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This week marks the third anniversary of the Affordable Care Act being signed into law, and the latest Kaiser Family Foundation poll shows that the majority of Americans still don't know what in the hell it does, and still think it does things it doesn't. And a plurality still doesn't like it.

Chart showing favorability of ACA over time since 2010.
The law hasn't gained in popularity, with 37 percent of respondents viewing it favorably and 40 percent unfavorably. They don't like it, even though they don't know what it does: 57 percent say they don't know enough about it to understand how it might affect their own health insurance. This is the ongoing challenge of the Obama administration: providing public education and, yes, public relations, to help ensure the success of the exchanges. Fully two-thirds of the group the law is intended to help the most—the uninsured and those making less than $40,000 a year are the ones who say they are least knowledgable about the law
Chart showing percentages of various groups' understanding of what's in the ACA
Finally, there's the large numbers of people who think the law does exactly what it doesn't. Almost 60 percent think the law has a public option; nearly half (47 percent) think it will provide government subsidies to undocumented immigrants to buy insurance; and, yes, 40 percent (and 35 percent of seniors) think it sets up government death panels (21 percent aren't sure on that one).

The bright side of this is that there are some very popular provisions of the bill that people don't yet know are in it. For example, tax credits to small businesses that offer health insurance, which 88 percent of respondents think is a great idea, but only 52 percent knew was in the law. Eighty-one percent of people think the Medicare donut hole should be closed, and only 46 percent knew it's in the law. The idea of a health insurance exchange is popular with 80 percent of respondents, but only 58 percent know they are coming. As these things come on line, the law will become more popular. But it won't happen without an organized, effective and well-publicized campaign by the administration.


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