A new poll conducted by Hart Research Associates, on behalf of the Service Employees International Union, finds that voters strongly oppose the idea of Affordable Care Act subsidies being denied to states that didn't set up their own exchanges. Eight hundred respondents were contacted in the middle of February. By a 43-36 margin, voters told the pollsters that they had an "unfavorable" view of the law. By a 10-point margin, they preferred repealing the ACA to keeping it as is; a large majority supported at least tweaking it.
Yet by a 63-29 margin, they said they'd disapprove of a plaintiff victory in King v. Burwell if it meant people who bought health care from the federal exchange would lose their subsidies. By a 59-21 margin, they disapproved of Republicans in Congress who'd ruled out a legislative fix to restore the subsidies. Among the results:
"This case creates an enormous amount of vulnerability for elected Republican officials," said pollster Geoff Gavin in a call for reporters. "There is nothing but trouble for Republicans on this case."
That's what Democrats have been saying; still, most Republicans have adopted a bring-it-on attitude to the King case. Even some senators who had previously referred to the subsidies as a fact, like Utah's Orrin Hatch and Wyoming's John Barrasso, have given speeches in recent weeks saying that the subsidies clearly were illegal. Most Republican governors of states that did not set up exchanges have said they'd respond to a plaintiff victory in King by letting the current version of the ACA wither.
"We do not set up a state exchange," said Louisiana Governor Bobby Jindal in an interview at last weekend's Conservative Political Action Conference. "When the subsidies go away, the individual mandate goes away, the employer mandate goes away. That's a great thing. That's a tax cut."
Below, you can read the key section of the memo Geoff Garin wrote about the results, as distributed to reporters.
1. The availability of tax credits to help individuals afford health insurance is a popular element of the Affordable Care Act, including among Republican voters. When asked about the tax credits and the income thresholds to be eligible for them, 61% of voters say they feel favorable toward this provision of the ACA, while only 16% feel unfavorable; 22% feel neutral. Democrats feel favorable toward the tax credits by 79% to 7%, independents feel favorable toward them by 54% to 21%, and Republicans feel favorable by 49% to 22%.
2. There is a strong and widely held consensus among voters that the Supreme Court should not restrict the availability of the Affordable Care Act tax credits. When informed of the possible outcomes of the Supreme Court decision in King vs. Burwell, fully 71% say they want a decision that continues the availability of the tax credits to people in all 50 states, including a 56% majority who strongly prefer this outcome. Only 16% prefer an outcome that would restrict the availability of the tax credits to people in the states that created their own state health insurance exchange. Large majorities in every subgroup, including rank-and-file Republican voters, want an outcome that preserves the tax credits in all 50 states, including those that use the national exchange.
3. A decision by the Supreme Court to restrict the availability of tax credits under the Affordable Care Act would be met with broad disapproval by voters across party lines. Sixty-three percent (63%) of voters say they would disapprove of a Supreme Court decision that would limit the ACA’s tax credits to only the 16 states that have their own state health insurance exchange and would make them unavailable in the other 34 states. There is significant intensity to these opinions, with 44% saying they would disapprove of such a decision strongly—three times the proportion who would approve strongly (15%). A decision restricting the availability of the tax credits would meet with disapproval among majorities of Democrats (74% disapprove, 22% approve), independents (57% approve, 35% approve), and Republicans (56% disapprove, 31% approve). Even among those who feel unfavorable toward the Affordable Care Act overall, the majority would react negatively to a Supreme Court decision restricting the availability of the tax credits (51% disapprove, 38% approve).
4. There is surprising and significant cynicism about what would motivate justices to restrict the availability of the ACA’s tax credits, with most voters believing that such a decision would be based on politics rather than the law. If the five conservative justices who were appointed by Republican presidents join together in a decision that eliminates the tax credits for people in the 34 states who buy insurance on the national exchange, 51% believe their decision would be based mainly on politics, while only 33% believe it would be based mainly on the law. Those who would disapprove of a decision restricting the tax credits say by 57% to 27% that such a decision would be the product of political considerations rather than legal ones. Democrats say by 41 points that the justices’ decision would be based on politics rather than the law, and independents do so by 15 points. Rank-and-file Republican voters are divided evenly on this question (44% based on law, 40% based on politics).
5. The posture of Republican leaders on King vs. Burwell creates a substantial vulnerability for Republican elected officials and candidates, who will be seen as complicit in an effort to take away tax credits from eight million or more Americans who depend on them. A 59% majority of voters say they feel less favorable toward Republican congressional leaders upon hearing that “they want the Supreme Court to take away the tax credits from people in the 34 states who buy insurance on the national health insurance exchange, and they say they will not take any action to restore the tax credits if the Supreme Court decides to take them away.” Not surprisingly, 86% of Democratic voters say the position of Republican leaders on this matter makes them feel less favorable toward the GOP leadership, and the negative impact on the GOP extends to a majority (53%) of independent voters and a significant minority (32%) of rank-and-file Republican voters. Fifty-eight percent (58%) of independents also react unfavorably to Republican leaders when they embrace the Supreme Court case as helping their efforts to totally repeal the Affordable Care Act.
This case also has the potential to harm Republicans in their geographic base. The 34 states that could be affected adversely are much more Republican in their party identification (34% Republican, 32% Democrat) than the states that would be able to keep the tax credits (45% Democrat, 28% Republican). Voters in the 34 states at risk express significant concern upon learning that their states would be the ones losing the tax credits, including half of all Republicans in those states.