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Politics Affect Uninsured Americans' Insurance Intentions

Politics Affect Uninsured Americans' Insurance Intentions

PRINCETON, NJ -- Three-quarters of uninsured Democrats say they still plan on getting insurance rather than pay a fine, double the percentage of uninsured Republicans. This strongly partisan divide in Americans' intentions to comply with the Affordable Care Act's individual mandate is in line with what Gallup has found in previous months, underscoring the ongoing political nature of the public's relationship with the ACA.

Trend: Insurance Intentions Among Political Groups: Get Insurance or Pay Fine?

The sharp political divide in these views highlights a key challenge facing the Obama administration and other ACA proponents: that Americans view the legislation not on its merits or benefits to the individual, but rather through strictly political lenses.

The degree to which uninsured Americans' actual purchases of health insurance will match their self-reported intentions is not clear. Gallup will report additional research in April that will shed light on the demographic makeup and health status of those who are newly insured since January, focusing particularly on whether Democrats have been more likely than Republicans to sign up.

Republicans' lower representation in the ranks of those who say they are uninsured somewhat mitigates the effect of uninsured Republicans' being less likely to plan to sign up. Sixteen percent of the pool of the uninsured in the March 1-26 sample identify as Republican, compared with 25% of the overall 18 and older population. Democrats represent 27% of the uninsured, slightly below their representation in the population. Independents, at 51%, are the biggest component of the uninsured, compared with 41% of the entire adult sample.

The preponderance of Democrats and independents in the uninsured sample helps explain why more than half of the total pool of uninsured continue to say they will get insurance rather than pay a fine, similar to January and February readings.

Trend: Uninsured Americans' Intentions for Getting Health Insurance

These data were collected March 1-26, in the last official month for enrollment in a health insurance plan, although the deadline has been extended for those who say they began the process of enrollment before the end of the month. With more than half of the uninsured still intending to get insurance even as the deadline approaches, there could be a last-minute rush to sign up. It is also possible that these self-reported intentions are more general reactions to the idea of the law itself rather than accurate predictors of behavior, and include the possibility that some intend to get insurance at an indefinite future time.


The Affordable Care Act, as is evidenced by the popular sobriquet "Obamacare" tying it directly to a sitting president, remains highly political. Not only are Americans' attitudes about the law itself highly partisan, but so are uninsured Americans' self-reported intentions to sign up for the health insurance that the law requires.

If politics are prompting some uninsured Republicans to refuse to get insurance even in the face of having to pay a fine, this would likely be distressing for the law's proponents, who presumably would want Americans to consider the law on its merits rather than its political origins. The survey results suggest that one approach that might work for ACA advocates would be to shift the discussion away from politics, perhaps using high-profile apolitical public spokespeople and focusing on the law's merits rather than on the politics of those who oppose it.

Survey Methods

Results for this Gallup poll are based on telephone interviews conducted March 1-26, 2014, with a random sample of 1,322 adults who do not have health insurance, aged 18 and older, living in all 50 U.S. states and the District of Columbia.

For results based on the total sample of uninsured adults, the margin of sampling error is ±3 percentage points at the 95% confidence level.

Interviews are conducted with respondents on landline telephones and cellular phones, with interviews conducted in Spanish for respondents who are primarily Spanish-speaking. Each sample of national adults includes a minimum quota of 50% cellphone respondents and 50% landline respondents, with additional minimum quotas by time zone within region. Landline and cellular telephone numbers are selected using random-digit-dial methods. Landline respondents are chosen at random within each household on the basis of which member had the most recent birthday.

Samples are weighted to correct for unequal selection probability, nonresponse, and double coverage of landline and cell users in the two sampling frames. They are also weighted to match the national demographics of gender, age, race, Hispanic ethnicity, education, region, population density, and phone status (cellphone only/landline only/both, and cellphone mostly). Demographic weighting targets are based on the most recent Current Population Survey figures for the aged 18 and older U.S. population. Phone status targets are based on the most recent National Health Interview Survey. Population density targets are based on the most recent U.S. census. All reported margins of sampling error include the computed design effects for weighting.

In addition to sampling error, question wording and practical difficulties in conducting surveys can introduce error or bias into the findings of public opinion polls.

For more details on Gallup's polling methodology, visit

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