Obama health reform law goes on trial amid deeply split public opinion

Whatever you call it – the Affordable Care Act, health-care reform, Obamacare – one aspect of President Obama’s signature health-care law is taken almost as if etched in stone: Americans “don’t like it, they think it’s unconstitutional, and they want it repealed,” as Senate minority leader Mitch McConnell put it in the GOP’s weekly television address last week.

As the US Supreme Court begins three days of argument over the 2010 health-care reform law, a close reading of several recent opinion polls shows that public sentiment may be more complex than that – and may complicate Republicans’ push to make health care a central part of their political agenda through November.

The crux of the matter? Americans see the individual mandate, the law’s requirement that almost every American buy health insurance or pay a penalty, as unconstitutional.

At the same time, the overall law – with popular measures like the ability to keep children on a parent’s health-insurance policy through age 26 – either divides public opinion or tilts slightly toward Democrats' positions.  

Americans have consistently shown a constitutional concern with the health-care law. Earlier in Senator McConnell’s weekly remarks, for example, he cited a February poll conducted by Gallup/USA Today in which 72 percent of respondents said they believed that the individual mandate is unconstitutional. A poll released Monday by The Hill newspaper found half of voters believe Mr. Obama’s health-care law should be overturned, versus 42 percent who say it should be upheld. A March 14 poll by Pew Research shows similar results – 41 percent “approve” of the individual mandate, while 56 percent “disapprove.”

Those same polls, however, show that overall public opinion about the law is more evenly divided.

In the Gallup/USA Today survey, a slight 47 percent to 44 percent edge goes to those who would favor repealing the entire health-care law under a Republican president come 2013. The Pew poll, moreover, shows a majority of voters say the law should be either expanded (33 percent) or left as is (20 percent), compared with 38 percent who say it should be repealed.

Similarly, The Hill’s poll shows a majority of voters (52 percent) say health-care quality will be about the same or better if the health-care law survives. Forty-two percent predict it will be worse.

Democratic voters are much more likely to support the health-care law than are Republicans. Independent voters, who are key to deciding the 2012 election, tend to be more sanguine than Republicans about the health-care reform law.

Independents are more likely to oppose repeal (47 percent) than favor it (43 percent), according to the Gallup survey. In the Pew report, a plurality of independents favor repeal (40 percent), but a combined 51 percent said Congress should expand the law (33 percent) or leave it as is (18 percent).

Finally, whom does the public trust to handle health care? Far and away, the answer is Democrats.

Pew’s poll shows the public says Democrats are better able to handle health care than are Republicans, by a 14 percentage point margin. They are also deemed better able to handle Medicare (13 percentage points) and abortion (16 percentage points).

What does that add up to for this election season? While both parties have vowed to make health care a top issue going into November, Democrats are expected to hammer Republicans over proposed changes to Medicare contained in the House Republican budget plan, because the Democrats have a significant polling edge on that issue.

“The Affordable Care Act shows that Democrats remain firmly committed to Medicare,” said Rep. Steny Hoyer (D) of Maryland, the House Democratic whip, in a statement. “This law strengthened Medicare by improving benefits, extending its solvency, and laying the foundation for reforms that will constrain costs and improve quality.”

On the other hand, Republicans may have to fight the perception that the fight over the health reform law is much ado about little. Seventy percent of Americans told Gallup that the law has not affected them at all.  

The margin of error in the Gallup/USA Today poll is plus or minus 4 percentage points. It is 3 points for the Hill  and the Pew polls (but greater when the Pew poll results are broken down by party affiliation).