As it is in the rest of the country, the 2010 health reform in Indiana continues to be unpopular, unlikely to be repealed and uncertain to put a dent in health spending, according to a poll of Hoosiers released last week by Ball State University.

The Muncie-based university’s annual poll found 51 percent of Hoosiers view the Patient Protection and Affordable Care Act unfavorably, while 35 percent view it favorably and 13 percent don’t know how they feel about it.

National surveys by organizations such as the Kaiser Family Foundation, CBS News and Rasmussen Reports have found similar results.

Still, key elements of the law remain overwhelmingly popular, making any repeal effort (which many Congressional Republicans have promised) difficult. Among Hoosiers, 93 percent said it is important to prevent health insurance companies from denying coverage based on preexisting conditions, something the 2010 legislation outlawed. Also, 84 percent of Hoosiers said “ensuring coverage for everyone” is important.

Nearly identical percentages of Hoosiers said those provisions were important in the same survey a year ago.

The most popular idea about health reform is “making coverage affordable,” and 96 percent of Hoosiers say that is important. But whether the 2010 health overhaul will make good on that promise is uncertain.

The law will raise various taxes in order to expand health insurance coverage to an additional 32 million Americans.

One of the main arguments for doing so was that uninsured Americans are forced to seek care at hospital emergency rooms, which is the most expensive place to do so. Often, these patients cannot pay their ER bills, so hospitals shift those costs onto those who can pay—patients with insurance.

If more Americans had health insurance, the argument went, ER usage and overall health care spending would decline.

But Ball State’s survey found that Hoosiers with health insurance go to the emergency room as often—and perhaps a bit more often—than those without coverage. Thirty-one percent of insured Hoosiers used the ER in the past 12 months, Ball State found, compared with 29 percent of uninsured Hoosiers.

Advocates of the health law say wider insurance coverage will lead more patients to see a physician, hopefully catching expensive medical conditions before they require hospitalization.

On that front, the expansion of insurance coverage may help. Ball State found that only 56 percent of uninsured Hoosiers had seen a physician in the previous year, compared with 87 percent of insured Hoosiers.

Ball State's survey was conducted by phone between Nov. 14 and 17. Its results, based on the answers of 607 respondents, have a margin of error of 4.4 percent.