By Tom Packer
Obamacare represents for good or ill probably the most important change in domestic policy of President Obama’s administration.
The two acts that compose ‘Obamacare’ represented a compromise with congressional sentiment rather than Obama’s ideal blueprint. Obamacare passed very narrowly in April 2010. Not a single Republican in the Senate or the House of Representatives voted in favour of the main bill. Large Democratic majorities allowed it to pass, in spite of 34 House Democrats voting against.
As I have already shown, the US healthcare system was already a distinctly mixed system in terms of government involvement. Nonetheless if Obamacare sticks and comes fully into effect it will be the most radical reform of US healthcare since at least the 1960s. How popular or unpopular has this proven to be with voters?
Since the law was passed in March 2010 most polls have shown the US public opposing it by margins ranging from ten to twenty points. Notably, most of these polls have been by Rasmussen Reports, often considered one of the more Republican-leaning pollsters. But the decision of Democrats to decline to publish polls on the health reform with a straight up and down question itself speaks volumes.
A rare exception to this general finding has been the Kaiser Tracking poll which has been taken monthly since April 2010 which has found much less opposition . In April 2010 this even found a plurality of Americans supportive of the law. However most even of Kaiser’s subsequent polling has found the reverse
Perhaps the most important test of public opinion so far is the 2010 US Elections. They are a particularly important test as they allow the measuring of intensity. Obamacare may appear to be unpopular with a (slim) majority of the public but who cares more and actually votes on it?
In November 2010 the Republicans made almost unprecedented gains in the midterm elections (Congressional elections, midway through a presidents’ term) elections which include the entire US House of Representatives and around a third of the Senate and matter a great deal for how the United States is governed
The party that holds the presidency almost always loses seats in midterm elections (1998 and 2002 being the two exceptions over the last seventy eight years). However 2010 was an extreme example of this, with Republicans gaining sixty three House seats from the Democrats – the most gains since 1938. They gained seven Senate seats despite having many more seats they held up for re-election than the Democrats.
This landslide is often ascribed to the economy but in fact the link between the economy and midterm election results is very tenuous there is simply no strong or clear link between the economy in a given year and midterm election results (Presidential elections are a very different story) For example in 1982 during a bad recession the President’s party actuallymade gains. Moreover, the polls found that only around a quarter of Americans blamed Obama for the bad economy fewer than blamed Bush.
Voting for Obamacare was correlated with defeat for Democrats. A greater proportion of Democrats in the House of Representatives who voted for the law won re-election.But overall they fought much safer seats than the Democrats who voted against, many of whose districts were in states that had voted for John McCain in 2008, not Barack Obama.
Congressman Bobby Bright of Alabama’s second district is an example of this. He voted against the law and then lost his seat. But he lost it by only 2%, while Barack Obama had lost it by 20% two years earlier in a much more favourable year for his party. Bright actually ran about fourteen points ahead of the typical Democrat result that year. This result therefore suggests voting against Obamacare helped rather than hurt Democrats.
For a given level of Democratic support in a district opponents of Obamacare did much better in the 2010 election. Democrats in districts reasonably competitive between the two parties were roughly twice as likely to lose re-election if they’d voted for Obamacare.
Interestingly, this was not true of other signature policies of the current US administration. For example the fiscal ‘stimulus’ (much bigger than in the UK) lacked the same correlation with a poor performance in November 2010.
In the two years since it was passed, Obamacare has not become popular. Kaiser’s tracking survey shows consistent levels of public support and opposition, with a little fluctuation in both directions. The first poll of April 2010 showed 44% approval to 41% disapproval. By this January approval was at 37% and disapproval at 44%. Rasmussen’s surveys also suggest that if there is a trend, it is of increasing unpopularity.
The Republicans are almost unanimously committed to repealing Obamacare given the opportunity, and will be hoping to benefit electorally. However, introducing a law and repealing one once it has been passed are different considerations. The same Kaiser poll in January also found that more voters wish to keep or expand the law than to repeal it. ‘Expand’ almost certainly means different things to different voters, but that people would give such an answer nonetheless speaks volumes.
Polling has showed considerable support for individual elements of the law taken by themselves. The ban on denying coverage for pre-existing conditions was in the Kaiser poll in December backed by 67% of Americans.
However what has sometimes received less attention is how much other aspects of the law are unpopular. Perhaps most notable of these is fining adults who neglect to buy health insurance. Kaiser’s January poll found opposition stood at 67% to 30% – much higher than opposition to Obamacare as a whole. So the complexity of Obamacare is reflected in the politics of the legislation. Some measures are decidedly popular, others decidedly not. In terms of the electoral politics as well as the policy Obamacare is more a collection of measures some popular some decidedly not.