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Healthcare reform is no poison pill

As the Supreme Court puts healthcare reform in the dock, I’ve seen at least a dozen commentators offer up some version of political apocalypse, calling the law “radioactive,” “poisonous” and “deadly.”

After all, a recent paper by five political scientists argues that by making members in conservative districts seem ideologically out of touch, the healthcare reform vote cost Democrats 25 House seats last cycle. Listening to the commentariat, you’d think it was a 20-80 issue, or maybe 30-70; that voters strongly and overwhelmingly oppose the law. In fact, they don’t.

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Now, most polls do show that voters oppose the law, but by rather skimpy margins, with some even reporting narrow support. The CNN/ORC poll found just 50 percent opposed to the law, with 43 percent in favor — a margin of opposition of just 7 points. The CBS/New York Times poll put the margin of opposition at a slightly larger 11 points. The ABC/Washington Post poll produced the same margin, but a bare 52 percent majority opposed “the federal law making changes to the healthcare system.” Indeed, not one public survey this year put opposition above 53 percent.

Strange as it might seem, given all the Sturm und Drang, some polls even suggest more Americans now favor than oppose the reform. Kaiser Family Foundation tracking in early March produced more favorable than unfavorable reactions to the law, albeit by the narrowest possible (1 point) margin. By an identical margin, Americans told Gallup that it was a “good thing” that “Congress passed a law that restructures the nation’s healthcare system.” A few days later, Pew found 2 percent more approving than disapproving of the “healthcare legislation passed by Barack Obama and Congress in 2010.”

Dig a bit deeper and the absence of overwhelming opposition is revealed more clearly. Kaiser found 23 percent who want the law repealed and not replaced. Another 18 percent want it repealed and replaced with a Republican alternative. A plurality reject repeal of any stripe.

Moreover, not all of those opponents are cut from the same conservative cloth. CNN/ORC found only 37 percent oppose the law because it is too liberal. Ten percent opposed it as insufficiently liberal, while 43 percent like it just the way it is.

There are 80-20 issues. Healthcare reform just isn’t one of them. Opinion is less explosive than unstable, varying depending on who is asking the question and how. Such instability is usually indicative not of “radioactive” issues, but of those unsettled in the public mind, and polling certainly uncovers plenty of contradictory views about reform.

The individual mandate is generally disliked, though Pew found Americans opposing it by a mere 1-point margin — with voters unable to comprehend that eliminating the mandate would render some of the bill’s most popular provisions unworkable. If people could wait until they got sick to buy insurance, and couldn’t be precluded because of preexisting conditions, the whole system would collapse.

At the same time, many elements of the law garner overwhelming support. Kaiser found 80 percent liked the tax credits for small businesses that offer insurance to employees; 71 percent like financial help for low-income Americans who don’t get insurance at work; 69 percent applaud eliminating copayments for many preventive services. CBS/New York Times data indicates 76 percent approve of requiring insurance companies to cover those with pre-existing conditions; 65 percent favor reducing prescription drug costs; and 56 percent approve
of allowing those under 26 to stay on their parents’ policy.

Americans do not reject healthcare reform en masse. They are cross-pressured — liking parts of the plan and disliking others — leading to uncertainty, instability and oscillation in public opinion.

Healthcare reform constitutes big, significant change and it is far from universally supported, but neither is it universally derided. The data-free “analysis” purports to find much more opposition than any poll reveals.

Mellman is president of The Mellman Group and has worked for Democratic candidates and causes since 1982. Current clients include the Majority Leader of the Senate and the Democratic Whip in the House.