To say that the Affordable Care Act, better known as Obamacare, is a polarizing law might be the understatement of the year.

According to the Kaiser Family Foundation, which tracks public opinion on Obamacare on a nearly monthly basis, just 39% of respondents surveyed in its June poll noted a favorable opinion of the law while 45% of those surveyed had an unfavorable opinion of Obamacare. The remaining 16% either didn't know or refused to answer. The two sides, which are largely split by political affiliation, have been feuding since the ACA was signed into law in March 2010.

But, as KFF notes, June also marked a major milestone in terms of where consumers are obtaining information about Obamacare. According to KFF, 26% of respondents based their impression of the law on their own personal experience, while another 22% noted their impression of the law was influenced by family and friends. Cumulatively at 48%, this marks the first time the media (37%) wasn't the leading influencer of Obamacare impressions.


Graph by author, Data source: Kaiser Family Foundation Health Tracking Poll.

It could also signify a turning point that Americans are able to make informed decisions with regard to Obamacare on their own because they're finally taking the time to understand the law.

Of course, just because understanding of the law is improving doesn't mean that favorability of the law is necessarily improving -- although the gap between favorable and unfavorable impressions of the ACA has shrunk to its lowest levels since October 2013.

A shocker from this recent poll
Keeping these figures in mind I'd like to turn your attention to a CNN/ORC International poll (link opens PDF) conducted May, a month before the aforementioned Kaiser Family Foundation poll, which also looked at consumers' opinions of Obamacare. Instead of simply asking the more than 1,000 respondents to offer their approval or disapproval of the law, CNN/ORC added a twist, asking consumers to pick what Congress should do from one of the following four choices:  

  • Leave the health care law as is.
  • Keep the law, but make some changes.
  • Repeal the ACA and replace it with something different.
  • Repeal the ACA and go back to the system we had before.

Here are the results to this CNN/ORC question:
Which of the following statements best describes your view of what Congress should do in the future:

Question

% of Respondents

Leave health care law as is

12%

Make some changes

49%

Repeal and replace

18%

Repeal, go back to original

20%

Source: CNN/ORC International, numbers may not add to 100% due to rounding.

What's not surprising? Only seeing 12% of respondents proclaiming that they'd like to see the law remain as it is without change. If you consider that 45% disapprove of the ACA, and take into consideration that the law is highly polarizing, witnessing more people take the middle ground should be expected.

But here's the shocker: 49% want to make changes, but keep Obamacare in place. Some will view this as the glass being half empty in that 87% of respondents want repeal or change to the law as it currently stands. However, another way to view this is 61% of respondents want to keep the basic premises of Obamacare in place and definitely don't want to go back to what we had in place previously. The implication here is that a majority of citizens (at least those polled) wanted change in our health care system, and generally speaking people are in favor of the steady progress being made.

Here's what really matters
Although we can continue to focus on the approval and disapproval ratings of the ACA, the key point here is that Obamacare isn't going anywhere, and more importantly that consumers are starting to become better educated with regard to how the law is affecting them.

With the ACA's acceptance improving I would opine that this could have notably positive implications for most insurers. While sicker individuals enrolled en masse during 2014 a number of younger adults still stuck to the sidelines and chose not to purchase insurance. For some this was a choice to remain uninsured, although I would suggest a number of people remained uninsured because they simply didn't understand the main tenets of the ACA and how it would affect them. As time passes I would expect ACA education to improve and for growing penalties associated with remaining uninsured in successive years to encourage additional younger adults to sign up.

Source: The National Guard, Flickr.

This would be especially welcome news for national insurers like UnitedHealth Group (UNH 0.23%) and Aetna (AET) which incurred losses from their individual Obamacare enrollment segments last year. One factor to keep in mind is that both UnitedHealth and Aetna kept their distance from most individual exchanges in 2014 in order to gauge demand, but have since noted their intention to expand into a number of new state exchanges in 2015. If both can bring in a substantial amount of healthier young adults in 2015 their medical cost ratios should dip and their Obamacare segments could turn profitable.

However, increased ACA awareness could have a number of different effects on private insurance platform eHealth (EHTH -0.66%). eHealth has been a big beneficiary of Obamacare's technical woes, picking up countless new members due to federally run Healthcare.gov's early infrastructure problems. In addition, eHealth provides a nice backdoor into comparing health care plans without having to officially use the "government's website." As penalties associated with not having insurance increase in 2015 and beyond it certainly could encourage those who've remained uninsured to get insurance through a private platform like eHealth simply to avoid going through the state or government-run exchanges.

Then again, with personal experience, as well as friends and family, being the now predominant force that helps citizens form an impression of the ACA we could see a greater willingness of consumers to use the marketplace exchanges as opposed to eHealth's private platform. In other words, as the ACA becomes better understood and is demystified in the public's eyes, eHealth, which had fed off that uncertainty, could see its growth prospects slow.

Ultimately, we need to understand that nothing on the scale of Obamacare has ever been enacted before in the U.S., so there's a learning curve for insurers, consumers, and regulators. The law itself may not be going anywhere, but there's certainly room for fluidity and change as the dynamics of the health care landscape change. In short, with ACA acceptance and awareness improving 2015 is set up to be another pivotal year for insurers.