No wonder Republicans can campaign against the ACA when a plurality of Americans still believes it includes ‘death panels’
President Obama’s healthcare law is hated and loved by some so much that they are willing to shut down the government over it. I’m not sure I’ve ever seen so much passion over an issue about which so few (myself included) know as much as we should.
I wrote about this divide when Obamacare was in front of the US supreme court. Americans were opposed to “Obamacare”, or the Affordable Care Act, yet they were in favor of many of its provisions. Not surprisingly, Americans lacked knowledge of what exactly the law did.
So, as the political fight has intensified, on the eve of implementation of one of the ACA’s key provisions, the creation of new health insurance pools, how much has changed? Does the noisy debate on the ACA mean Americans are better-informed than before about Obamacare? Here are five ways Americans’ opinions about Obamacare have and have not evolved over the past year.
1. Americans have grown more negative in their views
The HuffPollster chart tells the story fairly well. It includes polls that ask about Obamacare and the Affordable Care Act (ACA).
Last June, the split was about 47% opposed to, and 40% in favor of, Obamacare. That gap narrowed, after the supreme court upheld the law’s constitutionality. The difference between those for and against the law dropped to only 2pt by the election.
Since the election, however, US public opinion has changed drastically: 52% of Americans now oppose Obamacare – that’s tied at the record high. A little less than 38% are in favor of it, according to the HuffPollster aggregate.
2. The Obamacare v the Affordable Care Act difference still exists, though may be overblown
A few weeks ago, a CNBC poll purported to show major differences when asked about the law in different manners: 46% were against Obamacare, while only 37% were opposed to the ACA. Importantly, support for the healthcare law also dropped from 29% to 22%. What’s happening is that Americans have heard a lot about “Obamacare”, but not much about the ACA. The key is the difference between those who favor and those who oppose for each question, which is about 15pt.
Most of the polls that show the best numbers for Obamacare (that is, the margin of opposition at 10pt or less) don’t mention Obama’s name. These include the Kaiser and ABC/Washington Post surveys. A Fox News poll found the gap was slightly wider, with the margin between favorable and unfavorable towards Obamacare at 26pt, and just 16pt for the ACA. Some, such as the UConn/Hartford Courant poll, use similar wording and find the largest gaps.
The bottom line is that many Americans oppose Obamacare no matter the wording. But Obama’s name probably makes them even less likely to like it.
3. There is a percentage of Americans who oppose the law for not going far enough, though this, too, is likely overblown
Democrats like to point out that even as a majority opposes Obamacare, a certain percentage of Americans think it’s because the law is “not liberal enough”. A new CNN poll puts that percentage at 11%. When you add those who favor Obamacare to those who regard it as “not liberal enough”, you have a near-majority.
The problem with this finding is that I don’t believe that Americans necessarily know what “too liberal” means in this context. My evidence for that is that the group with the highest percentage of those who say they are against the law because it is “too liberal” are, in fact, Republicans.
The actual percentage who don’t like Obamacare because it’s not liberal enough is probably closer to 7%, if not lower. That’s the percentage Kaiser found when they asked if Obamacare went “far enough” in changing the healthcare system. I caution, however, that some of that may be those who want radical conservative change – such as yearning for government to get completely out of healthcare.
4. Americans continue to like the individual provisions, except for the individual mandate
While only 37% of Americans viewed the ACA favorably in a March 2013 Kaiser poll, most liked what the healthcare bill is scheduled to do. Over 55%, and up to 88%, of Americans regard the following facets of Obamacare at least somewhat favorably: tax credits to small businesses to buy insurance, closing the Medicare “doughnut hole”, creating insurance exchanges, giving rebates to customers of insurance customers that spend too much on administrative costs, and the employer mandate. Even Republicans like all of them except the Medicaid expansion, increase in Medicare tax, employer mandate, and individual mandate.
Indeed, the only requirement of Obamacare most people didn’t like was the mandate for all people to join it.
5. Americans still don’t seem to know what Obamacare means for them
Given the discordance between Americans’ feelings on the individual parts of Obamacare and the law as a whole, it’s not that surprising that a striking 41% of Americans don’t feel they have enough information about the ACA, per the UConn/Hartford survey. Only 19% say they are very familiar with the law.
The individual provision questions strike the same chord. More than a third of people are unaware of the health insurance exchanges, subsidy assistance to individuals, or the Medicaid expansion. The latter two provisions of the law have actually seen a decrease in the percentage of people who knew these policies were in the bill, since it first passed. The only part of Obamacare that Americans seem to know really well is the individual mandate, which has also seen the largest percentage-point increase in awareness.
More worryingly, more people than not thought that Obamacare includes a public option, undocumented immigrant insurance, “death panels”, and cuts to Medicare. The Affordable Care Act contains none of these.
The fact is most of Obamacare is liked by the public. The issue is that the provision that is not liked is the best-known.
Conclusion: Americans are confused on Obamacare
There are lots of confused and confusing data here, and it’s difficult to say anything definitive about how Americans feel about the healthcare law signed by President Obama in 2010. As I found more than a year ago, they don’t like the law overall, even while they approve many of its measures.
Some Democrats may say that this points in their favor, but the same dynamic of a differential between the backing people will give for a broad proposition as opposed to their support for individual policies could be said to operate in the case of gun control. Thus two Colorado state senators were recently recalled over a gun control law whose individual provisions many said they liked.
Overall, Americans clearly don’t know enough about Obamacare. Of course, they know just as little about the Affordable Care Act – but to the extent that they are less hostile to a law that doesn’t bear President Obama’s name, it does appear that the embrace of the term “Obamacare” by Democrats and the White House was a tactic that has not worked out.