Affordable Care Act, Obamacare, Polls — May 9, 2014 at 9:00 am

Good news hasn’t sold the public on Obamacare. Here’s why. And how to fix it.

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Don’t wait for facts or experience to change minds. Focus on values and make the other side defend

There has been lots of great Obamacare news over the last few weeks. But public opinion of the law hasn’t improved. The Wall Street Journal/NBC News poll has been tracking this issue since 2009, before the bill passed. Their most recent poll, conducted at the end of April, found 36% saying the law is a good idea, consistent with the range in the mid to high 30s that they have seen the whole time (link is PDF).

NBC News/Wall Street Journal Poll conducted by Hart Research Associates (D) and Public Opinion Strategies (R). April 23-27, 2014. N=1,000 adults nationwide. Margin of error ± 3.1."Now as you may know, Barack Obama's health care plan was passed by Congress and signed into law in 2010. From what you have heard about the new health care law, do you think it is a good idea or a bad idea? If you do not have an opinion either way, please just say so
NBC News/Wall Street Journal Poll conducted by Hart Research Associates (D) and Public Opinion Strategies (R). April 23-27, 2014. N=1,000 adults nationwide. Margin of error ± 3.1.
“Now as you may know, Barack Obama’s health care plan was passed by Congress and signed into law in 2010. From what you have heard about the new health care law, do you think it is a good idea or a bad idea? If you do not have an opinion either way, please just say so

Other pollsters, asking somewhat different questions, show higher or lower support for the law, but the same consistency over time. Why so little movement?

1. Obamacare was designed so that most Americans wouldn’t feel it.
For those who have employer-sponsored health insurance, or Medicare, Obamacare has not meant upheaval in your health care, only a handful of small improvements (no copays for preventive care, for example) that it would be easy not to notice. This was by design, of course, but it also means that polls asking about the personal impact of Obamacare find, unsurprisingly, that majorities say it has had no impact on them (58% in the most recent NBC/WSJ poll, for example).

2. Most people don’t pay close attention to policy news.
It’s hard to remember for those of us who are deeply engaged, but most people are not closely following the ups and downs of the cable news cycle or tracking the daily number of healthcare.gov signups. Nielson data, as reported by Pew, shows that local TV news remains the dominant source of news information for Americans, with 71% watching at least monthly. And of that 71%, most are not watching very long, an average of 12 minutes a day – enough to get traffic and weather, a little sports, and maybe a story or two. These folks’ views aren’t going to move up and down for every piece of news.

3. Facts don’t move opinions anyway.
Though it is wonderful to see the number of uninsured dropping, we shouldn’t expect the number of sign-ups to move the needle for the much larger number of those whose status hasn’t changed. As I have pointed out before, we resist facts that contradict our values. Earlier this week, Scott Clement and Aaron Blake in the Washington Post rightly pointed out that objections to Obamacare are based in concerns about too much government involvement (values) rather than facts (how many people are covered).

The conclusion Clement and Blake draw from this, however, is that opinions won’t move, and there I disagree. Change is possible. However, it will take aggressive communications focused on values, rather than emphasizing facts about budget savings or hoping that as more Americans experience Obamacare they will change their minds.

What would a values-focused effort look like? It should start with ideas like these:

It’s better for all of us to have a health care system where everyone is contributing and everyone can get the care they need.

If you are working, you should be able to get affordable health insurance.

One illness or injury should not leave your family in bankruptcy.

These ideas focus us on the “why” of Obamacare, the idea that health care should not be out of reach for ordinary people, a place of greater political strength than the details of implementation. Communications can go on to emphasize the ways Obamacare helps us meet these values: ensures that even those with pre-existing conditions can get care, makes affordable insurance available to people who don’t have it through their jobs, requires insurance companies to cover basic services such as mammograms, etc.

In addition, as I argued before, it is also important to take these messages and go on the offense, forcing Republicans to defend their efforts to take affordable health care away from people and go back to the days when a pre-existing condition meant you could not get care at all.

This is a more effective approach than bouncing back and forth arguing about numbers, in a conversation that most casual news consumers won’t follow (how many of the 8 million paid for their insurance?). It’s also more effective than waiting for Americans to see the benefits on their own through personal experience. Because so many people are not directly participating in Obamacare, without thoughtful communications there is a risk that people see Obamacare as something that benefits only other people, not themselves. Focusing on values and the ways Obamacare makes insurance better for everyone helps address that risk.

Fortunately, we are already seeing a move toward Democratic candidates running on Obamacare rather than away from it, as LOLGOP pointed out here. Hopefully we will see even more movement in this direction this summer. If Democrats decide their best hope in this election is running aggressively on Obamacare instead of away from it, we should finally start to see some shift in the polls.

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