December Trends in Obamacare Opinions (2013)

After some brutal polling numbers in November for the Affordable Care Act in connection with the glitch-filled website for signing up and the controversy over President Obama’s “If you like your plan…” promise, the December numbers have rebounded a bit, but are still not great. In the remainder of this post, I draw from Polling Report’s summary of Health Policy polling and other sources to highlight some key findings from the latest batch of polls.

The November polls with the harshest judgments against the ACA almost certainly were those conducted by CBS News and Quinnipiac University. Below, I’ve plotted the approval and disapproval numbers for the ACA from the last several polls conducted by CBS News (either with or without its frequent polling partner, the New York Times), the time frame of which encompasses both the original October 1 launch of online sign-ups and the December 1 relaunch. Whereas the absolute levels of approval and disapproval might be somewhat misleading because opposition includes some people on the left who don’t think the ACA has enough government involvement, the trends over time seem pretty clear.

In the first three CBS/NYT polls shown (mid-September, early-October, and mid-October), disapproval exceeded approval by roughly 10 percentage points, give or take. In the mid-November poll (Nov. 15-18), the margin had ballooned to 30 points. However, as of the December 5-8 survey, the difference between approval and disapproval is now back to around 10 points.

The November 6-11 Quinnipiac Poll asked respondents if they “believe[d] the problems with the website will be fixed by November 30, or don’t you think so?” Whereas 29% of respondents said yes, they thought the website would be fixed, a whopping 61% did not think it would be fixed. The Quinnipiac respondents’ pessimism regarding the website did not appear to be well founded, as the functionality of the website does appear to be improving, based upon both news reports and polling results.

Regarding the latter, the early-December CBS/NYT Poll found nearly three times as many people (36%) saying they thought the sign-up process for the Obamacare exchanges was “getting better,” than saying it was “getting worse” (13%). Forty-four percent claimed it was “about the same” as before. It is not clear to me if the part of the survey about the website was administered to all respondents or only those who had tried to sign up for insurance via the ACA exchanges. Most Americans already have health insurance and would not need to use the exchanges.

There have been suggestions by some in the media that Obamacare implementation has turned the corner and taken full repeal by the Congress — whatever its chances were in the past — off the table now. In looking at the aforementioned Polling Report compilation on health-policy polls, the only November 2013 poll I could find with a question on repeal was that by CBS News (Nov. 15-18). In this survey, 43% endorsed the view that, “The law has so much wrong with it that it needs to be repealed entirely.” That is a very high pro-repeal figure compared to the 2012 presidential exit polls and other previous polls (except for Rasmussen polls, which I think have a strange wording). It must be remembered, though, that the mid-November CBS poll was taken amidst the furor over the malfunctioning website and people losing their existing individual-market coverage.

Based on the small number of December 2013 polls I could find that included a repeal item, support for such a move is back in line with what one would have found prior to the October-November 2013 controversies. Gallup (Dec. 3-4) found 32% of respondents endorsing “repeal the health care law entirely.” The NBC/Wall Street Journal Survey (Dec. 4-8) found the following percentage breakdown (original wordings of choices shown):

Is working well the way it is ……………………….. 4 
Needs minor modifications to improve it ……… 36 
Needs a major overhaul …………………………….. 31 
Should be totally eliminated ……………………….. 26

Focusing on the combined percentages who favored minor or major modifications to the ACA, Chris Matthews, host of the nightly MSNBC cable show “Hardball,” said the following on his December 12 broadcast:

…after all this negative P.R., all the foul-ups, the screwups, the rollout, the whole thing, and still two-thirds put their heart and their mind on the need to have adequate affordable health care for their families. They don`t like the screwups, but they want the program to work and be fixed. That`s a powerful inducement for Democrats not to turn tail.

Another positive sign for the ACA comes from a recent poll (Dec. 3-8) by the Democratic Party-affiliated group Democracy Corps. The poll was conducted not of the nation as a whole, but of likely voters residing in U.S. House districts deemed “most competitive” for next year’s midterm elections (50 Republican-held and 36 Democratic-held). Democracy Corps gave respondents the choice between “implement and fix” vs. “repeal and replace” the ACA. In the 86 districts combined, implement and fix prevailed 49-44 (note that the overall sample is likely GOP-leaning, given that more of the seats are held by Republicans).

Finally, as discussed on HuffPost/Pollster, two somewhat conflicting pictures emerged regarding young adults’ views of the ACA. The Harvard Institute of Politics poll of 18-29 year-olds, conducted from October 30-November 11, found generally negative views toward the health care law, including sub-40% approval ratings. In stark contrast, a CNN poll conducted November 18-20 pegs 18-34 year-olds’ support for the law at 48% and that doesn’t include another 12% who say they oppose the law because it is not liberal enough. In other words, 60% of 18-34 year-olds either like Obamacare or wish more liberal provisions had been enacted, according to the CNN poll.

Included in what Harvard IOP describes as its “5 Key Findings” of this year’s poll, “Among the 18-29-year olds currently without health insurance, less than 1/3 say they’re likely to enroll in the exchange (13% say they will definitely enroll, 16% say they will probably enroll); 41% say they are 50-50 at the moment.” As has been widely discussed in health-policy circles, it is important for large numbers of young, healthy people (sometimes known as the “invincibles”) to sign up for health insurance, to balance the costs of treating people with pre-existing conditions who now have greater access to insurance under Obamacare.

In fact, Washington Post policy analyst Ezra Klein argues that the actuarial soundness of the ACA enrollee pool (in terms of age and healthiness distributions) is more important than the total number of people who sign up. Thus, if the Harvard IOP numbers on young people’s intent to sign up turn out to be accurate, the ACA could face difficulties.

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