Julia Wood, a 51-year-old mother of 12 from Chicago's East side, has some health insurance through a state program -- but is so worried she may lose it she asks not to give her real name.
Wood's husband, a plumbing contractor, watched his business dry up in 2008 with the mortgage crisis.
The economy hit us, said Wood in an interview at the not-for-profit Chicago Family Health Center.
Like millions of Americans, she is waiting for healthcare reform legislation signed into law by President Barack Obama in March to take effect. But like millions of Americans, she is not sure what it will do for her.
A Thomson Reuters poll of consumer confidence released on Monday shows Americans' confidence in their ability to pay for and access healthcare has fallen by 5 percent since December 2009.
The Thomson Reuters Consumer Healthcare Sentiment Index, based on a monthly survey of 3,000 consumers, asks if they have had trouble paying for or had to postpone care in the three months prior. And it asks if they expect to in the coming three months.
On every survey question, responses were more pessimistic in July than they were in December.
That's a cause for concern to healthcare providers and policymakers, Gary Pickens, chief research officer at Thomson Reuters, parent company of Reuters, said in a statement.
Pickens has seen a gradual eroding of confidence since December, despite a few notable peaks, such as in April, the month after Congress passed the Affordable Care Act.
I doubt the average person really knows what has been implemented, he said. They just know there is a lot of talk and there has been a lot of negative publicity.
David Kendall, a senior fellow for health and fiscal policy at ThirdWay, a centrist think tank, said dissatisfaction with the current health system likely reflects a letdown after the reform debate subsided.
The healthcare debate raised people's expectations and there is now disappointment as a result that the problem isn't solved, Kendall said.
He said growing dissatisfaction with healthcare may help Democrats who supported health reform a little. But it may also be polarizing.
In the Thomson Reuters poll, Republicans tend to have slightly higher confidence about access to healthcare, which may be linked to employment, Pickens said.
Clearly, at the top of the pile, the most important factor is having insurance coverage, Pickens said in a telephone interview. It's related to your employment status and, obviously, so many people in the country are out of work.
Republican National Committee Chairman Michael Steele said in a statement on Friday that the White House has failed to win widespread support for health reform.
For months, the White House promised wavering Democrats that the bill would become more popular once it became law. The White House was wrong, he said.
Kendall, however, thinks concerns about the economy will overshadow any concerns about health reform in the midterm elections.
What matters more to people right now is their concern about the deficit and the economy and their own jobs, he said.
Stephanie Washington, a 50-year-old clerk for the Chicago Public Schools, said she hopes healthcare does become an election issue.
We are in a recession. Anybody who thinks because the president is trying to reform healthcare and they don't think one day it's going to benefit you as well as the next person can go and vote Republican, she said.