Monday, September 30, 2013

New Poll from "The Morning Consult"

Via Political Wire, I learned of a new poll on attitudes toward the Affordable Care Act. The poll was released by a publication call The Morning Consult, with surveying done from September 25-28 by Survey Sampling International. I was not previously familiar with either of these entities. As best I can tell, the Consult is a business-oriented, center-right outlet. Its founder, Michael Ramlet, is described on this webpage as having done some work for Republican organizations and being affiliated with the bipartisan Purple Strategies group.

Regarding TMC/SSI's methodology, the poll's report claims that, "The interviews were conducted online... The data were post-stratified to match a target sample of registered voters based on age, race, gender, education and region." Post-stratification is a form of adjusting the amount of weight given to different demographic groups, to make the sample as a whole conform to known population parameters (e.g., from the U.S. Census).

According to the TMC/SSI report, 48% of respondents approve of "the health care legislation passed by Barack Obama and Congress in 2010" (21% strongly, 27% somewhat). The overall approval reported by TMC/SSI is thus about 10 percentage points higher than obtained by other recent polls. TMC/SSI provide extensive subgroup statistics, so we can look "under the hood" a bit at their recent poll. Partisan composition of the TMC/SSI poll certainly raises some questions:

519 Republican-leaning respondents (26.3% of sample, of whom 15% support ACA)
836 Democratic-leaning respondents (42.3% of sample, of whom 75% support it)
620 Independent respondents (31.4%, of sample, of whom 38% support it)

The TMC/SSI party-ID numbers are clearly out of whack with those of other survey firms. If one looks at HuffPost/Pollster's party ID averages (using the selection tool to limit the results to registered-voter samples, which is what TMC/SSI used), the percent of Americans identifying as Democrats is 37.9% and the percent identifying as Republicans is 33.7%, dramatically closer to each other than in TMC/SSI's partisan breakdown.

Relative party-ID proportions are not the only reason TMC/SSI reports higher approval for the ACA than do other polls. Even looking at self-identified party subgroups one at a time, TMC/SSI shows greater support for Obamacare in some instances than do other pollsters. Take, for example, a recent CNN/Opinion Research Corporation poll, which found 38% approval overall for the law. Approval from self-identified Democrats was virtually identical in the TMC/SSI (75%) and CNN/ORC (74%) polls. However, self-identified Republicans reported greater support to TMC/SSI (15%) than to CNN/ORC (7%). The same pattern occurred among self-described Independents: 38% approval in the TMC/SSI poll vs. 27% in the CNN/ORC survey.

Having said all of this, what first caught my eye about the TMC/SSI poll was response to the item, "What would you like to see Congress do when it comes to the health care law?" Response options were: "expand the law," "let the law take effect," "make changes to improve the law," "delay and defund the law," and "repeal the law." Among the full sample, a collective 67% endorsed the first three alternatives, all of which seem, at the least, accepting of the ACA (even the third category, though not representing a ringing endorsement, conveys a "mend it but don't end it" outlook). The two most anti-Obamacare categories -- delay/defund and outright repeal -- together comprised only 33% of the sample.

One way to put the apparent Democratic slant of the sample aside and escape the partisan lens is to focus directly on Independents. Among Independents, the combined percentage advocating delay/defund and repeal is only 37%. In contrast, 63% favored one of the supportive/accepting alternatives.

It would be interesting to see more pollsters offer the "make changes to improve the law" response option to their participants.

Saturday, September 28, 2013

Kaiser Foundation Survey Project Focuses on California

The Kaiser Family Foundation has released the first of four planned surveys over the next two years of California residents currently without health insurance. The just-released survey provides baseline data on respondents' knowledge and attitudes regarding insurance coverage, in anticipation of the October 1 start of the sign-up period for the health-insurance exchanges (or marketplaces) under the Affordable Care Act (aka Obamacare). Kaiser will attempt to re-survey members of the initial sample of 2,000 respondents three more times over the course of the project; conducting multiple interviews with the same people over time is known as a panel study. As the exchanges go into effect and data from the later phases of the survey are gathered and released, we will learn the rate at which California's eligible uninsured sign up for Obamacare and the characteristics of those who do and do not.

Wednesday, September 25, 2013

Recent Distillations of Health Care/Obamacare Polling

Via Huffpollster, here are some recent commentaries on what the polls are showing about the Affordable Care Act (aka Obamacare) and government's role in helping people obtain health insurance:
  • Liberal columnist Jonathan Alter argues that, when opposition from the left to the ACA (i.e., for falling short of single-payer) is taken into account, well below a majority of Americans accept conservative arguments against Obamacare. The phenomenon of opposition from the left was discussed previously on this blog here.
  • Republican pollster Bill McInturff summarizes what he sees as some key themes, such as considerable opposition to the ACA from subgroups of the population (e.g., those dissatisfied with their current health care) who might be expected to be supportive, and the persistently low levels of understanding of the law reported by the public.
  • Public support for a government role in helping provide health insurance for people who cannot afford it is not as high as it once was, but is still pretty high.

Friday, September 20, 2013

Washington Post/ABC News Poll Examines Government-Shutdown Aspect of Obamacare Implementation

A few days ago, I wrote about a Pew Research Center/USA Today poll that attempted to gauge the intensity with which opponents of the Affordable Care Act ("Obamacare") truly detest the new law. Respondents were first asked if they supported or opposed the ACA, and then opponents were asked the follow-up question of whether they thought political leaders who opposed the law should try to make it work as effectively or possible or make the law fail. Only about a quarter of the sample opposed the law and said they wanted political leaders to try to make the law fail.

A new Washington Post/ABC News poll likewise tries to assess intensity of opposition to the ACA, but this time in a different way. With the possibility looming of a federal government shutdown due to disagreement between the Republican-majority House and the Democratic-majority Senate on how to fund government operations beyond October 1, the Post/ABC poll asked ACA opponents the following question:

Would you support or oppose Congress shutting down major activities of the federal government in order to try to prevent implementation of the health care law?

Presumably, if someone advocates closing down "major" federal government activities -- would which could include no new patients being admitted to some National Institutes of Health medical studies, some veterans' services being unavailable, and delays on processing passport applications -- as a way of blocking Obamacare, he or she must really dislike the law. So how many people want to use a government shutdown to delay, disrupt, or diminish the October 1 opening of the ACA exchanges (marketplaces) for people to sign up? Again, it's about one quarter of them. Overall, respondents to the Post/ABC poll break down as follows:
  • Forty-two percent of respondents support the ACA.
  • Twenty-seven percent oppose the law and want a federal government shutdown to enforce that opposition (i.e., the shutdown is supported by 52% of the 52% who opposed the law).
  • Twenty percent oppose the law, but don't want a shutdown.
  • Five percent oppose the law and are undecided on a shutdown.
  • Six percent had no opinion about the law in the first place.

Another salient theme of the Post/ABC survey is the pervasiveness of respondents' self-claimed lack of knowledge about what is in the law. When asked, "Do you feel that you personally do or do not have the information you need to understand what changes will occur as the new health care law takes effect?," only 35% said yes and 62% said no, with the rest undecided. One might expect a positive correlation between education and feeling informed, but such was not the case. The percentages of those feeling informed were virtually identical among participants with a high school or less education (34%), some college (35%), a completed college degree (38%), and postgraduate education (37%).

Another poll, by Rasmussen, finds stronger support than does the Post/ABC survey for shutting down the government in connection with the ACA: "51% of voters favor having a partial government shutdown until Democrats and Republicans agree on what spending for the health care law to cut." Note that Rasmussen's question-wording arguably softens the impact of the scenario, relative to the Post/ABC wording, in two ways: Rasmussen describes the shutdown as "partial" rather than "major," and asks about cutting spending on the health care law rather than preventing its implementation.

Monday, September 16, 2013

Pew Research Center/USA Today Poll Examines Range of Health Care Issues

With the sign-up period for uninsured people (who aren't otherwise eligible for Medicaid) to join health care marketplaces called "exchanges" beginning in about two weeks, the Pew Research Center and USA Today have released a jointly conducted poll on a wide range of health care issues.

Some Republican elected officials have been doing whatever they can in recent months to try to derail, delay, defund, or destroy the Affordable Care Act before one of its major provisions, the system of exchanges, goes into effect on October 1. Some have said they will not help their constituents sign up for the Obamacare exchanges, whereas others have tried to dissuade professional sports leagues from working with the Obama Administration on ACA-related outreach.

After asking survey respondents whether they supported or opposed the ACA, Pew-USA Today pollsters asked opponents of the law a follow-up question: Did they want Congressional detractors of the law to "Do what they can to make the law work as well as possible" or "Do what they can to make the law fail"? As a result of these questions, the American public (generalizing from the nationally representative survey sample) falls into the following camps (the percentages sum to 101% due to rounding):
  • Forty-two percent support Obamacare.
  • Twenty-seven percent oppose Obamacare, but want their leaders to try to make it work.
  • Twenty-three percent oppose the law, and want their leaders to try to make if fail.
  • Four percent oppose the law, but don't know what course of action they want their leaders to take.
  • Five percent were undecided on whether they supported or opposed Obamacare in the first place.

Though only about one-quarter of Americans, overall, endorse the "make it fail" position, 64% of those who identify as "Tea Party Republicans" do. Whereas GOP officeholders working feverishly to put the kibosh on Obamacare appear to be hugely out-of-step with the U.S. public, one must remember that in their home states and districts, they could well be very much in tune with local sentiments (and maybe even fearing a primary challenge from the right).

From the perspective of Democratic officeholders and advocates of expanded health-insurance coverage, the key issue is potential enrollees' awareness of the exchanges and inclination to sign-up. Pew-USA Today also queried respondents on this topic. Here are some key findings (quoting from the above-linked report):

Awareness of the availability of health insurance exchanges is much lower in those states that have decided against state involvement in the exchanges. While about six-in-ten (59%) of those who live in states with state-based health care exchanges (or state-federal partnerships) say that exchanges will be available in their state, just 44% of those in states that have decided not to create their own exchanges say this (the federal government will run these state-level exchanges)...

Most people who do not have health insurance (63%) say they plan to get health insurance within the next six months... Nearly a third (32%) of those who currently lack health insurance have no plans to get coverage in the next six months.