Hurt by Health Care Reform?

Some of the major polling outfits ask questions in their health care surveys on whether respondents feel the Affordable Care Act has helped or hurt them personally. Variations on this question might ask about the respondent and his/her family collectively, or even whether respondents feel the ACA has hurt Americans at large. There are some interesting things to notice in Gallup's most recent poll (which uses the "you and your family" wording).

As Greg Sargent discusses, of the 19% of Gallup respondents claiming they or their family have been harmed by Obamacare, "Sixty percent of those who say the law has hurt them or their families are Republicans or GOP-leaning independents. Only 23 percent are Dems or Dem-leaning independents, and another 15 percent are non-leaning independents."

Sargent adds that, "It’s always possible Republicans and conservatives are disproportionately impacted by the law, but it’s also possible that some who already dislike Obamacare are more likely to tell pollsters they’ve been negatively impacted by it, perhaps because they’re inclined to blame problems they’re experiencing with the health system in general on the law. Of course, this could work the other way around: Dems and Dem-leaners could be less inclined to say they are being hurt by it."

Another aspect of this issue that jumps out at me is how stable the trend lines for "help" and "hurt" appear to be in Gallup's historical polling on the matter. In February 2012, when relatively few Obamacare provisions had gone into effect, 16% said they or their family had been hurt by the law and 12% said they or their family had been helped. Unfortunately, Gallup went a long time without polling on this question, but its three most recent percentages for "hurt" have been 19, 19, and 19 (from polls taken November 23-24, 2013; January 3-4, 2014; and January 31-February 1, 2014). The respective percentages for "helped" were 9, 10, and 13 in these polls.

Considering the turmoil with the malfunctioning federal-exchange website from its debut on October 1 until the re-launch on December 1, and the controversy over many individual-market plans being cancelled (which was heavily in the news from late October into November), it seems remarkable that the percentages of respondents claiming harm to themselves or their families rose only modestly from the 16% in Feb. 2012 to 19% in late 2013 and early 2014.

Two hypotheses come to mind (although additional plausible ones could probably be generated). One is that a fairly sizable share (greater than the 3% aggregate increment) of Americans who had not felt harm in Feb. 2012 did so in late 2013/early 2014, but that others who were claiming harm in Feb. 2012 (or would have, had they been polled) were no longer feeling this way by late 2013, thus limiting the net increase in felt harm to the aforementioned 3%. The other hypothesis (a la Sargent) is that the help/harm survey questions are being answered heavily through an ideological lens, with little basis in how people really are tangibly affected. This latter explanation is cynical, to be sure, but would seem to explain the consistency of the results from early 2012 to late 2013 and beyond.