Health Care Law Still on Trial in the Court of Public Opinion


Today, the Supreme Court ruled the Patient Protection and Affordable Care Act (ACA or ObamaCare)'s individual mandate can stand as a tax, thereby judging it constitutional. Chief Justice John Roberts was the swing vote in the 5-4 ruling. In stark contrast, polls have found consistent opposition to the law and public skepticism of its constitutionality.

A Fox News poll in early June found that 59 percent believe the individual mandate, if not the whole law, is unconstitutional. This is largely unchanged from a March Reason-Rupe poll which found 62 percent believe it is unconstitutional for Congress to require Americans to have health insurance. According to the same Fox News poll, 60 percent of Americans believe the federal government's forcing Americans to buy health insurance is a violation of individual rights protected by the Constitution.

According to the March Reason-Rupe poll, the more people know about the health care law, the more likely they are to oppose it. Intensity is clearly against the law, among those who say they know most about the law, 70 percent have an unfavorable view of it, 29 percent have a favorable view of it.

A series of New York Times/CBS News polls find consistent opposition to the law. Soon after the law was passed in 2010, 53 percent disproved of the health care law, and 32 percent approved. Public sentiment has remained consistently opposed; the most recent poll conducted May 31-June 3rd of this year found 48 percent disapprove and 34 percent approve of the law.


An additional hurdle for the law will be public reaction to the law's unintended consequences, for instance the likely steep increases in health insurance premiums, rationing, etc. Even Affordable Care Act chief architect Jonathan Gruber is backtracking on an earlier analysis, now saying individuals will experience dramatic premium increases.

Fifty-four percent of Americans expect the new health care law to result in rationing of the kind recess-appointed Medicare chief Donald Berwick thinks should be in place. For instance, in an his 1996 co-authored book, Berwick writes one of "the primary functions" of health regulation is "to constrain decentralized, individual decision making" and "to weigh public welfare against the choices of private consumers."

The public reaction to unintended consequences stands to undermine even the more popular aspects of the law. For instance, although a majority of Americans (52 percent) favor the ACA's community rating provision, which prohibits health insurance companies from charging different premiums based on medical history, support for this provision declines if it were to result in higher taxes (support drops to 37 percent), higher premiums (support drops to 38 percent), and longer wait times to see a specialist (41 percent).  Most dramatically, however, opposition skyrockets to 76 percent against the community rating provision if it were to result in lower quality health care.

According to the same March Reason-Rupe poll, 47 percent of Americans believe the employer mandate will lead to worker lay-offs and 58 percent think it will cause employers to pay their workers less.

In sum, although the health care law survived the Supreme Court ruling, it may have greater difficulty in the court of public opinion. The potential for lower quality care, higher premiums, longer wait times, rationing, and other unintended consequences may create additional obstacles for those who wish to continue reform in the direction of the ACA.

Emily Ekins is the director of polling for Reason Foundation where she leads the Reason-Rupe public opinion research project, launched in 2011. Follow her on Twitter @emilyekins.

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  1. But it is supposed to get more popular? It is supposed to have so many goodies once it kicks into place the public is going to love it?

    Not quite. This thing is going to be an albatross on Democrats. Give it too more elections and they will be voting to over turn it.

    1. Whatever John, if you don't like then...(take it away Facebook)

      people complaining about obamacare being upheld and "socialized" healthcare should just move to the democratic republic of the congo. i guarantee you there is no ("socialized") healthcare there.

      1. I'm sure the people making this argument were about to move to England if Obamacare went down.

      2. Romney got a money bomb today. Did Obama?

        1. Why would I have any idea about Obama's donations?

          1. It was a rhetorical question. I have no idea either. He have but I doubt it.

            1. I won't be sending money to Romney (though this actually makes me feel tempted to), but I have decided to send some money to a one or two Republican campaigns in close districts/states (Who? TBD).

          2. It was a rhetorical question. I have no idea either. He have but I doubt it.

            1. I do know that a girl I know who works for some bullshit newmedia liberal thing is very excited about "money rolling in."

      3. it's not for lack of trying. westerners have given that shithole billions in aid but their corrupt officials siphon it off.

        if i was a billionaire, i'd hire Xi or another merc group and be king there. diamonds, all sorts of natural resources. that's how i want to go out. nuked from orbit by progressive Americans b/c i dared to dream.

  2. 1) Alt-text.


    Chief Justice John Roberts was the swing vote in the 5-4 ruling.

    No, it was Kagan, the former SG who worked this case.

  3. Emily, have you tried to forecast the magnitude of the whatthefuckitwassupposedtobefree when the "tax" blindsides all the young assholes who voted for Obama?

    1. The young assholes who voted for Obama are under 26. They're now covered by their parents insurance. Which is free.

      They won't feel the tax.

      You think that 'up to 26' was an accident? That shit was done on purpose with the idea being that by the time you're 26, you've matured enough to have a job that'll give you healthcare anyway. If you think Obama was going to stick his #1 constitutency with a mandate/tax, you've got another thing coming.

      1. Clearly you haven't heard the endless bitching by college grads about how impossible it is to find a job.

      2. I imagine companies will, if they have not already, adjust their offerings accordingly per the "up to age 26" provision and mom/dad will let junior know all about it.

      3. The sickening thing is I was talking to a Connecticut legislator, a Republican yet, who thought the kids should be allowed to stay on the policy to age 30! There wasn't one employee at my company who left their kids on to age 26...because they didn't want to pay the extra 25% for family coverage that the company didn't cover. Our insurance carrier rep says the only ones leaving the kids on are either rich or their kids have some horrendously expensive medical problem (that will eventually drive the employer's premium through the roof if its group rated.)

  4. The sad part of this bullshit is that we can all, rich and poor alike, outsource our illnesses to cheaper healthcare structures in an increasingly globalized economy. Unfortunately, Right and Left still demonize globalization.

  5. The presence of all these brainy right-leaning lawyers was not without its drawbacks, however. There are many problems with ObamaCare?it's a huge tax increase, it's a redistribution of wealth, it increases the size of government, it's an overly complex exercise in central planning, it breaks Barack Obama's campaign promises, its implementation is timed so as to avoid electoral responsibility, it's a distraction from higher priority issues, it's unpopular with voters, it's bad for the economy. But in part because of the influence of all those lawyers, the conservative movement, at least for public discussion purposes, focused its energy for the past year or so on one main line of attack: the idea that the ObamaCare law is unconstitutional.

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