Several thousand interviews conducted by Gallup between May 21 and 25 revealed that “as of yet, there is no sign that Americans think the new healthcare law is having a net positive effect on their healthcare situations.” The majority of Americans reported that the Affordable Care Act has done little to change their “personal situations” since the research firm first started asking the question in 2012.
But still, since the reform’s cornerstone provision — the online insurance marketplaces — launched last October, public sentiment has gradually grown stronger. The number of respondents who say the law has had a positive effect, 14 percent, is within one percentage point of a record high. Yet, public opinion has turned increasingly negative as well; those Americans who say the law has had a harmful effect, 24 percent, is also within one point of being the highest negative measure recorded. And predictably, public opinion is guided by political affiliation and insurance status. Overwhelmingly, Democrats, those Americans earning less than $24,000 annually, and the newly insured support the law.
This data both shows how politically charged the Affordable Care Act remains and suggests that the Republican-lead movement to repeal, defund, or otherwise dismantle the health care reform law may still have some political capital.
It has been argued — and soundly — that repeal appears to be an untenable position for the Republican party. The future of the Affordable Care Act is stabilizing; President Barack Obama knows it, and Republicans facing reelection or challenging Democrat incumbents in November’s midterm congressional elections are beginning to realize it as well. After all, with 8 million Americans enrolled in individual insurance plans purchased through the Obamacare exchanges, about 4.8 million people signed up for Medicaid thanks to the reform’s optional expansion of eligibility, and the 3 million young people newly covered by their families’ plans, the health care reform would be no easy matter to unravel. But even while the foundations of Obamacare stabilize and the reforms becomes more closely intertwined with society, the fact that the public opinion remains far from positive could potentially impact further progress with implementation. Not only will Gallup’s data likely inject renewed vigor to those Obamacare critics arguing that the law was thrust upon an uninterested American public, an argument Louisiana Gov. Bobby Jindal made in a recent exposition on why the health care reform law can and should be repealed.
Still, the fact that the more than 8 million Americans enrolled for coverage through the Obamacare insurance exchanges, and that the provisions of the reform have lowered the national uninsured rate from last year’s high of 18 percent to 13.5 percent as of May, has necessitated modifications of party rhetoric for both Democrats and Republicans. Similarly, lawmakers will also have to respond to the fact that a large portion of the American public continues to view the reform unfavorable, as Gallup data and a recent Wall Street Journal/NBC Poll indicate. Forty-six percent of respondents told WSJ/NBC pollsters that the Affordable Care Act was a bad idea. Yet, repeal is not overwhelmingly popular. A March WSJ/NBC survey found Americans to be almost evenly divided when asked if they were more likely to vote for a Democrat that promised to fix the law or a Republican that would repeal it.
But while calls for repealing Obamacare have not rung out as loud as they did in October, amid the shutdown of the federal government, the most fundamental tenant of the health care reform debate has not noticeably changed; most Democrats still argue the health care reform is the most ambitious social program implemented in the United States since Medicare was passed in the 1960s, while Republicans still say it has put the United States on the slippery slope to socialism and a destroyed health care system. After all, it is election year and Republican lawmakers up for reelection need to appease those voters who want Obamacare repealed without alienating their more moderate constituents. More importantly, the party’s leadership is aware the same arguments against the individual insurance mandate can no longer be made.
But conventional wisdom on the Affordable Care Act is in transition. Democrats — who, for a time in the wake of the health website’s troubled launch, were hesitant to take a strong stance on the law’s benefits — are now taking a much more assertive stance on how the reform has improved the American health care system. And, more importantly, those lawmakers are discussing fixes that should made rather than simply trying to convince voters that the Affordable Care Act will improve their lives. The public’s low support for repeal, plus the technical improvement of the website, serve to explain why Democrats have become more comfortable discussing the reform. Of course lawmakers running for reelection are still employing tried and true strategies: criticizing Republican colleagues for attempting to derail the reform and reminding constituents that Obamacare has made insurance coverage more accessible for those with pre-existing conditions.
Meanwhile, Republicans criticism of Obamacare is also evolving. During the recent primaries, Republican candidates attack the law’s failings and provisions, using the Affordable Care Act as a stand-in for President Barack Obama. But as Republican pollster Bill McInturff told the Journal, both challengers and incumbent lawmakers will take a more nuanced approach to the repeal campaign. “You have to talk about what specifically [the Democrats] have screwed up, what went wrong what needs to be fixed. You have to have a bill of particulars about what hasn’t worked,” he said. And the mass cancellations of policies not compliant with Obamacare requirements would be the perfect example. A commercial supporting Republican Sen. Mitch McConnell of Kentucky illustrated the changing tenor of GOP rhetoric. The ad featured a clip of the senator claiming he was “leading the fight to fix this Obamacare mess,” and no mention was made of repeal.
For lawmakers going into November’s midterm election, the big question will be how big of an impact on the American health care system, how Americans truly feel about the reform, and the satisfaction levels of those newly insured by policies purchased through the exchanges or thanks to the expansion of Medicaid. Gallup’s survey data suggests that those who appreciably benefited from the law — either through subsidized insurance purchased through the exchanges or Medicaid coverage — are more likely to view the law favorably. But those individuals make up a relatively small percentage of the total American population. A plurality of survey respondents, 39 percent, said the law had not made much difference in their lives. And almost as many respondents, 36 percent, said the law had made their health care situation worse. Only 22 percent said the law made an improvement.
“That so few believe the healthcare law has had a positive impact on their lives could mean most Americans would not be upset if lawmakers change the law,” noted Gallup’s Frank Newport. “Democrats running for office this year appear to be adopting a ‘keep and improve’ position that acknowledges that the law needs changes.”
By comparison, House Republicans announced Wednesday that they would put forward their own reform plan for a vote later this year, promising that it would radically change how the American health care system works.
“This proposal almost certainly has little chance of becoming law this year, and it is far from clear if the proposed plan would be any more popular than Obamacare,” continued Newport. “But given the widespread perception that Obamacare has not benefited Americans so far, politicians on both sides of the aisle would appear to have little to lose by advocating changes to some elements of the law.”
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- Obamacare Remains the Elephant in the Room for Healthcare Costs
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