to changes in unemployment rate, the rates themselves also vary widely; agricultural workers experienced an unemployment rate of 19.5% while government workers experienced only 3.9% unemployment.

New Study Shows Teachers--and Test Scores--Matter in the Long-Term

A new study by three economists suggests that elementary- and middle-school teachers who help increase their students' standardized-test scores have a significant, positive and lasting impact on those students' lives in the long term. Their influence extends beyond academics, as good teachers also mean "lower teenage-pregnancy rates and greater college matriculation and adult earnings," writes the New York Times. The study tracked the lives of 2.5 million students over 20 years, "allowing for a deeper look at how much the quality of individual teachers matters over the long term."

Although the economists set out to challenge the use of value-added ratings, which according to the Times "measure the impact individual teachers have on student test scores," researchers ultimately found that "controlling for numerous factors, including students’ backgrounds...the value-added scores consistently identified some teachers as better than others, even if individual teachers’ value-added scores varied from year to year." They concluded that "using value-added scores would lead to fewer mistakes, not more."

And the positive effect of teachers who increased student test scores was striking. The Times notes, "Replacing a poor teacher with an average one would raise a single classroom’s lifetime earnings by about $266,000, the economists estimate. Multiply that by a career’s worth of classrooms." The researchers surmise that the same results would be obtained by replacing an average teacher with an excellent teacher: "Given the difficulty of finding, training and retaining outstanding teachers...the difference in long-term outcome between students who have average teachers and those with poor-performing ones is as significant as the difference between those who have excellent teachers and those with average ones."

The positive effect of an excellent teacher on one individual student is less impressive than that teacher's potential impact on the entire class taken together, of course. "All else equal, a student with one excellent teacher for one year between fourth and eighth grade would gain $4,600 in lifetime income, compared to a student of similar demographics who has an average teacher. The student with the excellent teacher would also be 0.5 percent more likely to attend college." Still, "students with top teachers are less likely to become pregnant as teenagers, more likely to enroll in college, and more likely to earn more money as adults."

The study will likely add fuel to the value-added score debate, as many people--and teachers' unions--"say that isolating the effect of a given teacher is harder than it seems, and might unfairly penalize some instructors." The researchers of this study are firmly on the other side: "The authors argue that school districts should use value-added measures in evaluations, and...remove the lowest performers." One of the researchers, Harvard Professor John N. Friedman, was quoted in the Times as saying, “The message is to fire people sooner rather than later.”