Written by John Lounsbury
Obamacare (the Patient Protection and Affordable Care Act of 2010 - ACA for short) remains extremely unpopular according to the Kaiser Health Tracking Poll. Overall only 35% of the population has a favorable opinion, while 47% has an unfavorable opinion. Among self-identified Republicans only 11% approve and just 4% have a very favorable opinion.
Before proceeding I want to caution that this Op Ed is laced with (random doses of) sarcasm. Those who do not detect these jabs may well be the object of them. And some who do detect them may be angered. Sobeit in both cases. Maybe a few in both camps will question what needs to be done about health care in the U.S. and something positive will come from this.
Since passage of the ACA law in December 2010 the negative opinion has fluctuated both sides of 50% while the favorable opinions which were once occasionally in the 40s have been consistently below 40% for the past two years.
Well over half of Democrats have a favorable opinion of ACA and less than a quarter have an unfavorable opinion.
A total of 41% of Americans say that the law has "directly helped you and your family" or has "directly hurt you or your family". Overall twice as many say they have been hurt as say they have been helped. There is a partisan impact of those who say they have been impacted: 37% of Democrats, 41% of Independents and 48% of Republicans. Nearly 1/3 more Republicans are personally impacted by Obamacare than are Democrats.
There are some questions raised by the Kaiser results. The major among these are the specifications of how the individuals directly impacted were affected. The adult population of the U.S. at the end of 2013 was approximately 242.2 million. Before ACA approximately 17.1% of adults were uninsured (41.5 million) and after the open enrollment ended 32.5 million were still uninsured (13.4%). See here for source of numbers. So 9 million more adults were insured, while more than 8 million obtained insurance through ACA websites (including a significant number of children). To reconcile these numbers as many as 1-2 million or more adults were added to the health insurance rolls outside of the ACA exchanges. For the years 2011-2012 there was almost no change in the non-elderly uninsured adult numbers (40.3 million 2011 and 40.1 million 2012) so it appears that something was happening in health insurance coverage in addition to Obamacare in 2013 and early 2014.
Question: Were these increases outside of ACA coverage because of Obamacare or in spite of it?
Let's consider another open question. Of the 242 million adult Americans, nearly 34 million (14%) say they or their family were directly helped by ACA. Since 8+ million actually obtained coverage, many of them in multi-person households, how can 34 million (or a family member) be directly helped? If the average coverage increase of 8 million individuals lived in 4 million households then the extent of family directly impacted in addition to household members would be in a ratio of 8-9 to 1.
The Kaiser survey needs to be more specific in specifying how family members have been impacted and what family relationships are included. Without such detail the results are suspect as being possibly second- or third-hand, or even worse, determined by "public service announcements" (ads) favoring or opposing Obamacare.
The numbers are even more troubling when negative opinions are considered. There are more than 65 million who say they or a family member was directly hurt by the ACA. With only 4 million or so households gaining insurance is it reasonable that there are 16 times as many family members directly hurt by Obamacare?
Without better surveying, the Kaiser results may be suspect as representing "feelings" about Obamacare rather than informed opinion.
One possibility for the Kaiser results is that respondents attributed any change related to their healthcare to have occurred as a result of Obamacare. That may be the case in some instances but in others there may be no relationship. To determine what the possible interactions are we need far better data than provided by the Kaiser surveys.
Perhaps there is a national scandal here and Obamacare is a law designed to persecute Republicans. Almost half of Republicans say that the ACA has directly hurt them or a family member.
Putting sarcasm aside, better data is needed to determine who is being hurt (and why) and ascertain how to put things right. In some cases Democrats may love their poison and in other cases Republicans may hate their cure. Those sorts of things can happen when belief is valued more than facts. Perhaps better defined facts can help "prisoners" of both political parties. And maybe the most expensive and arguably wasteful health care system in the world can become less expensive and more effective. No sarcasm intended in this final paragraph.