Thirty-four percent of Republicans say they personally know someone who lost health-insurance coverage, lost their job or had their hours cut because of the Affordable Care Act, according to a poll released today by the Kaiser Family Foundation.
Ten percent of Democrats say they know someone who lost their job or had their hours cut. Fifteen percent say they know someone who lost their health insurance because of the health-care law.
On the less negative side, 46 percent of Democrats say they know someone who was able to get health insurance because of the Affordable Care Act. Only 19 percent of Republicans could say the same. The two parties proved bookends for Independents on all three measures.
In other words, Republicans are three times more likely to think that the new health-care law is doing bad things to those around them than Democrats are, and Democrats are two times more likely to see Obamacare doing good things around them. Even when Kaiser controlled for demographic factors, the partisan tilt remained. When 60 percent of Americans think that the health-care law hasn't affected them yet, these opinions received by respondents secondhand are playing a big role in shaping how Americans think of the new health-care law.
What does this mean for assessing the implementation of Obamacare? It's hard to say. As we've mentioned on the Fix before, the strong ideological bent of opinions on the Affordable Care Act make it hard to learn anything definitively from the polls except, "Yup, Republicans still hate Obamacare, and Democrats kinda like it." Questions about Obamacare policy will always be answered as questions about Obamacare politics (and with a name like Obamacare, it may be impossible to ever separate the policy from the politics).
With that caveat out of the way, it is very possible that many Republicans could be seeing different outcomes from Obamacare than Democrats that would lead them to dislike the law for reasons other than politics. The map of states that decided to expand Medicaid -- inviting the federal government in to pay for most of the growth for the next decade -- look very similar to a map of electoral college votes in the 2012 presidential election. Only eight states with a Republican legislature or executive decided to expand Medicaid.
Earlier this May, Washington Post reporter Jason Millman looked at the red-blue divide in how the Affordable Care Act was visible in hospital admissions.
The Hospital Corporation of America, which has facilities in 20 states, reported a big gap in Medicaid and uninsured admissions between expansion and non-expansion states. In the four states it operates where Medicaid expanded under the ACA, the company saw a 22.3 percent growth in Medicaid admissions, compared to a 1.3 percent decline in non-expansion states. The company also had a 29 percent decline in uninsured admissions in the expansion states, while non-expansion states experienced 5.9 percent growth in uninsured admissions, chief financial officer William Rutherford said.
States where the leadership was active in fighting insurance companies for lower premiums saw rates that were about 2.6 percent lower than in states that were disengaged with the health-care law's rollout, according to reporting by CNN Money. The uninsured rate is dropping faster in states that built their own exchanges and expanded Medicaid.
Some states that voted for Romney in 2012 expanded Medicaid and built their own (non-clunky) exchange. Kentucky is probably the biggest success story, with 10 percent of residents now signed up through health insurance through the Affordable Care Act. However, public opinion on the health-care law in Kentucky reinforces the futility of trying to understand Obamacare as a policy with polling at this point. The Washington Post's Greg Sargent talked to Democratic pollster Celinda Lake, who did polling on the health-care law in the state. Residents love Kynect -- the name of Kentucky's exchange -- but hate Obamacare. Foundation for a Healthy Kentucky did a poll in January, and 79 percent of residents said they favored the Medicaid expansion, while still saying they didn't like Obamacare.
There are partisan differences that could possibly be explained by partisan differences in how the Affordable Care Act has been deployed around the country -- but it doesn't seem like most respondents are connecting the "health-care law" they keep hearing about in the news to the changes happening in their state. States made a smart PR move in not naming state exchanges in a way that would connect them in any way with the Affordable Care Act, but it also means that Republicans and many Independents are doubtful to ever think nice thoughts about the federal law and how it affects those around them -- especially with politicians in both parties trying their hardest to separate the state-level health-care successes from the meaningless bogeyman that "Obamacare" seems to be becoming, leading Republicans to find it hurts those around them and Democrats to think it helps, without either side quite sure what it all means, and hoping their legislators can explain it -- or at least stop talking about the law so much.