June 6, 2013

A new NBC/WSJ poll has the Affordable Care Act at the low point in the general range of popularity, or actually unpopularity, that it’s occupied for a long time now: Only 37 percent in their survey say that the ACA is a good idea, while 49 percent say it’s a bad idea. NBC’s First Read thinks it’s because of asymmetric support — Republicans opinion leaders are massively and enthusiastically against it, Democrats tend to be measured or talk about other topics. Kevin Drum agrees, and advises Democrats to do something about it.

Is that really a good idea?

Certainly, it does Democratic opinion leaders no good to talk down Obamacare. But it’s not really clear what they would gain with a full-court press, even if it could lead to a more even split of public opinion.

In terms of policy-making, there’s really not much at stake in the variations of ACA’s popularity. Democrats are not going to abandon the law, at least not while Barack Obama is president. On the other side, no matter what the polls say, Republicans are extremely unlikely to give up their intense opposition and continuing demand for total repeal. Does anyone think that if the numbers on the law were reversed that Republicans would agree to allow technical fixes through the House, or to fully fund implementation, or to drop their opposition to Medicaid expansion? I didn’t think so.

What would make a difference is if the insurance exchanges became toxic. But a presidential, much less a partisan, campaign to make “Obamacare” popular isn’t going to affect that.

My guess: within months the exchanges will just seem to people who buy insurance through them (and remember, it’s a relatively small group at this point) as part of the normal way things are done. It’s easy to imagine people successfully buying insurance on an exchange and being satisfied with the experience but still railing against “Obamacare” and its “government takeover of health care” without realizing that they’re the very same thing.

What really matters for the future of the ACA is whether the exchanges roll out successfully and whether the various reforms and incentives for cost control really work. If so, the law will be secure. No matter what the polls currently say about “Obamacare.”

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