The reaction to the Supreme Court Affordable Care Act decision last Thursday is divided, as we would predict.
I've seen five polls conducted after the decision -- our one-night USA Today/Gallup poll on June 28, and those conducted by the Kaiser Family Foundation, Pew Research, CNN/ORC, and ABC News, Washington Post. All found that the public's reaction to the ruling was split. In our one-night poll, amazingly enough, not only did we have a 46% to 46% split on agreement/disagreement with the ruling, but we had exactly -- I mean exactly -- the same number of respondents who said they agreed as said they disagreed.
The divide in reaction is predictably partisan. In our poll, 79% of Democrats agreed with the Supreme Court's ruling, while 83% of Republicans disagreed. Independents tilted toward agreeing by a three-percentage-point margin. The other polls found basically the same type of political divide.
Why would we expect this type of political divide? Well, it's because the underlying Affordable Care Act (ACA) is politically divisive -- a piece of legislation that has come to be extraordinarily partisan. The ACA was initiated and championed by President Barack Obama, and the informal sobriquet most often used to describe it incorporates his name. Republicans have generally opposed the ACA and focused on it as a main political target this year. The ACA has taken on symbolic gravity for partisans on both sides, as legislation sometimes does. Ergo, basic views of the Affordable Healthcare Act have been and continue to be highly divided along party lines. And so was the reaction to the Supreme Court decision.
So, in a way, asking why the reactions to the ACA, and the Supreme Court decision which affirmed its constitutionality, are divided is like asking why opinions of President Obama are divided. That's the reality of American politics today.
To be sure, it's clear that the fundamentals of the ACA resonate with two disparate themes in American politics today. Democrats on average favor more government action to improve the lives of Americans, while Republicans favor letting individuals and businesses handle more of this responsibility. Since the ACA is demonstrably the government attempting to make things better for individuals when it comes to healthcare, it fits with a Democratic view of social and political life. It does not fit with a Republican view.
People ask: How important will the Supreme Court's decision be in this fall's election? The answer: It will probably be highly important for some, but not that important for the majority. When we recently askedAmericans why they were voting for Obama or for Mitt Romney, healthcare was relatively low on the list of categorized responses. Just 10% of Obama voters mentioned healthcare and just 4% of Romney voters mentioned healthcare. Further, as my colleague Jeff Jones pointed out in his recent analysis, and I as reviewed here, few Americans at this juncture (at least through early June) mention healthcare as the most important problem facing the country. And, in our June 28 poll, only about one-fifth of Americans said that the ACA was going to be the determining factor in their voting decision for this presidential election, although another 59% said that it would be one of many factors they would take into account.
As I noted here, it may be possible that the decision, perhaps like President Obama's public announcement that he favors legalized same-sex marriage, will galvanize conservative voters to get out and vote this fall. On the other hand, there is some indication that the decision may have helped make Democrats more enthusiastic.
What does the American public want to happen now? Several polls have asked about that, with different results.
Our USA Today/Gallup poll gave Americans four choices:
- Expand government's role 25%
- Keep the law in place 13%
- Repeal parts of the law 21%
- Repeal the law entirely 31%
The CNN/ORC poll gave them two choices:
- Repeal all of the provisions in the healthcare law 51%
- Keep all of the provisions in place 47%
The Kaiser Family Foundation gave these four alternatives:
- Expand law 28%
- Keep law as is 25%
- Repeal and replace with Republican alternative 18%
- Repeal and not replace 20%
Obviously there is no one general conclusion here. This is one of those instances in surveys when the options the researcher give to respondents make a difference. There is clearly an appetite in some segments for repealing all or part of the ACA, up to about half of the public in our USA Today/Gallup and the CNN polls. These people are highly likely to be Republicans. When the Kaiser poll asked respondents if opponents of the law should "continue trying to block the law from being implemented" or "stop their efforts to block the law and move on to other national problems", the latter won with 56% of the choices. This suggests a tilt towards not attempting to repeal the law, although the question wording here, it seems to me, needs to be looked at carefully in interpreting the results.
The real impact of the SCOTUS decision won't be known for a while now. In modern elections, events tend to reinforce existing perceptions rather than change people's minds about the candidates they support. So one key result of the decision will be its long-term impact on the Holy Grail of elections -- voter motivation and turnout -- that campaign consultants so covet.