On the Fox New Sunday panel last weekend, there was an interesting discussion about Obamacare, a year after the controversial bill became law. Nina Easton said:
[T]hings haven't changed much in 12 months. We have a -- despite by, the way, ramped-up efforts by the White House which is going to ramp up again to explain the benefits of health care reform to the nation, we have a divided country.
Half the country hates it, thinks it's government overreach, possibly socialistic. We have got another half, though, which supports it or thinks it's not liberal enough. So none of that has moved.
Bill Kristol argued:
I think March 21, 2010 [the day the bill was passed], will be the high watermark, historically, of big government liberalism and of the entitlement state. This is sort of the overreach that shows how insane the modern entitlement state has become. And they expected their support to build, because in previous entitlements, when they got passed, people liked them once they were passed.
That has not happened in this case. The polls haven't changed. They're not changing. And I think it's going to be a burden for the president and his re-election effort. And as I said, I think this will be repealed.
Meanwhile, Juan Williams asserted:
I think so much has changed. You look at the polls, the polls now indicate -- I think it was Gallup now has it 46-40, the American people support this health care reform effort.
So, that's three different takes on Obamacare: no change and a split between supporters and opponents; no change, significant opposition; change toward the supporters.
What to make of all this?
The most recent poll from Gallup showed a split of 46-44: 46 percent said passing the bill was a "good thing," while 44 percent said it was a "bad thing." These are about the best numbers you can find for Obamacare, at this point. Indeed, the other numbers from Gallup are not that good. Just 39 percent said they thought it would improve health care in the U.S. and just 25 percent thought their own care would improve.
There have been other polls that have found mixed news for Obamacare. For instance, the NBC/Wall Street Journal poll in January found that 39 percent thought that passing the bill was a "good idea," and 39 percent thought that passing it was a "bad idea." Earlier this month, Bloomberg found that 41 percent thought it should be repealed, 42 percent thought we should wait to see how it works, and 12 percent thought it should be left alone. Meanwhile, the Kaiser poll found that 30 percent want to "expand" the bill, 21 percent want to keep as is, and 39 percent want to repeal it.
Against this data, we can look at the results from RealClearPolitics, which averages polls that ask the straightforward question whether respondents favor or oppose repeal. The numbers on this front are not good at all for those in support of Obama's health care overhaul.
These numbers are generally, but not uniformly, terrible for Obamacare. What is especially helpful about this is that there is a relatively consistent question asked across the polls -- and unlike the NBC/WSJ question, for instance, it is direct and to the point on the political issue.
Another direct question is whether or not respondents approve of President Obama's job performance on the health care issue. And here, the numbers are quite negative: see CNN (41-58), Bloomberg (44-50), Quinnipiac (40-56), and Gallup (40-56).
What can we say about all this? First of all, it's clear that changes in question wording and polling methodologies can produce different results, some of which can, and do, favor Obamacare, but not by much. Second, on two of the more straightfoward ways to query public opinion on this issue -- support/oppose repeal and support/oppose Obama's performance -- the numbers come back pretty strongly negative, just as they have been for over a year.
I'd explain the discrepancy this way. It is abundantly clear that the public does not really understand this bill. Indeed, just 15 percent in the Bloomberg poll said they know "a lot" about it. And breaking down support/opposition to different parts of the bill, we see a disconnect: respondents are supportive of the benefits of the bill (e.g. the prohibition on denying coverage for a pre-existing condition), but do not support the necessary cost that must be imposed (i.e. the individual mandate), and are generally skeptical that they will personally see any benefit from the bill.
So, while the public does not have a great deal of knowledge about it, they seem to be tilted toward skepticism and/or outright opposition, depending on how the questions are worded. (The one exception to this general trend is the Kaiser poll, which finds a big chunk of voters supporting "expansion." However, this is quite ambiguous from an ideological standpoint. For some, expansion could mean expanding the tort reform provisions, or expanding the exchanges to enable people to buy insurance across state lines, or expanding the options of the types of insurance that could be purchased, and so on.)
Why are people swinging toward skepticism/opposition? Here we have to be more speculative. Obviously, a big part of this has to do with the conservative opposition, which in principle does not support government imposition into private life. However, I think there is more to it that than this. I would point to the general, overall lack of confidence that voters have clearly expressed in the government over the last couple years. The approval numbers for Congress are in the garbage, where they have been for some time. And if you break Obama's job approval ratings down by issue, you'll see that he is usually in negative territory, especially on the most salient matters (the economy, the deficit, and of course health care). What's more, there has been a long-term trend in this country of people not having a great deal of faith in the government. The American National Election Study regularly asks voters whether they trust government to "do the right thing" -- be it, "just about always," "most of the time," some of the time," or "none of the time." The following chart tracks the percentage of respondents who claim to trust the government "just about always" or "most of the time."
There was a steep drop-off following the Vietnam War and Watergate, and the prior level of trust has not really been built back up.
So, consider the following hypothetical. You are a pragmatic, middle-of-the-road voter. You are not philosophically opposed to all new forms of government intervention in domestic affairs. However, you do not really trust the government to do the right thing; you are skeptical of Obama's job performance on specific issues; you strongly dislike the way Congress has handled itself for the last couple years; and you were quite appalled by the specific process that produced Obamacare, which seemed to represent a lot of what has gone wrong with the way government works. You do not know very much about the details of this bill. Under these conditions, which way would you be tilting? Considering how important health care is to you, you're probably tilting against Obamacare.
Conservatives who are opposed to the bill for ideological reasons obviously like the answer to that question, but unfortunately this skepticism about government cuts both ways. Right now, we have a huge deficit/entitlement crisis staring us down. The economy is in the midst of a weak recovery that analysts are now thinking is about to hit a soft patch. The health care bill that was passed last year was a politically expedient, ideologically incoherent, constitutionally questionable Rube Goldberg device that rests upon a series of shaky assumptions, and is in desperate need of massive, top-to-bottom overhaul. Put simply, there is a lot of work to be done. However, the two political parties are at each other's throats, and the electorate -- which is not terribly well informed -- is skeptical of just about everybody and everything in Washington, D.C.
Hmm. This doesn't seem to me to be the best recipe for solving the big problems that face the country.
In other words, lack of trust in the government is a bad thing for everybody, of all ideological stripes. It will ultimately come back to cut against Republicans -- if not in 2013 then sometime thereafter, unless the GOP can figure out a way to rebuild confidence in the nation's public institutions. There was great hope that Barack Obama would be able to do that, but it has been an opportunity missed.
