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Polls Indicate Deep Partisan Divide Over Affordable Care Act

Most Americans still don’t approve of the legislation

A comprehensive analysis of data from 27 public opinion polls conducted by 14 organizations, including a poll in September of those most likely to vote, shows an electorate polarized by political party when it comes to the Patient Protection and Affordable Care Act (PPACA).

Most Republican likely voters want the next Congress to repeal the law (56%), with an additional 27% favoring scaling it back. In contrast, most Democratic voters want the new Congress to move ahead with the law (74%), either by implementing the current law (30%) or expanding its scope (44%). Independent likely voters fall in between, with 34% favoring repealing the law, 27% scaling it back, 26% expanding it, and 8% implementing the current law.

“The intensity of partisan feeling about the [PP]ACA in this election could make the next phase of its implementation a very contentious issue in the next Congress,” said Dr. Robert Blendon, professor of health policy and political analysis at the Harvard School of Public Health. Blendon was co-author of the analysis, which appeared as an online special report on October 29 in the New England Journal of Medicine.

The polling results not only show health care as the third-ranked issue in this election, but also portray a number of other striking findings. Despite millions of Americans who were uninsured now receiving coverage under the PPACA, public approval of the act has not improved since it was enacted 4 years ago. Only a minority of Americans approve of either the PPACA or President Obama’s handling of health care policy.

In addition, the polling analysis shows that there has been a cultural shift among many Americans toward a key principle behind the PPACA. In 2007, during the presidential primaries, public support for the view that the federal government has the responsibility to make sure all Americans have health insurance coverage was at 64%. In 2014 this figure declined to 47%, and it is even lower among likely voters (41%). Of importance for the election outcome, support for the principle of universal coverage was 70% among Democratic likely voters and 12% among Republicans.

“The polling results point clearly to why the election outcome will matter for the [PP]ACA,” Blendon said. “Democrats, were they to be in the majority in Congress, would reflect the views of their party’s voters in favor of moving ahead with the implementation of the law, with a high priority on achieving universal coverage. With Republicans in the majority, they would see repealing or scaling back the [PP]ACA as reflecting the views of their core voters. In addition, they would likely place a lower priority than Democrats on achieving universal coverage in the upcoming congressional term.”

The analysis was part of a project supported by the Robert Wood Johnson Foundation called “The Public and America’s Health Agenda.”

Sources: Harvard School of Public Health; October 29, 2014; and NEJM; October 29, 2014.

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