KELLY MCEVERS, HOST:
As Republicans in Congress move to repeal the Affordable Care Act, we are going to dig into public opinion on health care. NPR, along with the polling firm Ipsos, decided to try to gauge voters understanding of the U.S. health care system broadly, as well as Obamacare in particular. NPR health correspondent Alison Kodjak reports that the public's knowledge about the law was mixed, and people's opinions were very much determined by their politics.
ALISON KODJAK, BYLINE: The poll shows Americans are pretty knowledgeable about the U.S. health care system overall. The majority know that this country generally spends more on health care than others, but people aren't necessarily healthier. Cliff Young is president of Ipsos, which conducted the poll for NPR.
CLIFF YOUNG: Overall, they have a pretty good command of the facts, though there's a little bit of confusion in certain places.
KODJAK: The majority of those polled know that Obamacare requires insurers to cover people with preexisting conditions and to pay for preventive medical care. At the same time, half of those in the survey didn't know that the ACA reduced the number of people who are uninsured to a record low. Michael Delli Carpini says that is a key communications failure of the Obama administration. He's the dean of the Annenberg School of Communications at the University of Pennsylvania.
MICHAEL DELLI CARPINI: I don't think they did as good a job as they could have taking the two or three things that were most central and most important and repeating endlessly the success that they've had.
KODJAK: Carpini says people may have voted for members of Congress or a president based on bad information, like death panels. They never actually existed, but the idea of bureaucrats who could cut off health care to the sick and dying was one of the most vivid parts of the ACA debate. It took hold and hangs on. About a third of those polled said the law limits care at the end of life, and half said they don't know if it does.
DELLI CARPINI: Once people get misinformation, if they believe it momentarily, even - even if the correct information gets to them, and they even accept the correct information at some level, they're going to be influenced by that misinformation right from the start. And they as easily are likely to forget the true information as they are the misinformation.
KODJAK: False information was just one challenge. Bill Pierce, who works on health care communications at APCO Worldwide, says the law got off to a rocky start the day people started trying to buy health insurance on the government's website.
BILL PIERCE: They essentially started with one foot in a bucket when the website failed.
KODJAK: So the idea of failure was firmly planted long before officials could point to any positive results.
PIERCE: By the time the insurance rate - the uninsured rate started to fall so much, a lot of minds were already set.
KODJAK: Whatever the facts, the poll shows that people's opinions come down to ideology. Republicans overwhelmingly say that people are responsible for securing their own health care, while Democrats say that the government should ensure everyone has access. Cliff Young of Ipsos...
YOUNG: It really comes down to ideology - really does. The linchpin is really - should there be a more active or less active government? What's the role of government? And we see the real distinctions there.
KODJAK: The same divide shows up in those who want to see the law repealed and those who want it to stay. But a message for lawmakers working to repeal Obamacare this week - even a majority of Republicans in the poll want to see the Affordable Care Act replaced if it's repealed. Alison Kodjak, NPR News, Washington.