November 1, 2013
President Obama (Reuters /Brian Snyder)
President Obama (Reuters /Brian Snyder)

With Democrats continuing to grow more skittish about Obamacare’s awful rollout problems, the Kaiser Family Foundation is out with some important new polling that deserves a careful look from Dem Congressional officials — and political commentators.

The most important finding in the Kaiser poll — which is in some ways the gold standard of health care polling — is that significantly more Americans want the Affordable Care Act kept or expanded than want it repealed and replaced with a GOP alternative or with nothing at all. Here’s the key finding:

What would you like to see Congress do when it comes to the health care law?

Expand the law: 22

Keep the law as is: 25

Repeal the law and replace it with a Republican-sponsored alternative 13

Repeal the law and not replace it: 24

A total of 47 percent wants to keep or expand the law, versus 37 percent who want to replace it with a GOP health reform plan or scrap it completely. This poll was taken October 17-23, more than two weeks after the problem-plagued rollout began (though in fairness, before the “you can keep your plan” furor blew up).

How is it possible that more Americans want to stick with the law, when it’s obviously (as Republicans and some commentators say) such an epic disaster, both in policy and political terms alike?

The answer lies in the way the question was asked, and this has important larger implications. Kaiser’s line of questioning may be the best out there at shining light on what people really mean when they say they either support or oppose the law (a plurality of 44 percent view it unfavorably), and what they really mean when they say they want to get rid of it. If anything, the question is generous to Republicans, because it offers respondents the choice of an unspecified generic Republican alternative. Ultimately, what this finding suggests is that, whatever their dissatisfaction with Obamacare, people do not want to return to the previous system, and perhaps more crucially, do not believe Republicans are offering a serious alternative. Indeed, only 13 percent favor repeal and replace, GOP style.

This is a useful depiction of the current political and policy situation. It’s true Republicans have offered alternatives to Obamacare. But there is no Republican consensus position on health care reform. Republicans probably can’t pass their ideas through the House and certainly can’t pass anything that would ever become law. Among GOP voters, the Kaiser poll shows a split: Only 29 percent of Republicans want repeal and replace, versus 42 percent of Republicans who want to scrap the law and replace it with nothing.

In other words, the de facto GOP position is to go back to the old system. Rather than do that, more Americans want to stick with Obamacare. (Yes, this is one poll. But this pattern — more prefer “keep and change” or “keep and fix” versus doing away with it entirely — goes back years in fine-grained polling.)

Could this change, if the “sticker shock” and “you can keep your plan” controversies take hold, as Republicans hope? Sure. And if the law’s problems continue into the new year, this could imperil the law’s long term prospects and turn into a full blown political debacle for Dems. But right now, the basic nature of the big choice voters face on health care reform remains clear. For the time being, it continues — improbably, perhaps, given the current political furor — to favor Obamacare.

* THE BIG CHOICE ON OBAMACARE: Jonathan Chait goes deep into the basic tradeoff that the law’s overhaul of the health care market requires, explaining why “letting people keep their insurance” would undermine that tradeoff. This:

People accept this transfer from the healthy to the sick because it is the only way to make medical care affordable to the sick…If you believe the healthy are entitled to keep the financial benefits of their good health, then you must also believe the sick must be denied medical care. Should that principle be the foundation of our health-care system?

As Chait suggests, this is the moral choice the law asks folks to make. The above polling suggests it’s possible people are prepared to make this trade. Republicans will argue that once more people clearly understand the true nature of this choice, they’ll want to get rid of it. Related to this is the question of how many people will pay more, and how many will benefit. We’ll just have to wait and see.

* DEMOCRATS NERVOUS ABOUT OBAMACARE PROBLEMS: The New York Times leads with a big story reporting on anxiety among Democrats, particularly those up for reelection in 2014, about the problems plaguing the Obamacare website. Their worry:

The politics of the rollout are coming into clearer focus by the day. Democrats emerged from the government shutdown Oct. 16 sure that they would be the political beneficiaries of a Republican brand that took a beating from voters tired of the brinkmanship. But the problems with the website are sending Democratic reputations plunging along with those of their adversaries.

The fact that Dems are proposing various delays is a political problem for the White House, but all that really matters in the long run is whether the website get working again. This maneuvering among Dems is unlikely to force a delay in the law. Failure to fix the website will.

* EMERGING BELTWAY NARRATIVE ON OBAMA’S COMPETENCE: Charlie Cook says the Obamacare rollout problems and NSA spying revelations are putting Obama at real risk:

What makes these problems more troublesome than some other controversies is that they go to the question of Obama’s competence, rather than to differences of policy or ideology. On policy disputes, one side may like a decision and the other may dislike it, often resulting in a political wash. However, competence issues cut across the partisan and ideological spectrum, and they can have a real impact on independents and moderates…While it is certainly understandable that no president is clued in on all of the sources and methods of various intelligence agencies, the fervor surrounding the surveillance issue has risen to the point of comedic fodder.

It’s still possible the law could fail long term and turn into an extended political debacle for Dems. But as noted here yesterday, this could cut both ways: If the law works, those independents and moderates could continue to see the GOP as an intransigent obstacle to constructive governing.

 * THE MASSACHUSETTS HEALTH CARE PRECEDENT TO OBAMACARE: Glenn Kessler has a deep, deep dive into the question of whether slow early enrollment in Romneycare is relevant to the current situation, where enrollment is also likely to be slugginsh at the outset. If you want all the facts, this is a good place to start.

Clearly there is some real relevance to the current situation, and clearly, it’s very possible most enrollment in Obamacare will occur very late in the process. But unfortunately, any such historical context is likely to be overlooked if early enrollment figures are low, and the coverage will continue to be brutal.

* MORE ON THE TEA PARTY/BUSINESS RIFT:  Keep an eye on this special primary runoff election in Alabama, where business is sinking big money into a battle between the business establishment’s candidate and a Tea Party opponent. A similar rift is already on display in the Georgia Republican Senate primary. I’m skeptical that the business community’s alliance with the GOP will be seriously compromised, even if the party remains in the grip of Tea Party elements. But many on both sides of this battle seem to see it an indicator of the future direction of the GOP, so it bears watching.

* ANOTHER ‘NUCLEAR’ STANDOFF LOOMS IN SENATE: With Republicans blocking two more nominees — Mel Watt to the Federal Housing Finance Agency and Patricia Millett to the D.C. Circuit Court of Appeals — Senate liberals are again pressing the Democratic leadership to revisit rules reform. Remember, in the resolution of the last nuclear crisis, Dems reserved the right to revisit the rules if GOP obstructionism continued.

Also, it bears repeating: Senate liberals are not calling for a complete elimination of the filibuster on everything, including legislation. They are calling for doing away with it on executive nominations, i.e, the President’s picks to run the government.

* THE GOP ‘WAR ON THE POOR’: Paul Krugman’s column today argues that a primary motivator of GOP policy positions today, particularly on Obamacare, is the base’s panic about a nation of takers allying with the Democratic Party to transform the country. Key nugget:

All of this hostility to the poor has culminated in the truly astonishing refusal of many states to participate in the Medicaid expansion. Bear in mind that the federal government would pay for this expansion, and that the money thus spent would benefit hospitals and the local economy as well as the direct recipients. But a majority of Republican-controlled state governments are, it turns out, willing to pay a large economic and fiscal price in order to ensure that aid doesn’t reach the poor.

In this telling, opting out of the Medicaid expansion isn’t about fiscal responsibility or any other serious policy rationale; it’s about who would benefit from the expansion.

* THE NEXT GOP ATTACK ON OBAMACARE: Related to the above: Sarah Kliff reports that thus far the vast majority of enrollees to Obamacare are those who are taking advantage of the Medicaid expansion. Note this:

The yawning gap between public and private enrollment is handing Republicans yet another line of criticism against President Obama’s health overhaul — that the law is primarily becoming an expansion of a costly entitlement program.

Expect a lot more of this. The GOP base just laps up this kind of stuff, but does the middle of the country see it in these terms?

* AND HAS THE LEAKER OF ROMNEY’S TAX INFO BEEN OUTED? The new book on Campaign 2012 by John Heilemann and Mark Halperin is out, and it reports that Jon Huntsman Sr. was the secret source for Harry Reid’s claim that Mitt Romney didn’t pay income taxes for 10 years. At the time, Huntsman insisted to me that he was not the leaker. I asked him repeatedly, and he repeatedly denied it.

What else?

Greg Sargent writes The Plum Line blog, a reported opinion blog with a liberal slant -- what you might call “opinionated reporting” from the left.