Affordable Care Act Subsidies

December 17, 2025

Key Findings

Most (70%) survey respondents believed that depositing the value of a household’s enhanced premium tax credit into a health savings account (HSA), instead of applying it directly to their monthly premium, would measurably worsen the affordability of health care for Marketplace enrollees. Only 10% thought that shifting enhanced subsidies to HSAs would improve affordability.
A number of respondents noted that their assessment depended on how affordability is measured and on the details of the HSA proposal. For example, requiring enrollees to select a bronze-tier or catastrophic plan to access the HSA contributions could worsen affordability, as many Marketplace enrollees are currently enrolled in more generous coverage. However, permitting people to use HSA funds to pay for premiums (a practice that is currently prohibited) could mitigate some of the affordability concerns.
Three-quarters of respondents (75%) agreed that requiring Marketplace enrollees who otherwise qualify for fully subsidized plans to pay a small (e.g., $5-$10) monthly premium would measurably reduce Marketplace enrollment among eligible individuals who intended to stay enrolled. 37% believed these small premiums would reduce fraudulent enrollment.
Most (81%) survey respondents agreed that a scheduled policy change that will effectively end automatic renewals with subsidy for most enrollees, which is scheduled to take effect in 2028, will substantially reduce Marketplace enrollment.

Read the full Health Affairs Forefront summary of results here

Survey Questions

Please note: our surveys will consistently use two modifiers to describe the size of an effect: “Substantial”: when an effect is large enough to meaningfully influence policy decisions, program implementation, or outcomes of interest “Measurable”: when the direction of an effect is clear, but the effect may not be sufficiently large to make much of a difference for a given policy, program, or outcome.

Response rate of 100% (63 out of 63 panelists responded)

Enhanced premium tax credits, which have been available since 2021 to people enrolled in health insurance through the Affordable Care Act Marketplaces, will expire at the end of 2025. Enhanced premium tax credits lowered net monthly premiums for eligible individuals and extended subsidies to some previously ineligible individuals. Policymakers are debating enhanced premium tax credit reforms, including a proposal to deposit the value of a household’s enhanced premium tax credits into a health savings account.

Question 1:

Depositing the value of a household’s enhanced premium tax credit into a health savings account, instead of applying it directly to their monthly premium, would measurably [improve, worsen, have no effect on] the affordability of health care for Marketplace enrollees.

a. Improve
b. Worsen
c. Have no effect on
d. No opinion

Enhanced premium tax credits have resulted in the availability of fully subsidized (zero-premium) Marketplace plans for some low-income individuals.

Question 2: Requiring Marketplace enrollees who otherwise qualify for fully subsidized plans to pay a small (e.g., $5-$10) monthly premium would measurably… (select all that apply)

a. Reduce fraudulent enrollment
b. Reduce the number of people who remain enrolled without their knowledge
c. Reduce Marketplace enrollment among eligible individuals who intended to stay enrolled
d. None of the above
e. No Opinion

Currently, people who enroll in subsidized Marketplace coverage and do not take action during a subsequent open enrollment period are automatically renewed into the same plan, with a subsidy that assumes no change in household income—a process known as “passive reenrollment.” Beginning in 2028, most people enrolled in subsidized coverage will have to reverify their household income in order to continue receiving a subsidy in the next plan year.

Question 3: Eliminating passive reenrollment with subsidy for people enrolled in Marketplace coverage will substantially reduce Marketplace enrollment.

a. Strongly Agree
b. Agree
c. Uncertain
d. Disagree
e. Strongly Disagree
f. No Opinion

Individual Survey Responses

Question One

Name	Vote	Confidence	Comments
Margarita Alegria	Worsen	8
David Asch	Worsen	7	Generally, perceptions of affordability are based on sticker price rather than sticker price adjusted for later costs or cost offsets. So I would predict that the sense of affordability would worsen by moving discounts into later credits–even if those credits could be foreseen to be easily used and applied.
John Ayanian	Worsen	3
Peter Bach	Worsen	7
Laurence Baker	Worsen	8
David Blumenthal	Have no effect on	7	This assumes that funds could be used to purchase insurance that no longer met minimum coverage requirements for qualified plans on the ACA marketplaces.
Erin Fuse Brown	Worsen	7	Current proposals would require enrollees to choose a bronze plan if they want to access the HSA, so it might worsen affordability for enrollees eligible for cost-sharing reductions who must choose a silver plan to keep their CSR payments. Further, because the HSA couldn’t be used for premiums, it might worsen affordability for those who can’t afford premiums for a bronze plan.
Melinda Buntin	Worsen	8
Michael F. Cannon	No Opinion	0	I would have chosen “Mixed.”
Lawrence Casalino	Worsen	7
Amitabh Chandra	Worsen	8
Lanhee J. Chen	Have no effect on	6
Michael Chernew	Have no effect on	7	The question is affordability. Basically, premiums would be $X higher but folks would get $x so they could afford same as before if I understand the policy. The only impact would be if premiums changed due to competition (doubt it) which would improve affordability or selection (possible) which would likely worsen it.
Janet Currie	Worsen	6	I think that some families will take the money and not purchase insurance which could lead to a death spiral in the exchanges’ insurance.
Lesley Curtis	Worsen	7	The higher monthly premium will lead some individuals to forego health insurance and, without health insurance, they won’t benefit from negotiated rates
David Cutler	Worsen	5
Julie Donohue	Worsen	7
Joseph Doyle	Have no effect on	7
David Dranove	Improve	7
Stacie Dusetzina	Worsen	4	I think that it would worsen the USE of the funds for enrolling (because they might view the premiums as too high, even if subsidized fully). That said, the question framing makes me think the person would technically not be worse off or less able to afford the plans if they received the same amount of money. It is how they respond to the money that I think would be worse off!
Jose Esarce	Worsen	8
Elliott Fisher	Worsen	9
Richard Frank	Worsen	7
Craig Garthwaite	Have no effect on	4	It is possible this could lead to some adverse selection as individuals may not sign up for coverage if they can keep the funds in an HSA and we might expect those who didn’t sign up would be healthier enrollees. I would imagine that how this would affect affordabilty (as opposed to spending) is a question of where on the subsidy schedule the remaining enrollees are.
Darrell Gaskin	Worsen	8	HSAS only save money for people who use care.
Martin Gaynor	Worsen	9
Sherry Glied	Have no effect on	6	I don’t really understand the term affordability in this context. Depositing money into an HSA will make the first dollar of health care cheaper for many people but they will face higher net-of-subsidy premiums. I suspect the net effect on average will be about zero for those who continue to buy coverage (I suppose they could use their HSA balance to pay their premium).
David Grabowski	Worsen	5
Jonathan Gruber	Worsen	10	The lowest income households don’t benefit from an HSA.
Vivian Ho	Improve	6	I like Tony LoSasso’s proposal along these lines: https://www.medpagetoday.com/opinion/second-opinions/118673?trw=no
Jason Hockenberry	No Opinion	0	I would expect heterogenous effects in different subgroups.
Haiden Huskamp	Worsen	9	Although there are exceptions, one generally can’t use health savings account funds to pay for premiums.
Benedic Ippolito	No Opinion	0	Depends on what measure of affordability. Would expect more enrollment in lower costs plans traded off against network size and cost sharing.
Anupam Jena	No Opinion	0
Nancy Keating	Worsen	6	Many people are likely to keep that money in the HSA and not purchase Marketplace insurance; those who enroll are likely to be higher risk, likely leading to premium increases and higher costs for Marketplace enrollees.
Aaron Kesselheim	Worsen	9
Jonathan Kolstad	Worsen	8
R Tamara Konetzka	Worsen	7
Rick Kronick	Worsen	2	A lot of uncertainty related to the proposal that might be made. If the money contributed to an ‘HSA’ could be used to pay for Marketplace premiums (not true for existing HSAs, but possible if new legislation allows), effects may be muted: fewer people may buy ACA compliant insurance and the risk pool might worsen, and more people might buy short term policies, again increasing costs for those who actually need insurance, but likely not a catastrophe. If the money deposited into an ‘HSA’ can only be used for qualified medical expenses, as is true for HSAs under current law, then big problems as many relatively healthier people drop their ACA coverage and premiums go up substantially for those left in the pool.
Valerie Lewis	Worsen	5
Nicole Maestas	Have no effect on	6
Tom McGuire	Worsen	9
Ellen Meara	Worsen	7	Any time you add an extra step in the process to get or keep insurance, people fall off.
Ateev Mehrotra	Improve	3	I found this a tough question to answer. As currently structured my understanding is that HSAs cannot be used to pay insurance premiums. So many Americans would now have money in their HSA they could use for care. For the majority of Americans who are healthy such a policy will be great and they will be able to pay for care out-of-pocket using their HSA. However, for those with more substantial costs who no longer have insurance, such a policy will make care unaffordable and/or lead to bankruptcy.
David Meltzer	Worsen	8
Joseph Newhouse	Worsen	10	This unties the subsidy from insurance. In principle an individual could just use the money to buy insurance, but good risks will disproportionately not do so, leading to a further increase in premiums and some deciding not to buy.
Sean Nicholson	Worsen	9
Steve Parente	Improve	8
Stephen Patrick	Worsen	10	Likely a large gap in expenditures on a high deductible plan and the amount deposited. Big risk of underfunded HSA accounts coupled with suboptimal insurance products.
Harold Pollack	Worsen	4	There is significant diversity of circumstance among marketplace participants. On balance, I suspect this will worsen things for most recipients
Daniel Polsky	Worsen	9	To be honest, the devil is in the details. The Scott proposal would destablize the market and is really a non starter. The Cassidy proposal is interesting and would make worsen affordability of health care for those who no loner enroll becuase the change makes the premium unaffordable (this was not specificlly in the question). For those under 250FPL who got premium tax credits, affordability woudl almost certainly worsen. Those above 250FPL who can still afford the premiums, may have some value, on net – this would create greater benefits for those who don’t use up all the HSA and can save – these are the relatively healthy.
Ninez Ponce	No Opinion	0
Thomas Rice	Worsen	9
Meredith Rosenthal	Have no effect on	8	My understanding is that that the proposal is to alter the HSA rules so people can use the funds to pay for insurance and thus depositing the funds into an HSA increases flexibility but should allow people to make the same choices as before. That said, any change will likely lose some people to confusion and cause a rise in uninsurance due to friction.
Joseph Ross	Worsen	8	I’m doubtful that all individuals will obtain the funds, and among those that do, I am doubtful that they will systematically use the funds to pay the premium for health insurance. And if they do not, it will mean fewer people will retain health insurance, ensuring its affordability for all.
Brendan Saloner	Worsen	5	I think it will shift more cost on consumers, but it could improve affordability if it allows consumers to shop for products that are less padded, have better value networks, etc. and therefore reduces inflation.
Kosali Simon	Improve	8	Many things about this would depend on the details, for example whether we meant longer term comprehensive affordability or short run individual affordability: capping the amount people receive and allowing them to allocate the funds would keep plans accountable knowing that families rather than the government spends the last dollar.
Jon Skinner	Worsen	8
Ben Sommers	Worsen	9
Neeraj Sood	Improve	7
David Stevenson	Worsen	8
Kevin Volpp	Worsen	7
Rachel Werner	Worsen	7

Question Two

Requiring Marketplace enrollees who otherwise qualify for fully subsidized plans to pay a small (e.g., $5-$10) monthly premium would measurably… (select all that apply)

Name	Vote	Confidence	Comments
Margarita Alegria	Reduce fraudulent enrollment; Reduce Marketplace enrollment among eligible individuals who intended to stay enrolled; Reduce the number of people who remain enrolled without their knowledge	7
David Asch	Reduce Marketplace enrollment among eligible individuals who intended to stay enrolled; Reduce the number of people who remain enrolled without their knowledge	8
John Ayanian	Reduce the number of people who remain enrolled without their knowledge	5
Peter Bach	Reduce the number of people who remain enrolled without their knowledge	3
Laurence Baker	None of the above	5
David Blumenthal	Reduce Marketplace enrollment among eligible individuals who intended to stay enrolled; Reduce the number of people who remain enrolled without their knowledge	8
Erin Fuse Brown	Reduce Marketplace enrollment among eligible individuals who intended to stay enrolled	6
Melinda Buntin	Reduce fraudulent enrollment; Reduce Marketplace enrollment among eligible individuals who intended to stay enrolled; Reduce the number of people who remain enrolled without their knowledge	9
Michael F. Cannon	Reduce fraudulent enrollment; Reduce the number of people who remain enrolled without their knowledge	10
Lawrence Casalino	Reduce fraudulent enrollment; Reduce the number of people who remain enrolled without their knowledge	6
Amitabh Chandra	Reduce Marketplace enrollment among eligible individuals who intended to stay enrolled	8
Lanhee J. Chen	Reduce fraudulent enrollment; Reduce the number of people who remain enrolled without their knowledge	7
Michael Chernew	Reduce fraudulent enrollment; Reduce Marketplace enrollment among eligible individuals who intended to stay enrolled; Reduce the number of people who remain enrolled without their knowledge	7
Janet Currie	Reduce fraudulent enrollment	6	My understanding is that one type of fraud is one where someone doesn’t know that insurance has been taken out in their name. Having people pay a small amount would presumably eliminate this type of fraud.
Lesley Curtis	Reduce Marketplace enrollment among eligible individuals who intended to stay enrolled; Reduce the number of people who remain enrolled without their knowledge	7
David Cutler	Reduce fraudulent enrollment; Reduce Marketplace enrollment among eligible individuals who intended to stay enrolled; Reduce the number of people who remain enrolled without their knowledge	6
Julie Donohue	Reduce Marketplace enrollment among eligible individuals who intended to stay enrolled	9	There is empirical research demonstrated increases in enrollment in markets that introduced zero premium plans.
Joseph Doyle	Reduce Marketplace enrollment among eligible individuals who intended to stay enrolled; Reduce the number of people who remain enrolled without their knowledge	6	Intended to stay enrolled at zero premium
David Dranove	Reduce fraudulent enrollment; Reduce the number of people who remain enrolled without their knowledge	9
Stacie Dusetzina	Reduce the number of people who remain enrolled without their knowledge	3	I do not know how big of a problem it is that people “do not know they are enrolled.” I do think that insurance should cost at least a nominal amount for everyone.
Jose Esarce	None of the above	6
Elliott Fisher	Reduce Marketplace enrollment among eligible individuals who intended to stay enrolled	9
Richard Frank	Reduce Marketplace enrollment among eligible individuals who intended to stay enrolled; Reduce the number of people who remain enrolled without their knowledge	8
Craig Garthwaite	Reduce fraudulent enrollment; Reduce the number of people who remain enrolled without their knowledge	5
Darrell Gaskin	Reduce Marketplace enrollment among eligible individuals who intended to stay enrolled	8
Martin Gaynor	Reduce Marketplace enrollment among eligible individuals who intended to stay enrolled	9
Sherry Glied	Reduce fraudulent enrollment; Reduce Marketplace enrollment among eligible individuals who intended to stay enrolled; Reduce the number of people who remain enrolled without their knowledge	6
David Grabowski	Reduce Marketplace enrollment among eligible individuals who intended to stay enrolled; Reduce the number of people who remain enrolled without their knowledge	6
Jonathan Gruber	Reduce fraudulent enrollment; Reduce Marketplace enrollment among eligible individuals who intended to stay enrolled; Reduce the number of people who remain enrolled without their knowledge	10	Lots of evidence that moving off zero has large effects
Vivian Ho	Reduce fraudulent enrollment; Reduce Marketplace enrollment among eligible individuals who intended to stay enrolled; Reduce the number of people who remain enrolled without their knowledge	8
Jason Hockenberry	No opinion	0	I am not sure we have good data to make a clear prediction on this.
Haiden Huskamp	Reduce Marketplace enrollment among eligible individuals who intended to stay enrolled	10
Benedic Ippolito	Reduce fraudulent enrollment; Reduce Marketplace enrollment among eligible individuals who intended to stay enrolled; Reduce the number of people who remain enrolled without their knowledge	8	Anticipate enrollment losses due to new admin burdens, like setting up payments or awareness, would shrink over time.
Anupam Jena	Reduce fraudulent enrollment; Reduce Marketplace enrollment among eligible individuals who intended to stay enrolled; Reduce the number of people who remain enrolled without their knowledge	7
Nancy Keating	Reduce the number of people who remain enrolled without their knowledge	6
Aaron Kesselheim	Reduce Marketplace enrollment among eligible individuals who intended to stay enrolled; Reduce the number of people who remain enrolled without their knowledge	9
Jonathan Kolstad	Reduce Marketplace enrollment among eligible individuals who intended to stay enrolled; Reduce the number of people who remain enrolled without their knowledge	9
R Tamara Konetzka	Reduce Marketplace enrollment among eligible individuals who intended to stay enrolled; Reduce the number of people who remain enrolled without their knowledge	7
Rick Kronick	Reduce Marketplace enrollment among eligible individuals who intended to stay enrolled; Reduce the number of people who remain enrolled without their knowledge	3
Valerie Lewis	Reduce Marketplace enrollment among eligible individuals who intended to stay enrolled	6
Nicole Maestas	Reduce Marketplace enrollment among eligible individuals who intended to stay enrolled; Reduce the number of people who remain enrolled without their knowledge	10
Tom McGuire	Reduce fraudulent enrollment; Reduce Marketplace enrollment among eligible individuals who intended to stay enrolled; Reduce the number of people who remain enrolled without their knowledge	7
Ellen Meara	Reduce Marketplace enrollment among eligible individuals who intended to stay enrolled; Reduce the number of people who remain enrolled without their knowledge	9
Ateev Mehrotra	Reduce fraudulent enrollment; Reduce Marketplace enrollment among eligible individuals who intended to stay enrolled; Reduce the number of people who remain enrolled without their knowledge	7	Extremely small monthly premiums will reduce enrollment. This will include reductions in fraudulent enrollment and those that cannot afford it. Further, in some way, the $5 per month would likely reduce enrollment because of the administrative burden of obtaining the $5.
David Meltzer	Reduce Marketplace enrollment among eligible individuals who intended to stay enrolled; Reduce the number of people who remain enrolled without their knowledge	7
Joseph Newhouse	Reduce Marketplace enrollment among eligible individuals who intended to stay enrolled; Reduce the number of people who remain enrolled without their knowledge	8	I’m more confident about reducing enrollment.
Sean Nicholson	None of the above	8
Steve Parente	Reduce fraudulent enrollment; Reduce Marketplace enrollment among eligible individuals who intended to stay enrolled; Reduce the number of people who remain enrolled without their knowledge	9
Stephen Patrick	No opinion	0
Harold Pollack	Reduce Marketplace enrollment among eligible individuals who intended to stay enrolled	6
Daniel Polsky	Reduce Marketplace enrollment among eligible individuals who intended to stay enrolled; Reduce the number of people who remain enrolled without their knowledge	10
Ninez Ponce	Reduce Marketplace enrollment among eligible individuals who intended to stay enrolled	8
Thomas Rice	Reduce Marketplace enrollment among eligible individuals who intended to stay enrolled	8
Meredith Rosenthal	Reduce Marketplace enrollment among eligible individuals who intended to stay enrolled; Reduce the number of people who remain enrolled without their knowledge	10
Joseph Ross	Reduce Marketplace enrollment among eligible individuals who intended to stay enrolled; Reduce the number of people who remain enrolled without their knowledge	9	If you require low income adults to pay for premiums out of pocket, some proportion will not, or not be able to, pay for coverage, destabilizing the insurance market.
Brendan Saloner	Reduce fraudulent enrollment; Reduce Marketplace enrollment among eligible individuals who intended to stay enrolled; Reduce the number of people who remain enrolled without their knowledge	8
Kosali Simon	Reduce fraudulent enrollment	5	This also depends on what we assume about checks and balances already in place, but adding this incentive for individuals to actually pay even $5 for a premium with $10,000 paid by the government would ensure that these are individuals who actively are signed up. However, we want to ofcourse avoid people finding that even a $1 contribution is a barrier to affordability.
Jon Skinner	Reduce fraudulent enrollment; Reduce Marketplace enrollment among eligible individuals who intended to stay enrolled; Reduce the number of people who remain enrolled without their knowledge	7
Ben Sommers	Reduce fraudulent enrollment; Reduce Marketplace enrollment among eligible individuals who intended to stay enrolled; Reduce the number of people who remain enrolled without their knowledge	8	I think the 3rd group above is much larger than the first two groups.
Neeraj Sood	Reduce fraudulent enrollment; Reduce Marketplace enrollment among eligible individuals who intended to stay enrolled; Reduce the number of people who remain enrolled without their knowledge	7
David Stevenson	Reduce Marketplace enrollment among eligible individuals who intended to stay enrolled; Reduce the number of people who remain enrolled without their knowledge	7
Kevin Volpp	Reduce Marketplace enrollment among eligible individuals who intended to stay enrolled	7
Rachel Werner	Reduce Marketplace enrollment among eligible individuals who intended to stay enrolled; Reduce the number of people who remain enrolled without their knowledge	8

Question Three

Eliminating passive reenrollment with subsidy for people enrolled in Marketplace coverage will substantially reduce Marketplace enrollment.

Name	Vote	Confidence	Comments
Margarita Alegria	Strongly Agree	9
David Asch	Uncertain	4
John Ayanian	Agree	5
Peter Bach	Agree	4
Laurence Baker	Agree	5
David Blumenthal	Strongly Agree	10
Erin Fuse Brown	Agree	7
Melinda Buntin	Strongly Agree	9
Michael F. Cannon	Disagree	8	The Samaritan’s Dilemma is hard.
Lawrence Casalino	Agree	7
Amitabh Chandra	Strongly Agree	8
Lanhee J. Chen	Agree	7
Michael Chernew	Strongly Agree	9
Janet Currie	Agree	8	Administrative processes for verifying income are often burdensome making it difficult for people to verify income even when they qualify for subsidies. Many studies have shown that increasing these types of administrative burden reduce enrollment.
Lesley Curtis	Strongly Agree	9
David Cutler	Strongly Agree	7
Julie Donohue	Strongly Agree	9	This statement is consistent with lots of empirical research on opt-in vs opt-out policies in insurance and other markets
Joseph Doyle	Strongly Agree	7
David Dranove	Disagree	8
Stacie Dusetzina	Agree	7	Assuming that subsidies are not provided if income isn’t verified, I would imagine that many people would drop coverage if premiums increased.
Jose Esarce	Disagree	8
Elliott Fisher	Strongly Agree	10
Richard Frank	Strongly Agree	9
Craig Garthwaite	Uncertain	5
Darrell Gaskin	Agree	6
Martin Gaynor	Strongly Agree	9
Sherry Glied	Agree	7
David Grabowski	Strongly Agree	6
Jonathan Gruber	Strongly Agree	10	Hassle costs matter!
Vivian Ho	Strongly Agree	10
Jason Hockenberry	Agree	7	I expect this would be largely concentrated among specific subgroups (i.e. those who use little or no care on a recurring basis).
Haiden Huskamp	Strongly Agree	10
Benedic Ippolito	Agree	1	Supporters would emphasize benefits of this policy change, like program integrity.
Anupam Jena	Agree	5
Nancy Keating	Strongly Agree	6
Aaron Kesselheim	Agree	9
Jonathan Kolstad	Strongly Agree	9
R Tamara Konetzka	Uncertain	5
Rick Kronick	Strongly Agree	7
Valerie Lewis	Strongly Agree	8
Nicole Maestas	Strongly Agree	10
Tom McGuire	Strongly Agree	9
Ellen Meara	Strongly Agree	10	We know that passive enrollment leads to higher enrollment than requiring administrative hurdles to keep enrollment. This is the justification for default re enrollment policies.
Ateev Mehrotra	Strongly Agree	8	Any administrative burden will substantially decrease enrollment. Verifying income is a substantial administrative burden.
David Meltzer	Uncertain	5
Joseph Newhouse	Agree	6	This assumes the hassle cost of reverifying income outweighs the benefits from being insured, which seems plausible for good risks/young invincibles.
Sean Nicholson	Uncertain	5
Steve Parente	Uncertain	5
Stephen Patrick	Strongly Agree	10
Harold Pollack	Agree	7
Daniel Polsky	Uncertain	5	It will measurably reduce enrollment, but I don’t think it would be substantial among those who should qualify.
Ninez Ponce	Uncertain	5
Thomas Rice	Strongly Agree	5
Meredith Rosenthal	Strongly Agree	10
Joseph Ross	Agree	7	I have high confidence that eliminating passive re-enrollment will reduce Marketplace enrollment, I am just not certain if the reduction will be substantial (in my mind, >5% of all enrollees) or only measurable.
Brendan Saloner	Agree	7	Basic behavioral economics suggests that default options are very important.
Kosali Simon	Agree	5
Jon Skinner	Uncertain	5
Ben Sommers	Agree	8
Neeraj Sood	Agree	7
David Stevenson	Strongly Agree	9
Kevin Volpp	Strongly Agree	9
Rachel Werner	Strongly Agree	10

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