We don't always like the policies that help us. The stimulus, which is deeply unpopular even though it arguably saved the economy, is one example. And that's also true of Obamacare, even among the people who have benefited from the healthcare system's overhaul.
The Urban Institute just released a new analysis of a survey of 8,000 adults conducted in September, and, unsurprisingly, there's not a lot of love for the Affordable Care Act.
Forty-one percent of respondents had an unfavorable view of Obamacare, compared with 28 percent who had a favorable view, and 30 percent who had no opinion. Here's a breakdown of everyone who has an unfavorable view, by demographic:
Let's look at the findings one by one:
Americans most likely to have an unfavorable view of the ACA are in the middle- and higher- income groups, have private insurance, are in very good/excellent health, are white, and live in rural areas.
This gets at the idea that Obamacare is, in a way, redistributive—it's a transfer of wealth from the healthy to the unhealthy. If you're healthy, you might not have "needed" health insurance before, but you're now required to have it or pay a fine. And among those who already had insurance, 4.7 million people received letters saying that their private insurance had been cancelled in the wake of the law's implementation, mostly because the law puts new requirements on what health plans must cover.
But keep in mind that "healthy" and "unhealthy" are categories that hinge on fate. You can get hit by a bus even if you never touch potato chips and run marathons every year. So you can think of this as a transfer from the lucky to the unlucky, as Jonathan Cohn put it. Rich white people (a.k.a. historically lucky people) are not happy about this.
Those living in states that have adopted the Medicaid expansion or that have a state-based Marketplace were less likely to have an unfavorable opinion of the law than those living in other states.
Also logical: States that set up their own exchanges and adopted the Medicaid expansion are more likely to be Democratic and supportive of the law in general. And those states have been promoting the law more actively.
Okay, then there's this one. People who have benefited from at least one Obamacare provision are still more likely to view the law negatively:
Large proportions of uninsured adults, particularly whites and middle-income adults, were more likely to have an unfavorable than a favorable opinion of the law. In addition, the uninsured most likely to benefit from the ACA (e.g., lower- and middle-income adults, including nonwhites and Hispanics) expressed only weak support for it and were more likely to have no opinion than to have a favorable view ... Those most likely to have no opinion are the groups most likely to benefit from the law—those in fair/poor health, those with lower incomes, the uninsured, nonwhites and Hispanics, high school graduates (or less), and the young.
To the Obama administration, this statistic must be like what it feels like to scrape your pennies together to buy your kid a bicycle, only to find that he wants to play with the box instead. The very people this law was designed to help are "meh" about it. Obamacare was for the uninsured people! Specifically for low-income uninsured people who now qualify for subsidies on the individual market and can't be denied coverage.
People seem to either be unaware that they benefit from Obamacare, or they are aware that it helps them, but they're ambivalent about it nonetheless. The Urban Institute suggests that, "public education and outreach efforts are falling well short of reaching and informing the ACA target populations who stand to benefit from the coverage provisions."
Obama officially embraced the term Obamacare in March 2012. But judging by these numbers, perhaps it's time for another rebranding. Here are some suggestions that would all have higher approval ratings, any of which I am happy to license for a small fee:
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