Understanding the Role of the ACA in the 2014 Elections

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1 Understanding the Role of the ACA in the 2014 Elections Robert J. Blendon, Sc.D. Professor of Health Policy and Political Analysis Harvard School of Public Health/ Kennedy School of Government October 7, 2014 Part of a collaborative project with the Robert Wood Johnson Foundation Key Issues of Discussion The geographic and demographic context of the 2014 election The political history of the ACA since enactment The important differences between voters views on the ACA and public opinion Outcome of the election: implications for health reform 1

2 14 Competitive States / Open Seats US Senate Races 2014 Real Clear Politics & Charlie Cook State Ratings for U.S. Senate Races (Alaska, Arkansas, Colorado, Georgia, Iowa, Kansas, Kentucky, Louisiana, Michigan, Montana, New Hampshire, North Carolina, South Dakota, West Virginia). Top 10 Liberal States in US 1. Vermont 2. Massachusetts 3. Delaware 4. New York 5. Hawaii Oregon 7. Maine 8. California 9. New Jersey 10. Washington Gallup Poll, January 31,

3 Public Approval of Health Care Law Averaged results from multiple polling organizations September 2014 (January 2009 September 2014) September 2014 State Variation in Public Support for the ACA (Obamacare) 2014 % supporting Massachusetts 1 California 2 56% 59% Colorado 3 North Carolina 4 New Hampshire 5 Kentucky 4 Louisiana 4 Arkansas 4 40% 38% 37% 35% 34% 29% 1 Boston Globe/HSPH Poll, June (registered voters) 2 Field Poll, July (registered voters) 3 Quinnipiac University Poll, July (registered voters) 4 New York Times/Kaiser Family Foundation Poll, April University of New Hampshire Poll, April

4 Registered Voters Support for the Affordable Care Act (Obamacare) % 71% 36% 11% Average of Pew Poll, Kaiser Family Foundation Poll, HSPH/SSRS Poll, September Top Issues in Vote for Congress 2014 Which one of the following issues will be most important in deciding your vote for Congress this November? The economy 38% Terrorism 17% Health care 16% Immigration 10% Federal budget deficit 8% International conflicts 6% CBS News/NY Times Poll, Registered Voters, September

5 The Likely Voter Dilemma in National Election Races Total population in a poll 100% Registered voters 73% 2012 Presidential Election Actual Voters 54% 2010 Congressional Election 2006 Congressional Election 38% 37% Federal Election Commission. Data drawn from Congressional Research Service reports, Election Data Services Inc., and State Election Offices. Effect of Support for Health Care Law on Vote for Candidate for Congress % saying if a candidate for Congress supports the health care law, would make respondent (likely voters): Less likely to support candidate 40% More likely to support candidate 31% Wouldn t make much difference / no opinion HSPH/SSRS Poll, September

6 Long Term Impact of Laws on Health Care (MA and Nation) Massachusetts Residents - MA Law 1 Make Better 44% Make Worse 21% US Residents - National Law 2 Make Better 37% Make Worse 46% 1 Boston Globe/HSPH Poll, June Pew Poll, September Impact of ACA on Country to Date, by Party Mostly Positive 33% 56% 28% 12% Mostly Negative 45% 22% 46% 73% Pew Poll, September

7 Health Care Law s Perceived Impact on Their Families Helped Them US Residents 14% Hurt Them Helped Them Hurt Them Helped Them Hurt Them Helped Them 10% 11% 2% 31% Hurt Them 46% Kaiser Family Foundation Poll, September Role of Federal Government in Ensuring Americans Have Healthcare Coverage Do you think it is the responsibility of the federal government to make sure all Americans have healthcare coverage, or is that not the responsibility of the federal government? Gallup Polls, ; Pew Poll, January-February

8 The Responsibility of Federal Government to Make Sure Americans Have Coverage % saying yes 47% 71% 44% 17% Liberals 77% Conservatives 10% Pew Poll, January-February Paid Advertising on the ACA Post-Enactment 2010 $445,000,000 94% $418,000,000 6% $27,000,000 Total Spent Favorable Messages Negative Messages Kantar Media Research, May

9 2013 Estimated Spending on Anti-ACA Political Advertising Negative Advertising on the ACA August 1 September 11, ,544 negative ads Kantar Media/CMAG, August 1 September 11,

10 What Should Congress do with the ACA in the Future? (likely voters) Part I Repeal the Law 4% 31% 34% 56% Scale Back the Law 23% 14% HSPH/SSRS Poll, September What Should Congress do with the ACA in the Future? (likely voters) Part II Keep the Law as is 14% 30% 8% 4% Expand the Law 44% 26% 9% HSPH/SSRS Poll, September

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