Passing ObamaCare Won't Make It More Popular

The public knows what's in the bill—and they aren't buying

Given the long, steep nosedive President Barack Obama's health care reform proposal's popularity has taken since last summer—Pollster.com's multi-poll average now shows opposition at 51.1 percent, with only 40.1 percent in favor of passage—liberals who still favor passage have had to work especially hard to come up with reasons why passing a deeply unpopular bill is still a good idea politically. Thus, they have been put in the position of arguing that once the bill is passed, its popularity will rise. The public may be skittish now, the bill's supporters admit, but they'll come around. 

But there's scant evidence to bolster this belief. Consider Massachusetts, where an ObamaCare-style proposal was implemented in 2006. Supporters of passing a national health care overhaul point out that Massachusetts voters may have elected Republican Scott Brown to fill Ted Kennedy's seat, but Brown actually supported the state's health care program. 

Yet this proves little about the current debate over a national plan. Massachusetts is far more liberal than the country as a whole, and the state's voters are far more open to government intrusion into the health care market. 

More to the point, however, there was widespread support for the outlines of the Massachusetts plan before it passed. According to a 2008 report published in the journal Health Affairs on how public opinion shaped the Massachusetts plan, there was "a favorable political environment" in the state to begin with.

In particular, solid majorities in the state supported the mandates and expansions of government care that are now driving opposition to the national plan. In 2003, for example, majorities supported an employer mandate (76 percent), an individual mandate (56 percent), and an expansion of state-run health programs (82 percent). In 2005, the year the bill was passed in the state legislature, the report notes that 66 percent of the state reported supporting a universal coverage ballot initiative. And immediately after passage, before most residents had had the opportunity to interact with the system, support remained high, with 61 percent of state residents supporting the law.  

In other words, a majority of Massachusetts residents liked universal-insurance-focused health care reform before it was passed, and a majority liked it afterwards—but there was no upward turn in approval. Indeed, since its passage, support for the Massachusetts plan has actually dwindled. At the end of November, 2009, a Rasmussen poll found that only 32 percent of the state's residents believed the plan had been a success. Far from a turn for the better, there was a significant slip in support. 

The second argument supporters make is that voters don't know what's in the bill, but would like it if they did. At the end of January, senior White House adviser David Axelrod argued that Democrats should proceed with passage by telling ABC's This Week that "people will never know what's in that bill until we pass it." This, too, is unconvincing. 

In fact, survey evidence shows that voters are well aware of the bill's major components, including the "benefits" that liberals believe will make the bill popular. According to a survey by the Kaiser Family Foundation, 72 percent are aware that the bill provides subsidies to help people purchase insurance, 63 percent are aware that it requires insurance companies to offer a minimum benefits package, 61 percent know that the bill prohibits insurers from refusing to provide coverage, and 62 percent know that it expands Medicaid coverage for low-income individuals. A large majority—68 percent—is even aware that the bill will raise revenue by increasing taxes for the rich. 

Considered in the context of the public's general level of political knowledge, this counts as widespread penetration. According to a January 2010 survey by the Pew Center for People and the Press, for example, only 39 percent of Americans know that Harry Reid is majority leader in the Senate, and only 26 percent know that it takes 60 votes to break a filibuster in the Senate.

Finally, supporters argue that individual elements of the bill such as prohibiting discrimination based on preexisting conditions often receive majority support when polled. But individual elements do not make a bill, and support for various provisions does not imply support for the whole. 

That's because support for those provisions alone fails to account for their costs. And the public, meanwhile, is well aware of the bill's significant costs, and deeply resistant to them. According to the Kaiser Foundation's survey, the bill's least popular elements are its massive taxpayer price tag and the individual mandate, which would legally require everyone in the country to purchase health insurance. 

In other words, the public knows what's in the bill, and they still don't buy it—and no amount of wishful thinking on the part of its Democratic supporters is likely to change that. 

Peter Suderman is an associate editor at Reason magazine.

Editor's Note: We invite comments and request that they be civil and on-topic. We do not moderate or assume any responsibility for comments, which are owned by the readers who post them. Comments do not represent the views of Reason.com or Reason Foundation. We reserve the right to delete any comment for any reason at any time. Report abuses.

  • Chad||

    Peter, there is a serious flaw in your analysis. The poll could not distinguish between people knowing what was in the health care bills, and people guessing based on the question. The poll authors make this clear in the notes. I wonder would happen if you framed the question more broadly, like "Can you list five elements contained in either the House or Senate health-care bills". Want to bet most people would fail? It would be a lot more telling than simply asking people whether they were aware policy X was in the bills, to which they can answer yes freely.

    From my experience, the tea-party crowd has little idea what is in these bills, nor do they care.

  • ||

    I thought you were in favor of single payer. So why are you rooting for mandated-buying-of-evil-corporations-product now?

  • spambot||

    Because Democrats told him it was ok.

  • Chad||

    It is mildy less awful than what we currently have.

    I love it when I hear people blather about Obamacare being "left-wing", when in fact, it would be the most right-wing system of any rich nation.

  • GenericBrand||

    hahahaha. Just because it's the most right-leaning definitely doesn't make it right-wing.

  • ||

    From my experience, the tea-party crowd has little idea what is in these bills, nor do they care.

    I know I'm only responding to a sockpuppet named Choad, but holy shit, I just had to point out the projection in this statement, whether real or just what someone thinks a leftist retard would say, because man, it's perfect.

  • ||

    The wheels within wheels of idiocy are amazing in that statement. Dare I say even genius?

    Naw, just a new level of retardation.

  • smartass sob||

    From my experience, the tea-party crowd has little idea what is in these bills, nor do they care.

    And just what experience might you have regarding the "tea-party crowd?"

  • The Gobbler||

    "Can you list five elements contained in either the House or Senate health-care bills". Want to bet most people would fail?"

    Then let's see you answer your own question. Give us five, please.

  • TickleStick||

    Chad = MNG

  • John Tagliaferro||

    Si

  • ||

    From my experience, the tea-party crowd has little idea what is in these bills, nor do they care.

    True to some extent, but the same holds for supporters of the bill. Plenty of people support it and think it involves single-payer, or don't realize that the taxes kick in four years before the subsidies, or that there's a mandate, etc.

  • RichN||

    "From my experience, the tea-party crowd has little idea what is in these bills, nor do they care."

    Can you elaborate please on your so called experience?

    Personally I think you're full of shit!

    I said it...therefore its true.

  • Chad||

    I grew up in, and my family still resides in, a dirt-poor rural area in the upper midwest. Every not in a union up there is a Limbaugh-worshipping Republican, and you know how many union members are left nowadays.

  • Jimmy 'Crack' Corn||

    "From my experience, the tea-party crowd has little idea what is in these bills, nor do they care." - Chad

    Ahh, Mr. Elitist joins the fray.

  • Poppin' Caps lock||

    People are not required to read through gazillion-page bills (that likely contain considerable amounts of lawyer-speak) in order to be against them.

  • ||

    liberals who still favor passage have had to work especially hard to come up with reasons why passing a deeply unpopular health care bill is still a good idea politically.

    I'm not sure shouting "It'll be good for you! Seriously!" really qualifies as especially hard work.

  • Jimmy 'Crack' Corn||

    +1

  • ||

    The healthcare bill is the Wagon Queen Family Truckster. "You think you hate it now, but wait till you drive it."

  • Kroneborge||

    Of course other instrusive government programs have become popular. IE SS, and Medicare.

    Hooray for bread and circuses.

  • Johnny Longtorso||

    ObamaCare has the taxes up front and the benefits later. Their lie to make the 10 year cost seem lower will bite them in the ass here. If it passes, we get several years of taxes w/o benefits to turn people against the damn thing.

  • ||

    If it passes, we get several years of taxes w/o benefits to turn people against the damn thing.

    One has to wonder if this wasn't its real intent all along.

  • ||

    """Can you list five elements contained in either the House or Senate health-care bills". Want to bet most people would fail? ""

    Don't kid yourself Chad, they couldn't tell you two elements. ;-)

    The people would wake up with the mandatory part kicks in. People in general have the, it won't happen to me, mentality. What's the odds that people think being forced to pay wouldn't happen to them? The day that comes, the universal part will be the hatered of it.

  • Chad||

    The only people that whine about the mandatory part are non-risk-averse young men in good health.

    aka, most libertarians.

  • RCTL||

    Do you mean the young men in good health that don't have any insurance in the first place and cost taxpaying public more than the dreaded welfare queens they constantly whine about?

  • ||

    Yeah, all the others love the idea of the feds getting in bed with the insurance companies by forcing Americans to buy their product.

  • Chad||

    Who, outside of the group that I just mentioned, neither has nor wants health insurance?

    Almost no one.

  • Untermensch||

    That, my friend, would be an argument for why we don't need ObamaCare. If only the folks who don't need it don't have it and don't want it, why are we trying to give it to everyone.

    Don't blame me for pointing out the stupidity of what you wrote...

  • Tim2||

    I don't mind purchasing health insurance, I just don't want to be forced to purchase more expensive health insurance so that politicians can lie about the low cost of their plans by paying for their wealth transfers not with explicit taxes but by forcing me to buy the same coverage some middle aged person would want so they can give that person a discount at my expense.

    You can't defend the mandate on "take care of yourself you stupid young immortal" grounds while at the same time arguing in favor of underwriting restrictions and minimum benefits packages which already exist in some states and are one of the reasons that young people in those states go uninsured. A young person in New York has to pay around two to four times on the low side more than he would have to pay in a less intrusive state, and his risk level doesn't justify spending so much on health insurance.

    This is what progressive liars do, they know full well the purpose of the individual mandate is to make guaranteed issue and underwriting restrictions economically feasible because of the moral hazard they create by prohibiting insurance companies from using individual's health information to determine prices; but instead of pointing out the obvious wealth transferring nature of these actions, which ironically is often from poorer younger citizens to wealthier older ones, they try to portray the entire opposition as merely irrationally risk loving healthy males too stupid to properly take care of themselves. That's just dishonest.

    Lets also not forget that many of these young men aren't full time or high paid employees, which means that they can't take advantage of the tax credit our government gives only to employers drying up the individual market they may like to participate in also indirectly subsidizing wealthier people on their behalf. I suspect that if this group was offered the same tax deduction that employers got and were they allowed to purchase health insurance from a less regulated state that could offer them the catastrophic coverage only plans, which is all a healthy young male needs, they would buy health insurance. What they won't do though in such a circumstance of freedom and equal treatment is buy coverage they don't need to subsidize someone else. I'm not in favor of a general health insurance subsidy enacted at the federal level, but that is the closest we can get as ending the employer tax deduction without a replacement is too politically unpopular. I'd favor broad based tax cuts with a means tested subsidy at the state/local level implemented in a manner such that it doesn't create punitive effective marginal tax rates where workers face huge drops in total wealth as they increase their productivity and lose access to the subsidy, another of Obamacare's major ills.

    I challenge Chad in addition to what was already said to answer why, given the general size in land area and population of many of his favorite social welfare states, we need a federal health insurance policy? Why is the federal government involved in welfare at all? If welfare really is a public good, there won't be a race to the bottom; we don't see people racing to the bottom in terms of states with little military or police forces.

  • RCTL||

    Tim2,"his risk level doesn't justify spending so much on health insurance... they try to portray the entire opposition as merely irrationally risk loving healthy males too stupid to properly take care of themselves. That's just dishonest." Yet you admit that these males fail to purchase insurance. "they would buy health insurance" I would think that not having any insurance is the falls under the rank of stupid and incapable.

  • Mikey||

    Is it your business to force them to carry health insurance?

  • RCTL||

    How do you think the oops I don't have insurance hospital bills are paid?

  • ||

    Well one way they are "paid" is the emergency medicine physicians like myself don't get any money for taking care of them (which we are required by law to do, regardless of how "sick" they might be). Of course we are legally actionable on the back end, so we're getting screwed both ways. All the ambulance chaser commercials are on during the day, when most people are working and don't watch television. Coincidence?

    Seriously, though, I see very few of the uninsured young healthy man you speak of...at least those that are employed. I do see the shot uninsured crack dealer fairly often, but I doubt a legal mandate is really going to help on that score.

  • RCTL||

    The fact is when these libertarian boys think they don't need any insurance. You know damn well they are statistically likely to be in car accidents in that age group. Are you saying you don't mind not being paid because they are not the crack dealer type? You also know that there is no such thing as a forgiven bill. We all pick up the hospital bill.

  • Tim2||

    It's not stupid behavior, it is rational; an infinitesimal risk of getting a truly catastrophic disease isn't worth paying hundreds of dollars month to avoid. They "fail" to buy health insurance because in many states regulations have inflated the costs of such insurance above the insurance's actual benefits; which are the risk of getting sick times the cost of treatment, not just the costs they would face if they got sick. As for the social costs via EMTALA, that's an argument against EMTALA; or at the very least illustrates the strange kind of "generosity" of government where government "gives" people a benefit and then forces them to pay for it expecting people to be happy. I doubt laws forcing ERs to treat all comers would have been passed if combined with an insurance mandate. If we did want a mandate just to pay for EMTALA, then we would mandate coverage for emergency services only; a mandate which cannot perform the functions that the politicians have in mind for it as it wouldn't change any of the underlying problems with forces insurers to cover everyone regardless of pre existing conditions with limitations on medical underwriting.

    As for accidents they may be more likely to get their cars dinged up which means you have to control for accidents that inflict few personal injuries and for accidents that are fatal; which will drive the expected medical costs down. Simply citing vague accidents statistics are meaningless. What is the difference between their rate of accidents and adults? What are the average medical costs? Who is at fault, because if the other guy is the cause he has to pay.

    I agree in theory that everyone should buy some level of health insurance, the trouble is that the politicians want to force people to buy more care than they need so they insurance companies don't go out of business when they are forced to provide care to the already sick and risky at a loss.

  • RCTL||

    How is it rational to pass your burden of non-payment on to others? Don't confuse I don't want it with I don't need it. To suggest that regulations/actual benefits prohibits a reasonable health care policy is ridiculous. They are already able to purchase a high deductible HSA that would include a catastrophic only policy. The argument that "the risk of getting sick times the cost of treatment, not just the costs they would face if they got sick." is another piece of bull. The fact is the costs of emergency care is inflated without the protection of insurance.

  • RCTL||

    "What is the difference between their rate of accidents and adults? What are the average medical costs? "


    " Drivers....under age 24 account for 30% - $26 billion Dollars of the total costs of Car accidents in the US...The car accident death rate...19.4 killed per 100,000 male drivers"

    "About 3.5 million motor vehicle crash victims were treated in emergency departments in 2006...The data show that crashes involving cars, motorcycles and trucks of all types constitute nearly 10 percent of hospital visits due to injury".

    "you have to control for accidents that inflict few personal injuries and for accidents that are fatal; which will drive the expected medical costs down. "


    During 2006 in Virginia, 73,349 people suffered injuries from crashes, and another 981 died. These numbers ticked downward in 2008, the last year for which complete data are available, but still stood near 70,000 injured and more than 800 killed."

    "What are the average medical costs?"


    .... males ages 16 to 25 ­ the age group least likely to buckle up....nation's highest-risk drivers...more crashes... more than 5,500 deaths and 132,000 injuries annually... We all pay...in higher taxes, higher health care and higher insurance costs. On average, inpatient hospital care costs for an unbelted crash victim are 50 percent higher than those for a belted crash victim. Society bears 85 percent of those costs, not the individuals involved. Every American pays about $580 a year toward the cost of crashes."


    Refusing to buy a policy now has no relevance to the possibility of government forcing people to buy insurance.

  • RCTL||

    My links will not pass the spam filter but they are

    car-accidents.com/teen-car accidents
    examiner.com Norfolk health care

  • bleek obummer||

    Congratulations RCTL - you have discovered statistics. There is hope for you yet. Now you can argue with something other than statist talking points. Welcome.

  • ||

    "They are already able to purchase a high deductible HSA that would include a catastrophic only policy."

    As a point of fact, in many states they aren't, due to mandated coverage laws, a problem that Obamacare makes worse. While I agree that these types of policies make sense for young people in good health, eliminating them is one of the first things Obamacare does.

  • ph||

    "Considered in the context of the public's general level of political knowledge, this counts as widespread penetration."

    Only when the bill passes does the real penetration begin.

    Couldn't resist.

  • RCTL||

    Glad you don't mind receiving your fare share ;-)

  • ||

    From my experience, the tea-party crowd has little idea what is in these bills, nor do they care.

    From my experience, progressive hipsters haven't the vaguest notion of how wealth is created, nor do they care.

  • ||

    I'd like to run you over with my truck. I know you don't like the sound of that, but once I do it your attitude will change.

  • Colonel_Angus||

    If I ever meet face to face with Stephen D. or Chav....

  • Colonel_Angus||

    Minimum benefits package- make me pay more for coverage I don't want, so that I end up subsidizing everyone else.

    This is exactly the problem we have now. State mandates turn insurance in to exactly what it shouldn't be. Chony's favorite policies are what really make people go bankrupt.

  • RCTL||

    Big deal that it adds a few dollars to the cost of your insurance. You end up paying for mammograms and pap smears and libertarian males need to help keep as many women alive as possible. These preventive measures will only help save more women who can tolerate the whiny boys on this post.

  • ||

    Liberals don't know much about or understand the vast majority of America. They live in their own self segregated enclaves and wouldn't be caught dead outside of them. As a result, the liberal political, activist and pundit class is geniunely shocked that the country doesn't want socialized medicine. It is Pauline Kael syndrome writ large.

    Since they can't fathom how anyone could be against universal government provided healthcare, they have now convinced themselves it will get more popular once people see and feel the benefits of this wonderful program, they for sure will love it then.

    No liberals. The rest of the country really hates you and your dumb ass programs. They really don't like you.

  • ||

    You're right about the enclaves. Once a region reaches a certain percentage of liberals, suddenly all the conservatives disappear. They're still there of course, but they are ignored as if they don't exist. Everyone assumes you are a fellow liberal. They are genuinely shocked when they discover conservatives in their midst. The first thing I learned when moving to the SF Bay area, was to keep my non-progressivism to myself if I ever wanted to get invited to parties.

    p.s. Libertarians are given a pass, if they don't lean objectivist or paleo, and aren't accidentally mistaken for conservatives, but even so they are treated as pariahs for not bowing towards D.C or the state capital five times a day.

  • ||

    LOL, that's been my experience too. I worked in downtown D.C. for a few years; people there were horrified to discover that I own firearms, carry a pocketknife, etc.

  • RichN||

    Why would you need firearms or a pocketknife working in downtown D.C.? Unless of course, you are a RACIST!

  • ||

    LOL, that's only a slight exaggeration of the usual reaction.

  • Colonel_Angus||

    I saw DC Cab. D.C., two or three blocks north, east, south, and west of the mall, is a dangerous shithole.

  • ||

    Brandybuck|2.12.10 @ 1:23PM|#
    "p.s. Libertarians are given a pass,..."
    Not in my experience. I'm tempted to have Reason and Liberty sent in plain, brown wrappers.

  • Tim2||

    It depends upon the issues of the day and who is in power, liberals liked libertarians much more when libertarians were criticizing George Bush. Pro-gay, Pro-choice, and anti-war libertarians get tolerated by the average liberal.

    We have to remember though that tolerated is different from accepted.

    The thing is though that most libertarians and liberals often come to the same conclusions about the demographic trends regarding social liberalism, while the predominately white male libertarians (who already have social freedoms) understand that economic freedom can and has begotten social freedom; which can lead to particularly nasty disputes over economic issues when they are at the forefront. Despite the civil libertarian overlap, liberals and libertarians don't really need each other unless conservatives are trying to actively roll back social freedom, fighting unpopular wars, or the economics of the day don't get the average liberal on the street that worked up about things like socialized medicine.

  • ||

    "Despite the civil libertarian overlap, liberals and libertarians don't really need each other unless conservatives are trying to actively roll back social freedom, fighting unpopular wars, or the economics of the day don't get the average liberal on the street that worked up about things like socialized medicine."

    So... basically every time the Republicans are in charge, then?

    I know there are a lot of liberals who just *loved* me during the Bush years but don't even want to talk to me these days.

  • Tim2||

    Pretty much, the best libertarians can do aside from voting for the few actual libertarian leaning politicians is to vote for gridlock.

  • Ring||

    I disagree, they know what a steaming turd the bill is which is why they have no passed it despite having the numbers to do so. They did not say, we will pass it and the voter can thank us later. They sought bipartisanship so they could share the blame.

    The Obamacare bill is all about making more people dependent on government so every 2 years before the elections they can trot out the fact that if Republicans get elected the funds will be cut and people will lose healthcare facilities.

    Creating dependence on government has been the plan for this whole administration, which makes it ever more crooked when liberals try and frame the arguments in terms of individuals.

    Incidentally, why doesn't everyone just go to MA and use their free healthcare?

  • Hope-A-Dope||

    I'm 100% in favor of passing Obamacare. That is, if by "passing" you mean pushing it out of the ass.

  • BakedPenguin||

    David Axelrod argued that Democrats should proceed with passage by telling ABC's This Week that "people will never know what's in that bill until we pass it." This, too, is unconvincing.

    The Obama administration is really doing wonders for transparency. Pretty soon, they'll equal the workings of the court of Suleyman II.

  • Andrew||

    Most people are very satisfied with Medicare and most Massachusetts residents like the Massachusetts plans AFTER they have had personal experiences with those plans. For me that's very powerful evidences for ObamaCare.

  • Jimbo||

    Well after I had "personal experience" with my current healthplan, I am also "very satsfied."

  • spambot||

    Sure and they are all going bankrupt. Next idea please.

  • RCTL||

    The satisfaction in Massachusetts is for the guarantee of health care. Those who use it only for preventive or moderate care and have not been subject to the tactics of the industry are not aware that time and bad luck will win erode their satisfaction.

  • ||

    Oh, I just HAVE to hear more about "the tactics of the industry", care to enlighten me?

  • Cap'n NoStar||

    Oh yeah, forcing me to buy a car I don't like will make me change my mind, especially if I have to make payments for four years before I can take delivery and drive it.

  • ||

    I am very much afraid that our elected representatives have turned our government into a dictatorship.

  • Jimmy 'Crack' Corn||

    Poll finds strong anti-Washington feeling

    http://seattletimes.nwsource.c.....tpoll.html

  • Soonerliberty||

    Such arguments are idiotic in the first place. Of course, I can be satisfied with something that I don't know is damaging me, because I only think it damages others. People like free shit and are satisfied with it. Satisfaction forced upon us doesn't justify the program itself. Are you satisfied with 53 trillion dollars in unfunded entitlements and a devalued dollar should be the proper question.

  • ||

    Can SOMETHING be done about the stupid Pingback?

  • ||

    PLEASE pass this bill via reconciliation, Dems. PLEASE, do it ASAP. You gotta do it, for the good of the country!!!

    And then I can't wait until you get WIPED OUT in November. Losing massive majorities in both the House and Senate in the same year and leaving Obamer essentially a lame duck....priceless!

  • John Mackey Greene||

    From my experience, the tea-party crowd has little idea what is in these bills, nor do they care.

    Does it matter what's in the bill? That's just a dumbheaded "What's te matter with Kansas?" argument.

    People aren't opposed to the bill because they don't like the specific things that the government is trying to force on them, they're opposed to the bill because they don't like the idea of the government forcing anything on them.

    Seriously, libs, it's the principle of the thing. Some people just can't be bribed.

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