WASHINGTON (AP) - Attacked as a rationing scheme and praised as a lifesaver, President Barack Obama's health care law remains as divisive and confusing as ever. But a new poll finds Americans are less worried the overhaul will undermine their own care.
As the Supreme Court prepares to hear arguments on the constitutionality of the Affordable Care Act, the Associated Press-GfK poll shows Americans are less concerned their own personal health care will suffer as a result of it.
Shortly after the law passed in 2010, nearly half - 47 percent - said they expected the quality of their care to worsen. Now just 32 percent say that's their worry.
Most of the law's major changes have yet to take effect, and dire predictions - of lost jobs, soaring premiums and long waits to see the doctor - have not materialized. Provisions that have gone into effect, including extended coverage for young adults on their parents' insurance and relief for seniors with high prescription costs, only had a modest impact on health care spending.
Lee Sisson, 63, a semi-retired businessman from Winter Haven, Fla., says he figures he might be better off personally as a result of the overhaul. For example, it would limit how much health insurance companies can charge older adults. But self-interest hasn't made Sisson a supporter.
"As a guy that's semi-retired, the law would probably benefit me, and I'm still against it because it's not good for our country," said Sisson. He's concerned about the cost of new government programs getting passed on to future generations.
Most of the drop in people saying they believe their care will worsen actually comes from those like Sisson, who are opposed to it. Of the law's opponents, 55 percent now say their care will worsen. But in April 2010, soon after the law passed, that share was 67 percent.
Overall, half of Americans say they don't think the quality of their care will change, while 14 percent expect it to improve.
The health care debate may be getting less edgy, but it's unclear how much it will help Obama and Democrats heading into a contentious 2012 election season. Americans remain cool to the major domestic accomplishment of the president's first term, even if they like some of the law's provisions.
The poll found that 35 percent of Americans support the health care law overhaul, while 47 percent oppose it. That's about the same split as when it passed. Then, 39 percent supported it and 50 percent opposed it.
Opposition remains strongest among seniors, many of whom object that Medicare cuts were used to help finance coverage for younger uninsured people.
"We were supposed to have a nice, relaxed retirement, and now we are scared," said Nancy Deister Knaack, 65, of Leawood, Kan., a retired special education teacher. "We don't know what's going to happen."
Confusion about the complex legislation has not helped Obama sell it to the public, contributing to an atmosphere in which wild charges about potential repercussions readily find an audience.
Only about three in ten say they understand the law extremely or very well. Most, 44 percent, say they understand it just somewhat, while 29 percent say they understand it not too well or not well at all.
On the key issue before the Supreme Court, however, public opinion is clear. Nearly 6 in 10 in say they oppose the law's requirement that Americans carry health insurance, except in cases of financial hardship, or pay a fine to the government.
Opponents argue such a mandate is an unconstitutional expansion of federal power, amounting to Congress ordering private citizens to buy a particular product.
The administration and many experts believe the overhaul cannot work without an insurance requirement. The law guarantees people with pre-existing medical problems can get coverage. Therefore, without a mandate, many healthy people may just postpone buying insurance until they get sick, driving up costs.
Even many Democrats are uneasy about the insurance requirement, although it can be fulfilled by getting coverage through an employer, a government program or by directly buying a policy, in many cases with the help of federal subsidies.
Las Vegas software engineer Michael Hugh, 37, says he supports the president and intends to vote for him, but the health care law should be revised.
"I am for the concept of it, but I am against the penalties," he said. "It's a good idea that they are taking down a wrong path because people shouldn't be penalized for not having health care." Hugh is currently uninsured but says he plans to get coverage through a new job.
While opposition to an individual insurance requirement remains strong, the poll found that 60 percent support putting the obligation on employers. Businesses are currently under no legal requirement to provide insurance, and the law would penalize medium to large companies that fail to do so.
The Associated Press-GfK Poll was conducted February 16-20, 2012 by GfK Roper Public Affairs and Corporate Communications. It involved landline and cellphone interviews with 1,000 adults nationwide and has a margin of sampling error of plus or minus 4.1 percentage points.