Most rural Nebraskans think the country as a whole will be worse off under the new health care reform law. Just over one-half (54%) of rural Nebraskans think the country as a whole will be worse off under the new health care reform law; only nine percent think it will be better off under the new law and over one-quarter (26%) are unsure of the impacts of the reform on the country. Similarly, the majority of rural Nebraskans (52%) think self-employed individuals will be worse off under the new health care reform law. Only eight percent think self-employed individuals will be better off under the new health care law and over one-quarter (28%) are unsure of the impacts on self-employed individuals.

Rural Nebraskans are also more negative than positive about the perceived impact of the new health care law on the following groups: middle class Americans, people age 65 and older, their family, people with pre-existing health issues, and children. As an example, almost one-half (46%) of rural Nebraskans think they and their families will be worse off under the new law, compared to only five percent who think they will be better off. Only one group (people currently without health insurance) had a higher percentage of rural Nebraskans saying they would be better off under the new health care reform law than worse off. Over one-third (35%) of rural Nebraskans think people currently without health insurance will be better off under the new law, compared to 27 percent who think they will be worse off. The proportion of rural Nebraskans saying lower income Americans would be better off under the new law (31%) was statistically equal to the percentage saying they would be worse off (30%).

In general, do you think the following groups will be better or worse off under the health care reform law, or don’t you think it will make much difference?

 

Worse off

Not much difference

Better off

Unsure

The country as a whole

54%

11%

9%

26%

Self-employed individuals

52%

12%

8%

28%

Middle class Americans

48%

21%

8%

24%

People age 65 and older

47%

20%

7%

26%

You and your family

46%

27%

5%

22%

People with pre-existing health issues

33%

12%

29%

26%

Lower income Americans

30%

15%

31%

25%

People currently without health insurance

27%

13%

35%

26%

Children

26%

24%

19%

31%

 

Even people currently without health insurance are more negative than positive about the perceived impact of the health care reform law on themselves and their family. Over four in ten (43%) of the uninsured think they will be worse off under the new law, compared to only seven percent who think they will be better off. Almost three in ten (29%) of the uninsured are unsure of the new law’s impact on themselves and their family.

Most of the persons living in or near the smallest communities think they will be worse off under the new law. Over one-half (56%) of persons living in or near communities with populations less than 500 think they will be worse off under the new reform law. And, 51 percent of persons living in communities with populations ranging from 500 to 999 think they will be worse off under the new law. In comparison, 43 percent of persons living in or near communities with populations of 10,000 or more think they will be worse off.

In general, do you think you and your family will be better or worse off under the health care reform law, or don’t you think it will make much difference?

 

Worse off

Not much difference

Better off

Unsure

Uninsured

43%

21%

7%

29%

Insured

46%

28%

4%

22%

 

 

 

 

 

Community population less than 500

56%

22%

4%

19%

Community population between 500 and 999

51%

29%

2%

19%

Community population between 1,000 and 4,999

45%

27%

4%

25%

Community population between 5,000 and 9,999

48%

26%

5%

21%

Community population 10,000 or more

43%

29%

5%

23%

 

In addition to having negative perceptions on how the new health care reform law will impact most groups, many rural Nebraskans do not think the law will accomplish many of its goals. Most rural Nebraskans (58%) think the new health care reform law will not be successful at decreasing health care costs overall. Only three percent think the new law will be completely successful at decreasing health care costs, 10 percent think it will be somewhat successful and 29 percent are unsure. And, many rural Nebraskans (44%) think it will not be successful at increasing the quality of health care. Twenty percent think it will be somewhat successful at increasing the quality of health care, 4 percent think it will be completely successful and approximately one-third (32%) are unsure. However, over one-third (36%) of rural Nebraskans think the new law will be somewhat successful at increasing access to health insurance coverage. Approximately one-third of rural Nebraskans are unsure if the new law will be successful at accomplishing the various items. Thus, there is a lot of uncertainty in rural Nebraska about the impacts of the new health care reform.

Based on what you know or have heard about the health care reform law, how successful is the health care reform law likely to be at accomplishing the following in Nebraska?

 

Not at all successful

Somewhat successful

Completely successful

 Unsure

Decreasing health care costs overall

58%

10%

3%

29%

Increasing quality of health care

44%

20%

4%

32%

Motivating and supporting people to improve their health

41%

24%

5%

30%

Health care professionals and organizations, such as hospitals, working together to better manage care for patients

38%

25%

5%

32%

Ensuring access to the latest and newest innovations in treatment, services and medical technology

38%

24%

5%

33%

Increasing access to medical health care services

33%

30%

4%

33%

Increasing use of the most up-to-date information technology in hospitals and doctors’ offices

33%

27%

5%

35%

Increasing access to health insurance coverage

27%

36%

4%

33%

Survey Methods

This study is based on 2,317 responses from Nebraskans living in the 84 non-metropolitan counties in the state.[1] A self-administered questionnaire was mailed in March and April to 6,320 randomly selected households. Metropolitan counties not included in the sample were Cass, Dakota, Dixon, Douglas, Lancaster, Sarpy, Saunders, Seward and Washington.

A 37% response rate was achieved using the total design method (Dillman, 1978).

Since younger residents have typically been under-represented by survey respondents and older residents have been over-represented, weights were used to adjust the sample to match the age distribution in the nonmetropolitan counties in Nebraska (using U.S. Census figures from 2010).

The margin of error for this study is plus or minus two percent.

[1] In the spring of 2013, the Grand Island area (Hall, Hamilton, Howard and Merrick Counties) was designated a metropolitan area. The mailing list for this survey was already purchased prior to this designation so those four counties were included in our sample and in the data presented here.

For more information about the Nebraska Rural Poll, click here.

The complete report can be viewed here.