Repealed, Replaced and Expanded

Last week’s State of the Union speech was notable because the President hardly mentioned the new health care reform law.

Avoiding what is supposed to be the centerpiece domestic accomplishment of President Obama’s first term stuck out like a sore thumb.

He said almost nothing because the Obama team simply doesn’t know what to say.

The fact is the Affordable Care Act (ACA) is generally unpopular, and its best-known provision, the individual mandate, is wildly unpopular.

Two years after passage and, the implementation of the law’s first steps all designed to build support, the public’s opinion of the law is unchanged and not good. The just out January 2012 Kaiser Health Tracking Poll leaves no doubt:

  • Only 37% of those surveyed have a favorable view of the law.
  • 44% have an unfavorable view of the Affordable Care Act.
  • But even some of those who don’t like it don’t like it because it didn’t go far enough—31% of all of those surveyed want to expand the current law while 19% want to keep it in its current form. That’s a total of 50% that want to keep or expand it.
  • 22% want it repealed outright and another 18% want it replaced with a Republican alternative—a total of 40%, fewer than want to expand it or keep it as it is.
  • On the individual mandate, 67% have an unfavorable view of requiring everyone to buy coverage, while 30% have a favorable view of the requirement.
  • While a total of 50% of those surveyed think the law should be kept or expanded, 54% say the Supreme Court should throw the mandate out, while only 17% say they think the mandate should be upheld.

So, let’s summarize. Only 37% have a favorable view of the law and 67% don’t like the mandate. But 50% think the law should be kept as it is or even expanded.  No wonder Obama and his political team can’t figure out how to play this.
Perhaps even more intriguing is the dilemma the eventual Republican presidential nominee is about to find himself in—everyone of the candidates is telling voters lots of times a day that the first thing they will do as President is to get rid of “Obamacare.”

For Republican presidential candidates that is a safe thing to say among Republicans—73% of Republicans have an unfavorable view of the ACA, while 62% of Democrats view it favorably.

But come the fall, when the eventual winner will need lots of independent voters, the Republican nominee will have to face the reality that only 40% of the overall electorate wants the ACA repealed or replaced.

Then Obama’s dilemma will have to become the Republican’s dilemma.

I guess the voters are telling us that to get a majority of support, the ACA needs to be repealed, expanded, and replaced—so long as it doesn’t have a mandate.


4 replies »

  1. Susan, your comment reminds me of the old story of the blind men describing their encounters with an elephant. While some might be amused by the different, inaccurate opinions or preceptions of the blind, it is not funny to the keen eyed, lifelong, elephant keeper, who recognizes the signs of a rogue elephant about to stampede and crush to death not only the blind, but the keeper as well.

  2. I think the public’s apparent confusion reflects a glaring lack of understanding of the provisions of ACA. Within my own family, there are people who are furious over “Obamacare,” but cannot provide a single detail of the law. The best they can offer is that it is a “government takeover” of health care.

    Ironically, many of the people I have spoken with who oppose “Obamacare” are actually very much in favor of some of its provisions, such as eliminating the exclusion or coverage delay for pre-existing conditions, and not allowing health insurers to deny coverage to someone because of health conditions or health history.

    The more people know about the actual provisions of the Affordable Care Act, the more they are likely to approve of it. Will they ever really agree with the purchase mandate? Maybe not. Americans are never fond of parting with their money for things that don’t provide immediate personal satisfaction. But the whole health-care package falls apart without the mandate. The only other way to make it work is to have a government-provided health-care system like they have in Canada. In other words, Obama’s health reform legislation is set up to provide an alternative to “socialized medicine.”

  3. As mentioned in this article, given the lack of attention President Obama’s devoted to health care reform during the SOTU address, it’s quite obvious there is a growing wave of concern forming against Obamacare and the ACA. This increasing level of discontent has been documented in a number of different surveys, including those discussed in this article as well as the link at the bottom of the comment box. Published on behalf of the American Action Forum, it appears that employers and physicians, two key groups within the healthcare system, are joining the ranks of those concerned about the consequences of Obama’s healthcare plans.

    Ultimately, the polling data only reinforces the point that the more people know about the ACA the more they oppose it. Is it safe to say the longer the debate continues, the more likely it will be repealed?