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Abstract In an age of increasing political polarization, the Affordable Care Act (ACA) stands out as one of the most politically divisive pieces of legislation in recent history. Unlike previous laws making changes to the US health care system, public views of the ACA did not improve measurably as people gained experience with the program, but remained deeply divided on a partisan basis in the more than eight years since its passage. In this article, we examine how the complexity of the law, lack of understanding by the public, and elite partisan messaging have contributed to this enduring partisan divide, and discuss what the future may hold for the measurement of public opinion on major health care legislation.

In an age of increasing political polarization, the Affordable Care Act (ACA) stands out as one of the most politically divisive pieces of legislation in recent history. Unlike previous laws making changes to the US health care system, public views of the ACA did not improve measurably as people gained experience with the program, but remained deeply divided on a partisan basis in the more than eight years since its passage. In this article, we examine how the complexity of the law, lack of understanding by the public, and elite partisan messaging have contributed to this enduring partisan divide, and discuss what the future may hold for the measurement of public opinion on major health care legislation.

Our annual analysis of health benefits contains findings from interviews of 2,046 public and private employers surveyed during January-May 2010. Average annual premiums in 2010 were$5,049 for single coverage and $ 13,770 for family coverage-up 5 percent and 3 percent from 2009, respectively. Workers paid more toward premiums in 2010, and more workers are in consumer-directed plans and plans with high deductibles than in 2009. Thirty percent of firms reported that they reduced the scope of benefits or increased cost sharing because of the recession. Surprisingly, the percentage of firms offering health benefits in 2010 increased to 69 percent, up from 60 percent in 2009. The change was largely driven by a thirteen-percentage-point increase in the number of firms with three to nine workers that offered benefits (up from 46 percent in 2009 to 59 percent in 2010). The reason for this increase is unclear. [PUBLICATION ABSTRACT]

This paper reports findings from a survey of 1,997 public and private employers with three or more workers, conducted during the first five months of 2007. Premiums increased 6.1 percent from spring 2006 to spring 2007-the lowest rate of increase since 1999. Enrollment in different types of health plans did not change significantly, and high-deductible health plans with a savings option did not experience major growth in enrollment. Despite the comparatively modest increase in premiums during a period of strong economic growth, the percentage of workers obtaining coverage from their employer remained statistically unchanged. [PUBLICATION ABSTRACT]

Our annual Employer Health Benefits Survey contains findings from interviews with 1,927 public and private employers surveyed during the first five months of 2008. Average annual premiums in 2008 are$4,704 for single coverage and $ 12,680 for family coverage. These amounts are about 5 percent higher than premiums were last year. Enrollment in high-deductible health plans with a savings option increased to 8 percent of covered workers, up from 5 percent in 2007. Deductibles in preferred provider organizations, the plan type with the largest enrollment, increased from 2007 levels. This paper also provides new insights into firms' offering wellness programs and retiree health benefits. [PUBLICATION ABSTRACT]

Based on a survey of 2,122 randomly selected public and private employers, this paper reports on the state of employer-sponsored health insurance in spring 2006, including recent changes. Premiums increased 7.7 percent from spring 2005 to spring 2006 and have risen 68 percent since 2001. About 4 percent of workers are enrolled in high-deductible health plans with savings options. The percentage of workers covered by their own employer did not statistically change from 2005 to 2006. [PUBLICATION ABSTRACT]

Each year the Kaiser/HRET Survey of Employer Health Benefits takes a snapshot of the state of employee benefits in the United States, based on interviews with public and private employers. Our findings for 2009 show that families continue to face higher premiums, up about 5 percent from last year, and that cost sharing in the form of deductibles and copayments for office visits is greater as well. Average annual premiums in 2009 were$4,824 for single coverage and $ 13,375 for family coverage. Enrollment in high-deductible health plans held steady. We offer new insights about health risk assessments and how firms responded to the economic downturn. [PUBLICATION ABSTRACT]

Our annual Employer Health Benefits Survey contains findings from interviews with 1,927 public and private employers surveyed during the first five months of 2008. Average annual premiums in 2008 are$4,704 for single coverage and$12,680 for family coverage. These amounts are about 5 percent higher than premiums were last year. Enrollment in high-deductible health plans with a savings option increased to 8 percent of covered workers, up from 5 percent in 2007. Deductibles in preferred provider organizations, the plan type with the largest enrollment, increased from 2007 levels. This paper also provides new insights into firms' offering wellness programs and retiree health benefits. Adapted from the source document.