The Supreme Court is days if not hours away from deciding the legality of the Affordable Care Act (ACA). Pundits are playing Health Reform Bracketology and our Congressional Representatives are reserving air time and their parcel of camera space in front of the Capital.
Jennifer Steinhaurer of the New York Times reports today that we are “Polarized on Health Care, United on the Ruling Drama.” But her headline is only 50% accurate.
CNN’s poll shows the ACA is second to only the economy as a Presidential campaign issue. And in March The USA Today/Gallup Poll tallied up that 50% of voters nationwide had a negative view of the law. That leaves a solid 50% as ACA supporters. When it comes to the ACA, the nation indeed appears once again to be “a house divided.”
Resonate looks beyond what people do to WHY they do it and have been able to ask voters regardless of party affiliation what they really think about the intricacies of the ACA. The response is a bit more complicated than the simple YEAS and NAYS seen in the headlines. But this is not the first time the American people have presented a more complex picture than the latest poll could capture.
Just to be clear, Resonate routinely conducts massive surveys of online adults on key political and policy issues. Included in that work are questions about values such as Patriotism, Issue Engagement, and Policy Orientations. All together this gives Resonate a broader and deeper understanding of what voters want and WHY.
With the ACA and all its complexity, Resonate wanted to look at the individual components of the Bill to see which were appealing to voters or inversely concerning them. We didn’t know if we’d see voters responding to the totality of the ACA or specific elements. These elements include:
- Requirement that everyone obtain health insurance (the Individual Mandate)
- Reduce out of pocket for the donut hole
- Extension of Medicaid to more people
- Extension of coverage to dependents up to age 26
- Removal of annual/lifetime caps
- Require that employers with >20 employees provide insurance
- No discrimination by pre-existing condition
- Independent Payment Advisory Board
First looking at voters responding the Law as a whole: thirty-one percent of voters want the ACA repealed in full and 27 percent want it to remain intact with no modifications. Not quite the 50/50 split touted by the polls.
But, it is the remaining 42 percent of voters that are fascinating. They are interested in different elements, and would like to see some modifications of ACA. They favor a partial appeal, but stop short of dumping the bill in the nearest waste basket. Whether you agree or disagree with them they deserve admiration for taking the time to figure it out.
Among these Partial Repealers: 53% would be quite satisfied if the Supreme Court strikes down the Individual Mandate and leaves the remainder of ACA intact. No other element of the bill is so polarizing.
As a reminder the Individual Mandate requires individuals not covered by employer or government-sponsored insurance plans to maintain minimal essential health insurance coverage or pay a penalty.
Not surprising that it represents the dividing issue for those questioning the wisdom of the ACA.
So, what would happen if the Individual Mandate were repealed yet the rest of the ACA remained largely unchanged? The ACA becomes largely a non-issue. While 31% of voters want the entire Bill ditched no matter what, 55% of voters would embrace the law once free of the Mandate . By the way the remaining 14% are for partial repeal and in favor of the Individual Mandate; it’s something else about the law that’s bothering them.
The furor over the ACA is mostly a concern about the Individual Mandate. The Supreme Court is focused on the same issue, doubting its constitutionality. And, while the Court has seldom been concerned with popularity, in this case their focus matches the concern of the majority of Americans.
Resonate works to understand the values and attitudes of the American electorate. When we hear phrases like “Americans demonstrate widespread opposition to the ACA”, we want to know more. So Resonate looked at what Americans had told us about ACA. The numbers show a much less dramatic but more complex understanding of ACA.
We will let provocateur bloggers and cable news pundits turn the ACA into a wedge issue splitting the nation apart. The truth speaks to an electorate that is looking deeper. For a majority, the ACA can be the healthcare solution for America if the courts or the legislatures just let the Individual Mandate go.