NEJM Review of ACA Polls Finds Gap Between Congress and Country
Researchers from the Harvard School of Public Health studied an average of 27 national polls on the Affordable Care Act taken by 12 different organizations.
The barrage of polls on the Affordable Care Act (ACA)—from news organizations to the Kaiser Family Foundation—offer snapshots of public opinion on the law, but taken together they tell us something more, say authors from Harvard’s T.H. Chan School of Public Health.
In a special report to the New England Journal of Medicine, Robert J. Blendon, ScD, and John M. Benson, MA, find that public values on healthcare have slowly shifted, but they are distinct from how people feel about the ACA itself. The trouble, the authors say, is that views among active members of political parties—especially members of Congress—are far more polarized than those of average Americans, making solutions hard to achieve.
In other words, tracking whether public opinion “for” or “against” the ACA is up or down misses the point. An average of 27 national polls from 12 organizations shows that approval of the ACA has moved just 5 points between 2012 and June 2017, to 49% support, the authors note. Barely half the public thinks the ACA should be retained with some improvements (51%), while 7% say it needs no changes.
That’s hardly a ringing endorsement of the law. In particular, Americans are split on the question of the individual mandate. Right now, 50% oppose it, and 48% support it.
The more important shift, the authors find, is the one in underlying values on healthcare. When asked if the federal government should ensure that people have health coverage, 60% say yes, up 4 points from 2013 and 10 points from its lowest point in 2014. However, there is a divide along party lines: 85% of Democrats favor a federal role, compared with 30% of Republicans.
Also interesting is the view of Medicaid: the authors find that 72% of Americans favor allowing those newly enrolled through Medicaid expansion to stay. Here, there was agreement among Republicans and Democrats, which played out on the Senate floor, as GOP senators withheld their votes specifically over the threat of Medicaid cuts.
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