Analysis: Congressional Races Poised To Affect Future of Health Care
While the Affordable Care Act has been a less prominent issue during this year's midterm elections, the outcomes of the congressional races could have a major effect on health care policy, according to an analysis published in the New England Journal of Medicine, the Washington Post's "Wonkblog" reports (Millman, "Wonkblog," Washington Post, 10/29).
For the analysis, Robert Blendon and John Benson of the Harvard School of Public Health analyzed the results of 27 polls from 14 news outlets that were conducted been 2010 and 2014 (Wheaton, Politico, 10/29).
Government's Role in Health Care
Blendon and Benson found that there had been a major shift in the public's view of what the government's role in health care should be. They found that 47% of U.S. residents said they believe the government should ensure universal health care coverage, according to a Gallup poll, compared with 64% of U.S. residents in 2007, according to a Pew poll ("Wonkblog," Washington Post, 10/29).
Blendon said the health care debate currently is "about whether or not you believe you want to get everybody covered." He continued, "Something happened on the way to the forum here that made that a much more controversial value," adding "There have been backlashes [to legislation], but never like this" (Politico, 10/29).
In terms of why opposition to the law has increased, the researchers found that:
- 40% of U.S. residents in September 2014 said they had trust in the government's ability to address domestic issues such as health care, compared with 51% in 2012, according to Gallup, which the researchers suggested might be a reason for declining support for the ACA (Blendon/Benson, NEJM, 10/29); and
- Opponents of the ACA spent $418 million on 880,000 negative advertisements between when the law was enacted in 2010 and May 2014, more than 15 times the amount spent by supporters of the ACA, according to a Kantar Media study.
Blendon said, "The scale of the negative advertising [on the ACA] is of historic significance," as ad campaigns in the past occurred prior to major votes and later "just went away," while ACA-related advertisements have continued. He added that the ads' emphasis on the health law's alleged "side effects" on employment and the middle class could explain the decreased support for the government ensuring universal coverage.
View of ACA, Effect on Midterm Elections
Blendon and Benson also found that, according to a new HSPH–Social Science Research Solutions poll:
- 31% of all likely voters said they want the ACA to be repealed, while 23% said they want the health law to be scaled back (Politico, 10/29);
- 56% of Republican likely voters said they support repeal of the ACA, while 27% of GOP likely voters said they want the health law to be scaled back; and
- 44% of Democratic likely voters said they believe the ACA's scope should be expanded, while 30% said they believe the law should stay as is.
The analysis also found that, in terms of health care's effect on the midterm elections:
- Health care is the third-most important issue to voters in the midterm elections, according to ABC News-Washington Post and CBS News-New York Times polls, and likely voters cited the economy as the most important election issue to them three times as often as they cited health care;
- 40% of voters said they are less likely to vote for congressional candidates if they support the ACA, including 69% of Republicans, compared with 31% who are more likely to vote for candidates supporting the ACA, including 60% of Democrats, according to the HSPH-SSRS poll; and
- About 25% of likely voters said a candidate's stance on the ACA would not affect their vote, according to the HSPH-SSRS poll.
Effect on Health Care Policy
Blendon and Benson said that whichever party wins the Senate likely would see the election as a mandate from voters to push for their favored health care policies.
The researchers suggested that if Republicans win the Senate, they could make changes to the ACA's tax provisions and mandates, mainly via the budget process. In addition, they suggested that while the Senate GOP might seek to repeal the ACA, that proposal would be unlikely to pass.
If Democrats maintain control of the Senate, Blendon and Benson said they likely would attempt to expand funding for the law. Further, they said the resulting political environment could encourage more states to expand Medicaid and provide Democrats running for president in 2016 reason to more enthusiastically encourage expanded health care coverage ("Wonkblog," Washington Post, 10/29).
McConnell: ACA Won't Be Repealed During Next Two Years
In related news, Senate Minority Leader Mitch McConnell (R-Ky.) said that Republicans would not be able to repeal the ACA over the next two years, even if the GOP gains control of the Senate, CQ HealthBeat reports.
McConnell noted that Republicans would need 60 votes for repeal in the Senate or the ability to overcome a certain veto from President Obama.
However, McConnell said a repeal of the ACA was still his top priority, he said that a Republican-controlled Senate would work to "put the Senate Democrats in the position of voting on the most unpopular parts of this law and see if we can put it on the president's desk." Specifically, he cited the law's medical device tax and individual mandate as provisions the Senate GOP might target during the next Congress (Lesniewski, CQ HealthBeat, 10/29).This is part of the California Healthline Daily Edition, a summary of health policy coverage from major news organizations. Sign up for an email subscription.