FILE - In this March 23, 2010, file photo President Barack Obama is applauded after signing the Affordable Care Act into law in the East Room of the White House in Washington. Having health insurance is no panacea for high medical costs. Overall, 1 in 4 privately insured Americans say they lack confidence they can pay for a major unexpected medical expense according to an The Associated Press-NORC Center poll. This may help explain why Obama faces such strong headwinds trying to convince the public that his health care law is working to hold costs down. Many who recently switched plans are paying more for their new plan, and very few report a corresponding increase in quality. (AP Photo/Charles Dharapak, File)