Blumenthal Has One-Year Follow-Up After ACA Passage

Mark Blumenthal reviews current polling on health care reform, now roughly a year after the landmark legislation passed.

A View from Canada

Canadian blogger Oleh Iwanyshyn takes a critical look at polling during the U.S. health care reform debate.

NY Times Summarizes ACA Implementation

The New York Times offers this report-card-type synopsis on how successfully the health care reform law is being implemented throughout the nation and how major constituencies (i.e., insurers, doctors, the public) are reacting. The synopsis touches upon public opinion in only limited ways, but how successfully the law gets put into place in the next few years is likely to affect future public opinion.

Parsing Question-Wordings Used in Surveying on ACA Repeal

Recently, a number of columnists have remarked upon the lack of consistency (and in some cases, lack of precision) in how various pollsters have attempted to assess public opinion on repealing the health care reform (HCR) law enacted last March (see Jon Terbush, Greg Sargent, and Frank Newport).

My aim in this posting is to distill these writers' comments into a graphical format, depicting polling results obtained this month. First, though, I classify different polling outfits' question-wording formats into different categories (links to reports of a particular poll's results are given only if they're not available on Polling Report's HCR compendium).

QUESTION FORMATS

Only a dichotomous repeal/uphold item.

CNN/Opinion Research Corporation

NBC News/Wall Street Journal (respondents could choose whether they "strongly" or "not so strongly" held their views toward repealing or upholding HCR law; I combined the two pro-repeal and two pro-retention options in the graph)

Quinnipiac

Rasmussen (respondents could choose whether they "strongly" or "somewhat" held their views toward repealing or upholding HCR law; I combined the two pro-repeal and two pro-retention options in the graph)

Dichotomous repeal/uphold item, followed by item(s) to probe in greater detail (e.g., repeal all or only part of HCR law)

ABC News/Washington Post

CBS News/New York Times

Item directly asks respondents to choose between four main options: repeal all, repeal parts (i.e., make law do less), keep law as is, or expand law.

AP/GfK ("What would you prefer Congress do with the new health care law? Leave it as is. Change it so that it does MORE to change the health care system. Change it so that it does LESS to change the health care system. Repeal it completely.")

McClatchy/Marist ("Which one of the following comes closest to your opinion about what Congress should do with the 2010 health care law? Let it stand. Change it so it does more. Change it so it does less. Repeal it completely.")

GRAPH OF RESULTS

Each segment along the horizontal axis at the bottom of the graph represents a different poll (identified by sponsor/pollster and dates in the field). Above each entry, you can find the percentages of respondents endorsing a particular option signified by the color of a given dot. (You can also click on the graph to enlarge it.)

Let's look first at the blue and orange dots, which represent, respectively, percentages favoring repeal and retention in polls that examine the issue dichotomously (either with only a dichotomous item, or a dichotomous item followed by a probe for further detail). In other words, these items do not permit distinctions between full or partial repeal, or keeping the law as is or perhaps expanding it.

As Sargent says, "When pollsters offer respondents a straight choice between full repeal and leaving the law as is, more end up supporting repeal." Actually, this trend is more apparent for polls taken earlier in the month than later, although on the available information, we cannot separate the effects of polls' timing vs. those of the outfits conducting the poll.

The polls that use what I think is the best format -- AP/GfK and McClatchey/Marist -- both show expanding the scope of the HCR law (green) to be more popular than full repeal (red), status quo (brown), or partial repeal (lavender). In the polls shown in the graph, full repeal -- which is what passed the Republican-controlled House on January 19 -- tended to draw between 20-30 percent support.

In his January 19 column, Newport alluded thusly to an additional survey: "A USA Today/Gallup poll question we asked over this past weekend found that if given a number of options about what to do with the bill, 13% of Americans would keep the bill just as it is, and 32% would repeal in entirely. The rest, 53%, would opt to make minor or major changes in the bill." I overlooked this poll when I was creating my graph. The 32% support for full repeal is at the high end of the aformentioned range; also, the phraseology regarding preferences for major/minor changes is different from other polls' wordings.

[This entry replaces and expands upon my January 21, 2011 posting.]

Blumenthal Analyzes ACA Opinion As GOP Assumes Power in U.S. House

With the just-sworn-in Republican majority in the U.S. House poised to pass a repeal of last year's health care reform legislation (such repeal being extremely unlikely to go any further, as the Democrats still control the Senate), Mark Blumenthal of Huffington Post/Pollster.com looks at recent months' polling on the topic of repeal.

Some of the issues addressed by Blumenthal seem inherently difficult to resolve, regardless of how people might have answered the survey questions. If, for example, respondents report favoring repeal of only part -- but not all -- of the reform law, what degree of endorsement does that convey for the total repeal the House GOP is apparently planning to offer. Polls whose questions do not distinguish full from partial repeal are even less informative.

More intriguing, in my view, were some seemingly unusual response patterns reviewed by Blumenthal, which were not necessarily inevitable. Based on cross-tabulations Blumenthal obtained from Gallup, "more than a quarter (26%) of those who said it was a 'good thing' that Congress passed health reform also said they 'favored' repeal. A smaller number (20%) of those who said they considered the passage of reform a 'bad thing' opposed a repeal."

For all of these reasons and others, Blumenthal concludes that "Attitudes about repealing the health reform law do not easily reduce to a single number. And support for an explicit repeal of all aspects of the law falls far short of a majority."

Fall 2010 Attitudes Toward Health Care Reform and its Possible Repeal

With the Republicans having regained a majority in the U.S. House and narrowed the Democrats' majority in the Senate last Tuesday, there is a very real possibility the GOP will try to repeal all or parts of the landmark health care reform (HCR) bill enacted earlier this year. What does recent polling tell us about the public's attitudes toward repeal?

The Kaiser Family Foundation issued an October report, summarizing the findings of eight national polls taken from September 9-October 10. Bruce Drake of Politics Daily characterized the Kaiser report in the following terms: "roughly, five of the eight polls looked at by Kaiser fall in the column of pro-repeal sentiment (some by small margins) while three do not."

Kaiser also has just released its November Tracking Poll, the findings of which are reported in greater detail here. The survey was conducted in the four days immediately following Election Day, and many of the results are reported separately for the overall sample and for people who say they voted. The findings of this poll are similar to those of many other HCR polls. The overall legislation is not all that popular, with 49% of the general-public sample favoring repeal of some sort (25% favoring repeal in part and 24%, in whole). Forty percent seem favorable to the new law, divided nearly evenly between favoring expansion of its provisions and keeping them as is. The voter subsample comes down more negatively toward HCR, 56% favoring some type of repeal and 36% expressing favorable sentiments.

As with virtually all HCR polls, however, the Kaiser survey shows specific provisions to be far more popular than the overall package. Among partial-repeal advocates in the general-public sample, 75-85% still favor small-business tax credits to help fund insurance, prohibiting coverage denial due to pre-existing conditions, filling in the "doughnut hole" in prescription drug coverage that seniors must pay out of their own pockets, and financial assistance to low-moderate income individuals to help them purchase coverage. The partial-repealers are lukewarm (55% support) on upper-income tax increases and downright hostile to the individual mandate that persons be covered (19% support). Even among persons endorsing full repeal, the tax-credit and pre-existing condition provisions of HCR each enjoy roughly 50% support. 

Similarly, an October poll for Bloomberg News found most specific HCR provisions to enjoy support. According to this article on the Bloomberg poll, "Among eight of the law’s provisions on which the poll sought opinions, repeal was backed by a majority of likely voters for just two: requiring everyone to have health insurance and taxing companies that offer especially generous coverage."

Gallup Will Track Impact of HCR Provisions Now in Effect

Gallup has announced that it will use its existing polling on health care utilization to track the effectiveness of provisions of the health care reform law that have now gone into effect (via Pollster.com's "Outliers"). For example, "Gallup asks Americans each day if there have been times in the past 12 months when they did not have enough money to pay for healthcare or medicine that they or their family needed." Should there now be a drop in the percentage of seniors responding affirmatively to this question, it can be taken as a sign of effectiveness of government checks being sent out under the new law to close the "donut hole" in seniors' Medicare prescription-drug payments.