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 that 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 that 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 that 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 that 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 that the overhaul cannot work without an insurance requirement. The law guarantees that 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.

Medigap Quotes are readily available from many sources, especially this time of year (during the annual enrollment period for the other types of plans – Part D and Advantage plans). It is highly advisable to get quotes for Medigap coverage (also called Medicare Supplements) on an annual basis, if you are already on Medicare. This way, you can confirm that you have the best “deal” available, and if you do not, make a change to save money.

There are three primary reasons why you should obtain Medigap quotes:

1. First of all, and quite simply, the plans are Federally-standardized. If you are on Medicare and have a Medicare Supplement (Medigap) plan currently, you have one of the standardized plans, which are named after letters. For example, a Plan F is the plan that fills in all the gaps in Medicare Parts A & B so that you don’t have any out of pocket costs at the doctor or hospital. If you have a Plan F with one company, it is very easy to compare other Plan F’s with other companies to confirm that your plan is the most competitively priced.

2. Secondly, you should obtain Medigap quotes because it is extremely easy to do and does not cost you anything. In fact, in 90% of cases, you can save money on your Medigap insurance for equal coverage. Because of the above point, that Medigap plans are standardized, you can often save money. Insurance, particularly Medicare insurance, is an extremely fast-moving and changing thing. A plan that is good today may not be competitively priced tomorrow. Because of this, it is important to stay “on top of” your coverage and compare quotes on an annual basis. You can do so online. The rates themselves aren’t published online (this is not allowed by most companies); however, if you find the right independent brokerage, you can get a rate quote comparison sent to you by email. Full disclosure: we do this and would be happy to send it to you if you want to request Medigap quotes.

3. Last of all, you should get Medigap quotes to save money. Since the plans are standardized and the quotes are easy to obtain, you can usually save money. Everyone likes a little extra money in their pocket and this is one of the easiest ways to get it. Keep the same coverage and save money – it’s a no brainer.

If you would like more information or to obtain Medigap quotes by email, please request information on our website or give us a call. While many people do this this time of year, during the annual enrollment period for the Part D plans, you can actually change Medicare Supplements at any time, and should consider doing so whenever your rates change, which is typically on your policy anniversary date.

Medicare dodged the bullet in the recent battle over deficit reduction, but the next fight will soon begin. The agreement that was reached to raise the debt limit and avoid default by the U.S. government requires leaders of both parties to appoint 12 members to a “Super Committee” that must come up with at least $1.5 trillion in spending cuts. The Committee must finish its work by November 23, 2011, and Congress must vote to approve or reject their proposals by December 23rd.

According to the Center for Medicare Advocacy, there have been many proposals for cutting Medicare, in addition to the Ryan plan for privatizing Medicare and turning it into a voucher program. Ideas that have received a better reception and might be part of the Super Committee’s final proposal include the following possible changes to Medicare:

• Raising the Age of Eligibility From 65 to 67
• Combining Part A and B Deductibles Into a Single Annual Deductible – Different proposals sought to create a deductible between $550 and $560, impose 20% cost-sharing on all Medicare services (including Part A services that currently require either no cost-sharing, or a set co-pay), coupled with a total annual out-of-pocket cap of between $5,250 and $7,500;
• Additional Means Testing of Medicare – Currently, higher income beneficiaries pay a larger share of their Part B and Part D premiums; one proposal sought to increase Part B premiums from 25% to 35% of program costs for those not already paying income-related premiums;
• Eliminating First-Dollar Medigap Coverage – This proposal prohibits Medigap plans covering the first $500 of cost-sharing and limits coverage to 50% of the next $5,000 (might include policies already held by individuals)
• Shifting Coverage of Persons Dually Eligible for Medicare and Medicaid (Dual eligibles) to Medicaid – This proposal gives Medicaid full responsibility for providing health coverage for persons dually eligible for Medicare and Medicaid, and requires Medicaid plans to place dual eligibles in Medicaid managed care plans.

Medicare and Social Security are exempt from large cuts.

If the Super Committee fails to agree on spending cuts to a long list of government programs, or Congress votes against the final proposal by the Super Committee, that will trigger automatic spending reductions across the board, with Department of Defense taking the biggest hit. But Social Security and Medicare would be exempt from large cuts, and any cuts that are made would be directed at providers rather than patients. Of course, if doctors take the hit, they can decide to stop seeing Medicare patients.

o the struggle continues and it will take place behind closed doors until November, when the public will find out who gets hurt the most from the large cuts that will be made in government spending.