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.