Medical Students’ Views and Knowledge of the Affordable Care Act: A Survey of Eight U.S. Medical Schools

• Published in: Journal of general internal medicine : JGIM 2015-07, Vol.30 (7), p.1018-1024
• Main Authors: Winkelman, Tyler N. A., Lehmann, Lisa Soleymani, Vidwan, Navjyot K., Niess, Meredith, Davey, Cynthia S., Donovan, Derek, Cofrancesco, Joseph, Mallory, Mia, Moutsios, Sandi, Antiel, Ryan M., Song, John Y.
• Format: Article
• Language: English
• Subjects: Adult; Attitude of Health Personnel; College students; Cross-Sectional Studies; Female; Health Care Reform; Humans; Internal Medicine; Knowledge; Male; Medical schools; Medicine; Medicine & Public Health; Opinions; Original Research; Patient Protection & Affordable Care Act 2010-US; Patient Protection and Affordable Care Act; Polls & surveys; Professional Competence - statistics & numerical data; Schools, Medical; Students, Medical - psychology; United States; Young Adult
• ISSN: 0884-8734; 1525-1497
• DOI: 10.1007/s11606-015-3267-9

ABSTRACT BACKGROUND It is not known whether medical students support the Affordable Care Act (ACA) or possess the knowledge or will to engage in its implementation as part of their professional obligations. OBJECTIVE To characterize medical students’ views and knowledge of the ACA and to assess correlates of these views. DESIGN Cross-sectional email survey. PARTICIPANTS All 5,340 medical students enrolled at eight geographically diverse U.S. medical schools (overall response rate 52 % [2,761/5,340]). MAIN MEASURES Level of agreement with four questions regarding views of the ACA and responses to nine knowledge-based questions. KEY RESULTS The majority of respondents indicated an understanding of (75.3 %) and support for (62.8 %) the ACA and a professional obligation to assist with its implementation (56.1 %). The mean knowledge score from nine knowledge-based questions was 6.9 ± 1.3. Students anticipating a surgical specialty or procedural specialty compared to those anticipating a medical specialty were less likely to support the legislation (OR = 0.6 [0.4–0.7], OR = 0.4 [0.3–0.6], respectively), less likely to indicate a professional obligation to implement the ACA (OR = 0.7 [0.6–0.9], OR = 0.7 [0.5–0.96], respectively), and more likely to have negative expectations (OR = 1.9 [1.5–2.6], OR = 2.3 [1.6–3.5], respectively). Moderates, liberals, and those with an above-average knowledge score were more likely to indicate support for the ACA (OR = 5.7 [4.1–7.9], OR = 35.1 [25.4–48.5], OR = 1.7 [1.4–2.1], respectively) and a professional obligation toward its implementation (OR = 1.9 [1.4–2.5], OR = 4.7 [3.6–6.0], OR = 1.2 [1.02–1.5], respectively). CONCLUSIONS The majority of students in our sample support the ACA. Support was highest among students who anticipate a medical specialty, self-identify as political moderates or liberals, and have an above-average knowledge score. Support of the ACA by future physicians suggests that they are willing to engage with health care reform measures that increase access to care.