There’s a lot of noise about “what most Americans think” about the Affordable Care Act. But if democracy works, the law and President Obama’s legacy will rest on what Fred thinks. (More)
Who is Fred?
For new readers, Fred is our archetypal median voter. He is a statistical fiction: median age (37), family size (married to Mrs. Fred with one child, the Fredling), and household income ($50,000 per year). Fred also gives the median response on every poll, and by definition Fred votes with the winner in every election.
In short, Fred is data personified, a human face on the lives and opinions of typical swing voters. You’ll probably never meet anyone who is exactly like archetypal Fred, but you probably have friends, neighbors, coworkers, and family members who are a lot like Fred.
If democratic government worked perfectly, any major policy change would reflect Fred’s opinion on that issue, so long as that doesn’t violate the Constitution. (For example, even if Fred thought the U.S. should be governed as a Christian nation, the First Amendment forbids any state religion.) But of course democracy doesn’t always work perfectly. As Larry Bartels documented, elected leaders are much more likely to vote the opinions of wealthy constituents than those of lower income voters. His data show elected leaders vote with Fred about half the time.
Even so, grassroots progressive Democrats should know what Fred’s opinions are. If Fred agrees with a well-reasoned progressive policy idea, we should say so. And if Fred disagrees, we need to spend more time talking with Fred, to understand why he disagrees and to earn his support.
“The most unpopular law ever passed in the history of the country”
In 2010 I found that Senate Democrats followed their states’ Freds in supporting or opposing a public option in the Affordable Care Act. That suggests that, at least among Democrats, elected leaders are more likely to follow Fred on very high profile policy issues. So what does Fred think about the ACA?
Republicans take every chance they can get to cite polls that, they say, prove the ACA is “the most unpopular law ever passed in the history of the country.” Hyperbole aside, that Republican meme is simply wrong, according to Slate’s William Saletan:
Look at the polls. In a CBS News survey taken Oct. 1-2, a majority of Americans – 51 to 43 percent – disapproved of the Affordable Care Act. Only 43 percent, however, said the law went “too far in changing the U.S. health care system.” Thirty percent said the law was about right, and 20 percent said it didn’t go far enough. The plurality supported the law or an extension of it. In an NBC News/Wall Street Journal poll taken Oct. 7-9, 43 percent of respondents said the law was a bad idea. Only 38 percent called it a good idea. But 50 percent opposed “totally eliminating federal funding” for it, compared with 39 percent who favored cutting off funds.
Twenty-one percent of Americans in a Gallup poll conducted Oct. 12-13 said they’d like major changes to the law. Ninteen percent said they’d like minor changes. But only 29 percent said they’d like the law to be repealed entirely – less than the 32 percent who took that position three years ago, and not much more than the 24 percent who said they’d like to keep the law as it is. When Gallup pressed further, asking respondents whether the changes they had in mind would scale the law back or expand it, 40 percent of those who wanted changes (and who answered the question either way) said they preferred to expand the law.
A CNN/ORC survey taken Oct. 18-20 found that respondents opposed the law, 56 to 41 percent. But when pressed further, 12 percent – nearly a quarter of those who opposed the law – said it wasn’t liberal enough. Only 38 percent of the entire sample – less than the number who favored the law – said it was too liberal. In a CBS News poll taken Oct. 18–21, a majority disapproved of the law, 51 to 43 percent. But when pressed as to why, the numbers turned upside-down. The percentage who said the law went too far dropped to 43. Twenty-nine percent said the law was about right, and 22 percent – nearly all of them Democrats and independents – said it didn’t go far enough.
Now comes a second NBC/Journal poll, conducted Oct. 25–28. The numbers look grim: Forty-seven percent say Obamacare is a bad idea, up from 43 percent in early October. When they’re asked whether the law “is working well the way it is,” “needs minor modifications to improve it,” “needs a major overhaul,” or “should be totally eliminated,” only 6 percent say it’s working well as is. But among the remaining options, 38 percent of respondents say the law needs minor modifications, 28 percent say it needs a major overhaul, and only 24 percent say it should be completely eliminated.
What does Fred think?
Again, Fred is our archetypal median voter. Fred is with the majority in any two-option poll, but that doesn’t mean Fred is with the largest bloc in any multi-option poll. Instead, Fred will fall into the median bloc. If a poll says 32% of voters want A, 25% want B, and 43% want C – and if those options logically progress from A-to-B-to-C – then Fred is at the 50% point … in the Bs.
What does that mean on the ACA? According the polls Saletan cited:
- In the October 1-2 CBS News poll, Fred thinks the ACA is “about right.”
- In the October 7-9 NBC News/WSJ poll, Fred did not say the ACA was good or bad, and opposed defunding the law.
- In the October 12-23 Gallup poll, Fred is within the margin of error between leaving the law as it is and scaling it back.
- In the October 18-20 CNN/ORC poll, Fred is with the 41% minority who support the ACA, not the 38% who think it’s too liberal or the 12% who think it’s not liberal enough.
- In the October 25-28 NBC/WSJ poll, Fred is within the margin of error between thinking the law needs “a major overhaul” and thinking it needs only “minor modifications.”
Taking all of that together, the data say Fred wants to give the law a chance to work, and fix its problems. If those problems turn out to be minor, as President Obama and leading health policy analysts predict, Fred will want minor changes.
Fred probably won’t see any immediate impact himself …
— Justin Wolfers (@JustinWolfers) October 31, 2013
… but if the ACA helps Fred or someone he knows get better coverage at the same or less out-of-pocket cost – especially if he or they get premium rebates next year – the data suggest Fred will like the law a lot.
And that’s exactly why Republicans are working so hard to break it.