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Problems Implementing Obamacare Could Spell Trouble for Democrats
Korin Davis, William A. Galston, Ph.D.,


This piece was originally published by the FixGov blog at Brookings Institution. 

Many public opinion polls have taken America’s temperature on Obamacare and its components, but few have asked whether government-guaranteed health insurance, as a principle, is a worthy government endeavor. A new survey by the Public Religion Research Institute does just that, and Democrats may find the results troubling.  Many Democratic-leaning groups outside the party’s core are ambivalent about government’s role. Perceptions about the implementation of the Affordable Care Act, which has not gone well so far, could therefore prove critical for the future of the law and for the Party’s electoral prospects in 2014 and beyond.

The survey offered respondents a scale, at the ends of which were opposing propositions: that government should guarantee health insurance for all citizens; or that individuals should take responsibility for getting insurance. Respondents were asked to locate their preference, from 1 to 7, on this scale.  One through 3 represent support—with diminishing intensity—for a government role; those selecting 5 through 7 endorse—with increasing intensity—the principle of personal responsibility; and  the center of the scale—4—represents undecided or don’t know.

The findings from these data are available in an interactive graphic, and we review the findings below.

At first blush, the survey’s findings are unsurprising. Government-guaranteed health insurance is supported by the Democratic Party’s core constituencies: 70 percent of liberals, 62 percent of Blacks, and 55 percent of the religiously unaffiliated feel at least somewhat strongly that government should guarantee health insurance for all citizens. Conversely, only 15 percent of Republicans, 21 percent of conservatives, and 20 percent of White Evangelicals agree with that proposition, while 70 percent of Republicans and 67 percent of conservatives feel the opposite—that individuals should be responsible for getting insurance. The intensity level, however, is noteworthy: 35 percent of Democrats and 39 percent of liberals were at the furthest end of the scale, while 37 percent of Republicans and 38 percent of conservatives were at the opposite pole.  The same is true of Black Protestants and White Evangelicals. Despite having similar views theologically, on this questions they are poles apart—40 percent of Black Protestants chose 1, whereas 34 percent of White Evangelicals selected 7.

Among other groups critical to sustainable Democratic majorities, there is weaker support for the idea of government-guaranteed health insurance. Only 41 percent of women and 35 percent of independents endorse this principle, while 34 percent of women and 29 percent of independents think individuals should be responsible for their own coverage. An additional 23 percent of women and 25 percent of independents do not feel strongly either way. Only about half of Hispanics and those with post-graduate degrees (49 percent) support the notion of government-guaranteed health insurance, though of the 49 percent of Hispanics who favor a government role, 30 percent felt very strongly this way.

Young people are undecided on the issue. They split almost evenly into thirds: 34 percent support a goverment role in guaranteeing health insurance; 32 percent favor individuals taking responsibility for their own coverage; and 31 percent fall directly in the middle, favoring neither proposition over the other.

Catholics, an important swing vote, especially in the Midwest, are often considered to be more communitarian than their Mainline Protestant peers. At first glance, this much-discussed “Catholic difference” appears to have tilted Catholics a bit more toward support of a government role in assuring health coverage: 40 percent of Catholics but just 33 percent of White Mainline Protestants support this principle. But that difference is wholly explained by Hispanics, who now make up a significant portion of the U.S. Catholic population. When Hispanics are excluded, White Catholics and White Mainline Protestants are almost identical on the question: 33 percent of each group is sympathetic to a government role in assuring health coverage, 49 percent of Catholics  and 44 percent of White Mainline Protestants favor individuals taking responsibility, and 16 percent and 20 percent, respectively, fall in the middle. For Hispanic Catholics, 47 percent support a government role, 27 percent favor individual responsibility, and 24 percent are undecided.

If the Obama Administration has yet to make the sale at the level of principle, it certainly hasn’t closed the deal at the level of practice. The PRRI survey found that a majority of Americans (54 percent) have an unfavorable opinion of Obamacare. While there is, unsurprisingly, a large partisan divide (89 percent of Republicans have an unfavorable opinion, while 76 percent of Democrats have a favorable one), the data uncover troubling signs for the Democratic coalition. When asked if they have a very or somewhat favorable or very or somewhat unfavorable opinion of the 2010 health reform bill, 56 percent of 18 to 29 year olds, 52 percent of women, 62 percent of independents, and 53 percent of moderates have a very or somewhat unfavorable opinion of the bill.  Strong minorities of Hispanics (42 percent) and post-graduates (41 percent) share this view.

For these potentially persuadable groups, the implementation of Obamacare will be critical. If people who have voted Democratic in recent elections but who are ambivalent about government-guaranteed health insurance watch the law’s roll-out continue to stumble, they are likely to listen more sympathetically to the calls of ‘I told you so’ from across the aisle.

An interactive graphic of these data is available here.

This series on the PRRI American Values Survey is part of an ongoing research collaboration between Brookings’ religion, policy and politics project and Public Religion Research Institute.