What the public thinks of health care repeal

WHAT THE PUBLIC THINKS OF HEALTH CARE REPEAL…. In advance of tomorrow’s House vote on eliminating the entirety of the Affordable Care Act, proponents insist that the public is on their side. The truth is far more complicated.

Over the weekend, the latest national poll from the Associated Press, for example, found that only about one in four Americans (26%) want to scrap the Affordable Care Act altogether. Sounds like pretty abysmal support for the Republican plan, right? Today, however, a CNN poll was released, asking respondents whether they’d like to see Congress repeal all of the law or leave it in place. Half the country (50%) favored repeal.

Obviously, that’s a huge difference. One credible national poll finds one in four support repeal, and two days later, another credible national poll finds one in two support repeal. Statistical variations of a few points between surveys are to be expected; 24-point differences on the same issue at the same time are not.

So what’s going on? Greg Sargent has an important piece that explains the larger problem. The key is giving respondents enough options to get an accurate sense of their attitudes.

This pattern now seems obvious. How to explain it? One possibility is that while there’s no quibbling with the fact that health reform is unpopular, there are many differing reasons why people don’t like the law. When people are given the opportunity to tell pollsters that they don’t think the bill is ambitious enough, a third or more of Americans do just that. Another chunk of voters says there are some problems with the bill, and it needs to be partially scaled back. Result: The sum total calling for full repeal drops sharply.

But when they are given only a straight up choice — keep the bill as is, or get rid of it — the number who opt for blowing it up is considerably higher. This probably reflects a high degree of frustration with the current law, but it seems to exaggerate the depth of support for doing away with reform completely.

Looking back over the last year or so, it seems there have been three relative constants in public opinion as it relates to health care. The first is that the public soured on the Democratic plan, even if most Americans didn’t know what the Democratic plan was/is. The second is that the individual components of the reform package were quite popular — in some cases, extremely popular — when pollsters actually told respondents was in the proposal.

And the third is that “opposition” to the reform plan has never been monolithic. Reform’s detractors have been large in number for quite a while, but the assumption that they were all on board with the GOP’s criticism has been deeply flawed — a big chunk of reform’s opponents have been from the left, with a sizable group who believe the law is too timid, too limited, and not nearly ambitious enough.

It’s why Greg’s point is so important: polls that offer respondents a range of options end up offering a better look at the nuances of public opinion. Something to keep in mind as the House vote draws closer.