AEI Special Poll Report: Health Care Update

(October 2013)
Karlyn Bowman and Andrew Rugg

Few pieces of contemporary legislation have received as much scrutiny and attention as the Affordable Care Act. Few have been as divisive. This document makes it possible to see eight major pollsters trends on the bill and the law. For each pollster, opinions on the law have fluctuated in a narrow range, but they have been more negative than positive recently. Polls on President Obamas handling of health care generally show more negative than positive views. Democrats have lost considerable ground on whether they or Republicans in Congress would better handle the issue. NBC/WSJ shows Democrats with an 8 point advantage, down from a 16 point advantage in February. Pew shows Republicans up one point on handling health care. The economy and jobs are still the top issues of concern to Americans, but health care often ranks third in terms of concern. However, the tone of the publics concern has changed. Recent polls show a

shift in opinions concerning the presumed impact of the bill on the country as a whole. In September 2012, a plurality said the country would be better off under the Obama health care plan. Now, a plurality thinks it would be worse off. People have been more skeptical about the impact on their families for some time. Currently, 24 percent think they would be better off, 37 percent thought there would be no difference, and 32 percent think they will be worse off under the law. As for what to do with the law now, a four-part question from CBS News shows opinions tilt mostly toward repealing the law entirely (39 percent), followed by repealing the mandate (18 percent). Sixteen percent prefer to keep the law in place and, 20 percent wanted to expand it. Kaiser asks if people support defunding the law. Thirty-seven percent supported defunding in their September poll. Full wording of the questions at the beginning of the document appear on pages 13 and 14.

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Views on the Legislation/Law

Jul. 2009 Aug. 2009 Sep. 2009 Oct. 2009 Nov. 2009 Dec. 2009 Jan. 2010 Feb. 2010 Mar. 2010 Apr. 2010 May 2010 Jun. 2010 Jul. 2010 Aug. 2010 Sep. 2010 Oct. 2010 Nov. 2010 Dec. 2010 Jan. 2011 Feb. 2011 Mar. 2011 May 2011 Jun. 2011 Aug. 2011 Sep. 2011 Nov. 2011 Dec. 2011 Jan. 2012 Feb. 2012 Mar. 2012 --ABC/WP-Sup Opp 45% 50% 46 48 48 48 48 49 44 51 44 51 47 49 48 49 49 49 45 50 47 48 43 52 45 50 41 52 --Pew--CBS/NYTFav Opp App Dis 38% 44% 39 46 42 44 34 47 - 42 39 40% 45% 35 48 39 48 38 50 40 47 37 48 40 44 - - 43 47 35 47 36 49 44 46 38 45 37 49 39 43 43 47 41 48 36 50 33 51 37 48 35 51 47 45 CNN/ORC Fav Opp 46% 49% 38 58 39 59 39 54 43 56 40 56 43 54 37 59 39 56 38 56 43 50 ---Fox--Fav Opp 36% 47% 34 49 33 53 35 54 35 51 34 57 39 51 35 55 39 50 AP/GfK Sup Opp 34% 49% 40 40 39 45 36 44 42 42 41 43 39 45 41 40 38 40 35 36 29 35 46 42 46 45 47 41 45 46 49 47 --Kaiser-Fav Unfav 46% 40% 41 44 48 41 50 35 43 45 49 40 42 44 42 40 42 41 41 50 43 48 42 46 42 44 42 46 39 44 41 43 37 44 41 43 37 44 42 43 41 40 NBC/WSJ Good Bad 36% 42% 36 42 39 41 38 42 32 47 31 48 36 48 38 44 38 46 36 46 39 39 34 41 2|Page

Apr. 2012 May 2012 Jun. 2012 Jul. 2012 Aug. 2012 Sep. 2012 Oct. 2012 Nov. 2012 Jan. 2013 Feb. 2013 Mar. 2013 Apr. 2013 May 2013 Jun. 2013 Jul. 2013 Aug. 2013 Sep. 2013

--ABC/WP-Sup Opp 39% 53% 49 45 47 47 42 49 42 52

--Pew--CBS/NYTFav Opp App Dis 41% 49% 39% 47% 34 48 47 43 36 50 38 50 42 46 35 44 36 54 38 50 39 51

CNN/ORC Fav Opp 43% 51% 39 49 42 51 43 54 38 57

---Fox--Fav Opp 40% 53% 39 49 40 55 38 58

--AP/GfK-Sup Opp 34% 46% 24 62 22 64 -

--Kaiser-Fav Unfav 42% 43% 37 44 41 41 38 44 38 43 45 40 38 43 43 39 36 42 36 42 37 40 35 40 35 43 37 42 39 43

-NBC/WSJGood Bad 36% 45% 35 41 40 44 37 49 37 49 34 47 34 44

How is President Obama Handling Health Care?

July 2009 Aug. 2009 Sep. 2009 Oct. 2009 Nov. 2009 Dec. 2009 Jan. 2010 Feb. 2010 Mar. 2010 ---Gallup--App Dis 44% 50% 43 49 43 52 40 53 37 58 36 60 42 54 --ABC/WP-App Dis 49% 44% 46 50 47 48 48 48 47 49 44 53 45 52 43 54 48 49 Quinnipiac App Dis 46% 42% 39 52 41 51 41 53 38 56 35 58 35 58 44 50** -CBS/NYTApp Dis 46% 38% 40 47 47 45 47 42 44 48 42 50 40 54 35 55 47 48 ---Fox--App Dis 43% 45% 44 48 42 50 39 54 37 56 -CNN/ORCApp Dis 44% 53% 51 47 42 57 40 59 45 54 -AP/GfKApp Dis 50% 43% 42 52 48 47 49 46 49 46 48 48 49 46 Economist App Dis 37% 55% 40 52 44 48 3|Page

Apr. 2010 May 2010 Jun. 2010 Jul. 2010 Aug. 2010 Sep. 2010 Oct. 2010 Nov. 2010 Dec. 2010 Jan. 2011 Feb. 2011 Mar. 2011 May 2011 June 2011 Aug. 2011 Oct. 2011 Nov. 2011 Dec. 2011 Jan. 2012 Feb. 2012 Mar. 2012 Apr. 2012 May 2012 Jun. 2012 Jul. 2012 Aug. 2012 Sep. 2012 Oct. 2012 Nov. 2012 Jan. 2013 Feb. 2013 Mar. 2013

---Gallup--- --ABC/WP-- Quinnipiac -CBS/NYTApp Dis App Dis App Dis App Dis 49% 49% 40% 55% 41% 51% 44 51 42 52 46 50 40% 57% 46 37 43 52 44% 51% 40 56 40 56 40 56 41 55 41 56 41 56 40 56 41 52 43 52 38 50 42 46 49 46 35 44 -

---Fox---CNN/ORCApp Dis App Dis 40% 53% 41 55 44 54 39 55 44 55 41 58 42 56 40 57 41 54 47 50 38 59 42 55 43 52 44 51 44 51 43 51 48 47 47 49 50 49 43 52 -

-AP/GfKApp Dis 44% 52% 45 51 49 46 45% 53% 50 50 47 53 48 51 51 49 52 48 54 46 45 54 46 53 45 54 44 55 48 51 48 50 -

Economist App Dis 43% 50% 41 51 40 52 41 50 39 53 39 55 40 54 39 55 40 53 47 39 38 54 37 54 38 55 38 50 35 55 36 52 37 53 39 51 39 50 41 48 37 52 38 52 40 48 47 50 44 49 45 48 46 46 42 47 40 48 4|Page

---Gallup--- --ABC/WP-- Quinnipiac App Dis App Dis App Dis Apr. 2013 May 2013 Jun. 2013 40% 57% Jul. 2013 Aug. 2013 Sept. 2013 42% 52% -

-CBS/NYTApp Dis 40% 54%

---Fox---CNN/ORCApp Dis App Dis 43% 53% 44% 54% 41 55 38 58 42 55

-AP/GfKApp Dis -

Economist App Dis 38% 53% 38 50 42 51 37 50 39 50 38 51

Democrats vs. Republicans on Health Care

AP-GfK/Roper ---Kaiser--Dem Rep Dem Rep Party Party Party Party Sep. 2007 Nov. 2007 Feb. 2008 Jul. 2009 Aug. 2009 Dec. 2009* Jan. 2010 48% 38% Feb. 2010 Mar. 2010 48 37 Apr. 2010 48 40 May 2010 47 39 Jun. 2010 51 38 Jul. 2010 Aug. 2010 50 40 Sep. 2010 49 40 49% 32% Oct. 2010 48 43 46 31 Jan. 2011 49 37 Feb. 2011 44 31 Mar. 2011 53 36 -ABC/WP- -CNN/ORC- -NBC/WSJ- -CBS/NYTDem Rep Dem Rep Dem Rep Dem Rep Cong. Cong. Cong. Cong. Party Party Party Party 56% 26% 54 29 56 29 40% 23% 51% 42% 43 40 44% 27% 47 34 48 46 37 28 40 30 44 39 46 45 46 38 42 32 46 28 ---Fox--Dem Rep Party Party 42% 43% 44 40 ---Pew--Dem Rep Party Party 46% 27% 45 32 46 36 39 32 42 40 5|Page

AP-GfK/Roper Dem Rep Party Party Apr. 2011 May 2011 53% 35% Jun. 2011 50 38 Aug. 2011 49 37 Sep. 2011 Dec. 2011 Mar. 2012 Jun. 2012 Dec. 2012 Feb. 2013 Sep. 2013 -

---Kaiser--Dem Rep Party Party 45% 36% -

-ABC/WP- -CNN/ORC- -NBC/WSJ- -CBS/NYTDem Rep Dem Rep Dem Rep Dem Rep Cong. Cong. Cong. Cong. Party Party Party Party 42% 25% 39 26 41 28 41 25 37 29 -

---Fox--Dem Rep Party Party -

---Pew--Dem Rep Party Party 49% 38% 47 31 48 38 39 40

Better Off?
Q: Do you think _______ will be better off or worse under the new health care reform law, or dont you think it will make much difference? (Kaiser) ---You and your family------The country-----The uninsured--Better Worse No Diff Better Worse No Diff Better Worse No Diff Feb. 2009 38% 11% 43% 59% 12% 19% Apr. 2009 43 14 36 56 15 21 Jun. 2009 39 16 36 57 16 19 Jul. 2009 39 21 32 51 23 16 Aug. 2009 36 31 27 45 34 14 Sep. 2009 42 23 28 53 26 14 Oct. 2009 41 27 28 53 28 12 Nov. 2009 42 24 27 54 27 11 Dec. 2009 35 27 32 45 31 17 Jan. 2010 32 33 29 42 37 12 Feb. 2010 34 32 26 45 34 12 Mar. 2010 35 32 28 45 34 14 Apr. 2010 31 32 30 45 35 11 67% 15% 10% 6|Page

May 2010 Jun. 2010 Jul. 2010 Aug. 2010 Sep. 2010 Oct. 2010 Nov. 2010 Dec. 2010 Jan. 2011 Feb. 2011 Mar. 2011 Apr. 2011 May 2011 Jun. 2011 Jul. 2011 Aug. 2011 Sep. 2011 Oct. 2011 Nov. 2011 Dec. 2011 Jan. 2012 Feb. 2012 Mar. 2012 Apr. 2012 May 2012 Jul. 2012 Aug. 2012 Sep. 2012 Oct. 2012 Feb. 2013 Mar. 2013 Jun. 2013

---You and your family--Better Worse No Diff 29% 30% 32% 28 28 39 32 29 33 29 30 36 32 28 33 31 29 32 25 31 34 32 33 28 20 32 44 28 31 38 26 30 39 27 28 37 28 28 38 27 29 39 24 33 37 27 32 34 18 31 44 23 31 41 26 31 39 26 33 35 27 25 41 26 33 34 26 32 34 23 31 37 25 32 37 26 30 37 31 26 33 26 32 33 24 32 36 21 29 40 19 33 40

----The country--Better Worse No Diff 43% 35% 13% 42 32 19 43 35 15 39 37 18 42 34 15 39 34 18 38 36 16 40 37 15 34 38 22 37 39 19 38 35 19 39 35 18 37 38 19 35 39 20 39 35 20 33 37 21 38 36 18 28 36 39 35 36 22 37 37 19 37 36 19 39 32 22 37 38 18 39 38 17 34 35 20 35 41 18 36 37 17 40 33 17 34 35 21 34 38 19 31 40 20

---The uninsured--Better Worse No Diff 57% 50% 15% 55 25 15 49 20 22 51 23 17 53 25 14 51 24 16 47 29 16 -

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Aug. 2013 Sep. 2013

---You and your family--Better Worse No Diff 23% 34% 37% 24 32 37

----The country--Better Worse No Diff 34% 40% 19% 37 39 16

---The uninsured--Better Worse No Diff 48% 26% 18%

Q: In the long run, how do you think the healthcare law will affect your familys healthcare situation will it make things better, not make much difference, or will it make things worse? ----------How law will affect familys healthcare------Not make much Make better difference Make worse 24% 34% 38% 22 33 42 24 34 38

Feb. 2012* Jun. 2013 Aug. 2013

Gallup Gallup Gallup

Note: * Question wording included Now suppose all of the provisions of the healthcare law go into effect in the next few years. Q: In the long run, how do you think the healthcare law will affect the healthcare situation in the U.S. will it make things better, not make much difference, or will it make things worse? ----------How law will affect the healthcare in U.S------Not make much Make better difference Make worse 34% 16% 47% 35 15 44

Jun. 2013 Aug. 2013

Gallup Gallup

Q: From what you've heard or read, do you think the 2010 health care law will mostly help you personally, will mostly hurt you personally, or don't you think it will have much of an effect on you personally? Help 20% 17 16 13 Hurt 35% 36 36 33 Not have much effect 38% 39 41 48 8|Page

Mar. 2010 Apr. 2010 May 2010 Jul. 2010

CBS CBS CBS CBS

Jan. 2011 Dec. 2011 Mar. 2012 Jul. 2013 Sep. 2013

CBS CBS CBS CBS CBS

Help 18% 13 19 13 18

Hurt 30% 32 31 38 39

Not have much effect 47% 46 43 43 40

Repeal, Replace?
Q: Do you think Congress should try to repeal the new health care law, or should they let it stand? Repeal Let it stand 48% 43% 44 45 47 41 Repeal Let it stand 52% 39% 51 38 49 43

Jan. 2011 Apr. 2011 Nov. 2011

Quinnipiac Quinnipiac Quinnipiac

Feb. 2012 Apr. 2012 Jul. 2012

Quinnipiac Quinnipiac Quinnipiac

Q: What would you like to see Congress do when it comes to the health care law? They should expand the law. They should keep the law as is. They should repeal the law and replace it with a Republican-sponsored alternative. They should repeal the law and not replace it. (Kaiser) Keep Replace w/ Repeal & as is GOP alt not replace Unsure 19% 23% 20% 10% 20 19 20 10 21 18 21 10 19 15 20 14 21 19 19 10 20 19 19 12 20 16 21 10 19 16 21 12 18 15 24 11 Keep Replace w/ Repeal & as is GOP alt not replace Unsure 20% 16% 22% 11% 19 18 22 11 19 18 19 9 19 18 23 12 20 18 21 13 25 18 20 10 21 23 23 10 23 20 20 11 22 14 19 18 9|Page

Jan. 2011 Feb. 2011 Mar. 2011 Apr. 2011 May 2011 Jun. 2011 Jul. 2011 Sep. 2011 Nov. 2011

Expand 28% 30 30 33 30 31 33 33 32

Dec. 2011 Jan. 2012 Feb. 2012 Mar. 2012 May 2012 Jun. 2012 Jul. 2012 Aug. 2012 Nov. 2012

Expand 30% 31 35 28 27 28 24 26 27

Q: Which one of the following comes closest to what you would like to see lawmakers do with the new health care law? Would you like lawmakers to repeal the law entirely, repeal parts of the law, expand the law, or leave it as is? (Fox News) Leave Repeal as is Expand parts Oct. 2010 15% 20% 29% Dec. 2010 16 15 32 Jan. 2011 14 20 34 Apr. 2011 16 18 29 Mar. 2012 14 22 28 Note: Asked of registered voters. Repeal entirely 29% 27 27 31 31 Leave as as 22% 22 20 19 Repeal parts 28% 26 25 19 Repeal entirely 29% 28 30 39

Jul. 2012 Oct. 2012 Mar. 2013 Jun. 2013

Expand 18% 17 20 17

Q: What, if anything, do you think Congress should do with the health care law? (PSRA/Pew) Expand it 30% 35 Leave it as is 22% 20 Repeal it 40% 37 Expand it Leave it as is 31% 22% 33 20 Repeal it 38% 38

Nov. 2010 Jan. 2011

Oct. 2011 Mar. 2012

Q: And, would you favor or oppose repealing and eliminating this health care law? Strongly Not so strongly Not so strongly Strongly oppose favor repeal favor repeal oppose repeal oppose repeal Jan. 2011 NBC/WSJ 35% 10% 12% 34% Dec. 2011 NBC/WSJ 36 10 15 25 Apr. 2012 NBC/WSJ 40 9 12 30 Note: Question wording for January and December 2011 read . . . this new health care law . . .

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Q: What would you like to see Congress do when it comes to the 2010 health care law? Expand the health care law. Keep the entire health care law as it is. Repeal the part of the law that requires Americans to obtain health insurance if they don't have it, but keep the rest of the law intact. Repeal the entire health care law. Expand the law 17% 22 22 24 20 Keep entire Repeal law in place the mandate 15% 27% 15 26 21 19 18 19 16 18 Repeal the entire law 34% 30 29 33 39

Jul. 2012 Sep. 2012 Oct. 2012 Jan. 2013 Jul. 2013

CBS/NYT CBS/NYT CBS/NYT CBS/NYT CBS

Q: Which comes closer to your view? Now that the Supreme Court has ruled to uphold the health care law, opponents of law should stop their efforts to block the law and move on to other national problems or opponents of the law should continue trying to block the law from being implemented? (Kaiser) Jun. 2012 Jul. 2012 Stop their efforts to block the law and move on to other national problems 56% 58% Continue trying to block the law from being implemented 38 37

Defunding
Q: Some lawmakers who oppose the health care law say that if Congress isn't able to repeal the law, they should try to stop it from being put into place by cutting off funding to implement it. Whether or not you like the health care law, would you say you approve or disapprove of cutting off funding as a way to stop some or all of the law from being put into place? Approve 33% 34 30 30 33 Disapprove 62% 61 64 64 63 Approve 32% 35 31 36 37 Disapprove 58% 56 58 57 56 11 | P a g e

Jan. 2011 Feb. 2011 Mar. 2011 Apr. 2011 May 2011

Kaiser Kaiser Kaiser Kaiser Kaiser

May 2012 Jul. 2012 Apr. 2013 Aug. 2013 Sep. 2013

Kaiser Kaiser Kaiser Kaiser Kaiser

Views on the legislation/law Full question wordings Q: Overall, given what you know about them, would you say you support or oppose the proposed changes to the health care system being developed by Congress and the Obama administration? (ABC/Washington Post) Beginning in March 2010, ABC/WP question wording read Given what you know about them, would you say you support or oppose the changes to the health care system that have been enacted by Congress and the Obama administration? Beginning in March 2012, question wording read Overall, do you support or oppose the federal law making changes to the health care system?" Q: As of right now, do you generally favor or generally oppose the health care proposals being discussed in Congress? (Pew) Starting in April 2010, the question wording changed to ask Do you approve or disapprove of the health care legislation passed by Barack Obama and Congress last month? In September, August and July 2010 the question asked about legislation passed in March. In November, the question read earlier this year. In January 2011, the question asked about legislation passed last year. The March 2012 question asked people whether they approved or disapproved of the health care legislation passed in 2010. Q: From what you have read or heard, do you mostly approve or mostly disapprove of the proposed changes to the health care system under consideration in Congress? (CBS/NYT) In November 2009, question wording read mostly approve or mostly disapprove of the proposed changes to the health care system under consideration in Congress For March 2010, question asked about the current health care reform bill. After March 2010, question read: From what you've heard or read, do you approve or disapprove of the new health care reform bill? After March 2012, question referred to the health care law that was enacted in 2010 . . . Q: As you may know, the U.S. House of Representatives recently passed a bill that would make major changes in the countrys health care system. Based on what you have read or heard about that legislation, do you generally favor it or generally oppose it? (CNN/ORC) Question wording for January 2010 asked about the U.S. Senate and the U.S. House of Representatives recently passed bills. May 2010 question wording was Do you approve or disapprove of the passage of the health care bill which became law in April? Favor is equated with approve and oppose is equated with disapprove. The October, August, and March 2010 and June 2011 question read As you may know, a bill that makes major changes to the countrys health care system became law earlier this year. Based on what you have read or heard about that legislation, do you generally favor or generally oppose it? In 2012, question wording changed to As you may know, a bill that makes major changes to the country's health care system became law in 2010 . . . ? Q: Based on what you know about the health care reform legislation being considered right now, do you favor or oppose the plan? (Fox) Question wording for April 2010 read Based on what you know, do you favor or oppose the new health care law?. Question wording for April 2012 reads Do you favor or oppose the new national health care law that was passed by Congress and signed into law by President Obama in 2010. In May 2013, question wording was changed to As you may know, a bill that makes major changes to the country's health care system became law in 2010. Based on what you have read or heard about that legislation, do you generall y favor or generally oppose it? Q: In general, do you support, oppose or neither support nor oppose the health care reform plans being discussed in Congress? (AP-GfK/Roper) Question wording after April 2010 reads: In general, do you support, oppose or neither support nor oppose the health care reforms that were passed by Congress in March? Q: President Obama did sign a health reform bill into law last month given what you know about the new health reform law, do you have a generally favorable or generally unfavorable opinion of it? (Kaiser) Question wording after April 2010 reads As you may know, a new health reform bill was signed into law earlier this year. Given what you know about the new health reform law, do you 12 | P a g e

have a generally favorable or generally unfavorable opinion of it? Q: From what you have heard about Barack Obama's health care plan that was passed by Congress and signed into law by the President in 2010, do you think his plan is a good idea or a bad idea? If you do not have an opinion either way, please just say so. (NBC/WSJ) Question wording for May and June 2010 was "From what you have heard about Barack Obama's health care plan that was recently passed by Congress and signed into law by the President, do you think his plan is a good idea or a bad idea? If you do not have an opinion either way, please just say so." Question wording for March 2010 and earlier was "From what you have heard about Barack Obama's health care plan, do you think his plan is a good idea or a bad idea? If you do not have an opinion either way, please just say so." July 2012 question asked of registered voters. How is President Obama Handling Health Care? Full question wordings Q: Do you approve or disapprove of the way Barack Obama is handling health care policy? (Gallup, Pew, CNN/ORC) Q: Do you approve or disapprove of the way Obama is handling health care? (ABC/Washington Post) Q: Do you approve or disapprove of the way Barack Obama is handling health care? (Quinnipiac, CBS/New York Times) Q: Do you approve or disapprove of the job Barack Obama is doing on the following issues . . . healthcare? (Fox) Q: If you had to choose, do you lean more toward approving or disapproving of the way Barack Obama is handling health care?(AP/GfK-Roper) Q: Below are some issues facing the country. For each one, indicate whether you approve or disapprove of the way Barack Obama is handling that issue health care. (Economist/YouGov). The Economist/Yougov poll is an internet poll. The February 2010 poll was asked immediately after the congressional health care vote. Democrats and Republicans on Health Care Full question wordings Q: Who do you trust to do a better job of handling health care, the Democrats or the Republicans? (AP-GfK/Roper) Q: Overall, which party, the Democrats or the Republicans, do you trust to do a better job handling health care reform going forward? (Kaiser) Q: Which political party, the Democrats or the Republicans, do you trust to do a better job handling health care? (ABC/Washington Post) Q: Do you think the Republicans in Congress or the Democrats in Congress would do a better job of dealing with each of the following issues and problems . . .Health care?( CNN/ORC) Q: Regardless of how you usually vote, do you think the Republican Party or the Democratic Party is more likely to improve the health care system? (CBS/New York Times) Q: Which political partythe Democrats or the Republicansdo you think would do a better job on each of the following issues Health Care? (Fox) Q: Please tell me if you think the Republican Party or the Democratic Party could do a better job in each of the following areas . . . Which party could do a better job of dealing with health care? (Pew Research Center) Q: When it comes to dealing with health care which party do you think would do a better job the Democratic Party, the Republican Party, or both about the same?(NBC/Wall Street Journal) . Note: * Question wording Who do you trust more to handle major changes in the countrys health care systemthe Democrats in Congress or the Republicans in Congress? **Question wording Which party could do a better job of reforming the US health care system? Will you/the country be better off? Full question wordings February 2009 through March 2010, Kaiser Family Foundation wording was Do you think (you/the country) would be better off or worse off if the president and Congress passed health care reform, or dont you think it would make much difference? 13 | P a g e