Is that Obamacare or the Affordable Care Act? Photographer: Andrew Harrer/Bloomberg
Is that Obamacare or the Affordable Care Act? Photographer: Andrew Harrer/Bloomberg

I hope you won't mind if I point out that this month’s Kaiser health-care survey confirms pretty much what I’ve been saying would happen?

  • Obamacare remains unpopular: Or at least, it polls badly. Kaiser has disapproval spiking to 53 percent in July, up 8 points from June. I’d be shocked if the increase is anything but noise: there hasn’t been enough about health care in the news to suggest any kind of serious change in people’s views. But it’s also clear that those who believed that implementation would make the Affordable Care Act popular were dead wrong. And there’s no reason to expect it to be popular in the foreseeable future.
  • Obamacare also remains politically safe: Along with the pluralities (or, last month, a majority) of people who are unhappy with the ACA, there continue to be solid majorities of people who want it improved, not repealed. As Greg Sargent is fond of noting, only Republicans -- indeed, only conservative Republicans -- are for repeal. Everyone else says they would prefer keeping and improving the law. That’s only the beginning of it. For one thing, a flat-out repeal is impossible at this point, given how much has changed since the spring of 2010. The oft-repeated, but never delivered, “replace” part of the Republicans' repeal-and-replace promise -- which is still the party's official position -- would be absolutely necessary, and is no closer to reality. Bashing is easy; building a replacement system is hard. And the polling also understates the other political problem with repeal, which is that more than 10 million people would be bounced from their current health insurance. That creates a group of intense opposition to repeal, which matters a lot to politicians.
    By the way, Conn Carroll points out that a new "Conservative Policy Agenda" from Heritage Action doesn’t use the word “repeal.” Meanwhile, the new House majority leader, Representative Kevin McCarthy of California, published a Washington Post op-ed that contains his agenda, which almost completely ignores health care. The attack ads aren’t going away, but repeal is dead.
  • We’ve hit or passed peak Obamacare awareness: The Kaiser poll shows, again, that people have no idea what “Obamacare” is really about. This time, we get plenty of respondents who incorrectly believe that Obamacare exchanges offered “a single government plan” rather than choices from private insurance.1 *
    The main reason I expect the ACA to remain unpopular is that no one has “Obamacare.” The millions of people in expanded Medicaid have, well, Medicaid; the millions of people in the exchanges have insurance through private insurance companies, and many of them received it through a portal that said “Kynect” or “Covered California” or another state-based name. Even those who went through Healthcare.gov didn’t see the words “Affordable Care Act,” much less “Obamacare.” With time, fewer and fewer people are going to identify any of these programs with the health care reform enacted in 2010 and implemented over the last few years.
  • Obamacare won’t matter much in 2014 elections: There is nothing definitive in this poll, though, generally, respondents don’t seem to believe that politicians should be spending their time on health care and consider issues such as the economy and immigration more pressing. It’s very difficult to make the case that ACA implementation has been driving President Barack Obama’s approval ratings. There’s no health care news to account for his long slump in the first half of 2013 or his recent (probable) slump this summer. It’s more likely that it's the other way around: If people don’t like Obama, they are more likely to say they don’t like Obamacare. That means the president, and not his health care plan, will be driving the vote this fall.

1 It’s not a great question, unfortunately, since many of those who “got new health insurance under the health care law” did so via Medicaid expansion, and therefore received government insurance. So it’s not clear whether people answered the question incorrectly or were just thinking about a different part of the law. Nonetheless, other polls show that people still have no idea what health-care reform actually was.

To contact the writer of this article: Jonathan Bernstein at Jbernstein62@bloomberg.net.

To contact the editor responsible for this article: Max Berley at mberley@bloomberg.net.