Last week, when Congress sent President Obama a plan to repeal portions of the Affordable Care Act (ACA) and the president vetoed the bill, there were predictable partisan reactions. House Republicans cheered that after dozens of attempts, they finally got legislation to the White House. House Speaker Paul Ryan spoke for most of his colleagues when he said that the law “will collapse under its own weight, or it will be repealed.” President Obama boasted about its success, criticized its GOP opponents, and vetoed the amended bill, writing, “Because of the harm this bill would cause to the health and financial security of millions of Americans, it has earned my veto.” The 2016 GOP and Democratic candidates also retreated to their familiar partisan positions.
The Kaiser Family Foundation has been tracking views of the ACA on a monthly basis since the law passed in April 2010. Their website enables you not only to look at national attitudes, but also to analyze partisan responses. Over the past five years, national opinion has usually been more unfavorable than favorable, though still closely divided. Nationally, support for the law has never been higher than 53 percent, while opposition never lower than 33 percent. In Kaiser’s December poll, 46 percent had an unfavorable opinion of the law and 40 percent a favorable one.
Since the law’s passage, Republicans’ favorable views of it has never been higher than 24 percent and their unfavorable ones never lower than 65 percent. In the same time period, in almost every poll, more than 60 percent of Democrats have had a favorable opinion of it. In the past year, Democrats’ opinions have become slightly more positive, ending with a 67 percent favorable rating for the ACA in December and a 19 percent unfavorable rating.
But what about the important swing group of independents? How do they feel? For the past five years, their views about the law have been more negative than positive, although in a few cases, they have been closely split. In Kaiser’s latest December 2015 poll, 53 percent of them had an unfavorable opinion and 32 percent a favorable one. Although independents’ opinions of the ACA occupy the middle ground between Republicans and Democrats, they appear to correspond more closely with Republicans’ views.
In Gallup’s polling, health care is almost always near the top when people are asked about important problems facing the country and their families. Most people say they can handle ordinary health care expenses, but they can’t imagine paying for life-threatening or long-term illnesses. Still, in many recent surveys, around two in ten say they have had serious problems paying a doctor’s bill or getting the care they need. In November 2015, 19 percent told Gallup pollsters they had put off medical treatment for a serious condition due to cost. These persistent anxieties keep health care and the ACA at the forefront of political and policy debates.
What do Americans think Congress should do about the law now? In Kaiser’s polls, people are asked whether they want Congress to “expand what the law does,” “move forward with implementing the law as is,” “scale back what the law does,” or “repeal the entire law.” Not surprisingly, a strong majority of Republicans want to repeal it—62 percent in Kaiser’s latest poll. Only 8 percent of them wanted to expand it. For Democrats, 36 wanted to expand it, and 10 percent were at the other end, seeking repeal.
A close examination of independents’ views over the past year shows that between 17 and 29 percent have wanted to expand the law. A fairly consistent three in ten have wanted to repeal it, although the most recent survey showed a bump in that response. In December, 17 percent wanted to expand it, 16 percent move forward with implementation, 17 percent scale back, and 39 percent repeal. Once again, independents are in the middle, tilting slightly to the GOP.
Poll responses can’t give us hard data about health care in America. They can, however, give us a sense of the politics of the issue, and here, almost six years after passage, independents’ views seem to be trending slightly more in the direction of Republicans’ than Democrats’. For this reason, expect to see some surgery on the ACA in the future but considerable opposition to full repeal. As for campaign 2016, this is one issue on which Republican candidates have the potential to make inroads with the sought-after independent vote.
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