Obamacare Isn't As Divisive As You Thought

Opposition to the president may determine hostility to Obamacare, not the other way around.

Obamacare gets the side eye.

Photographer: Joe Raedle/Getty Images

Great work this month from the Kaiser Family Foundation, which dug into attitudes (or, perhaps better, non-attitudes) toward the Affordable Care Act's individual and employer mandates. Kaiser found that support (for the employer mandate) and opposition (to the individual mandate) are a lot less firm than one might think.

Take, for example, the unpopular individual mandate:

It remains among the least popular aspects of the law -- with just a 35 percent approval rating. But when people are told that the mandate doesn’t affect most Americans because they already have coverage through an employer, support jumps to 62 percent. Conversely, when supporters are told that the requirement means some people might have to purchase insurance “they find too expensive or don’t want,” opposition grows from 64 percent to 79 percent.

The same is true of the popular (on the surface) employer mandate: Change the wording of the question and it can become more or less popular.

What this tells us is that we should approach claims about public opinion and health care reform with caution. Saying “Obamacare polls badly” or “the individual provisions of the ACA other than the individual mandate poll well” isn't the same as saying “Obamacare is unpopular” or “the Obamacare subsidies and  Medicaid expansion are popular.”

It's likely, though still not certain, that most people just don’t have opinions about either the program or its various parts. That’s normal; most of us don’t bother to form real opinions about many things, even though we are willing to answer polling questions.

And if these findings are correct, then I’m even more skeptical that it was opposition to Obamacare, and not feelings about President Barack Obama, that drove Republican election gains in 2010 and 2014. Yes, as political scientist Matthew Dickinson mentioned in a recent post, some studies purport to show that Obamacare, specifically, cost Democrats quite a few seats in 2010 (I don’t think anyone has run numbers for 2014 yet). But I’ve been very skeptical of that finding. In particular, it’s extremely likely that if Democrats had ignored health care in 2009-2010 some other program would have symbolically done the same work. That is, Republicans would have replaced attacks on Obamacare with additional attacks on the stimulus, bailouts or Dodd-Frank. But really, voters were just reacting to Obama, his job performance and the economy.

Why are health care opinions so loosely held? The ACA is designed to be invisible to most people. If we all had “Affordable Care Act” cards in our wallets, we would have firm opinions about the program, and those opinions would be at least somewhat separate from our views of the president. As it is, however, most of us just project our feelings about the president onto the program. 

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