THE TREATMENT MARCH 8, 2010
It would be nice if members of Congress voting on health care reform thought more about what's good for the country rather than what's good for their re-election prospects. But let's not kid ourselves. Many Democrats are plainly spooked by the prospect of supporting a measure that, according to the polls, a majority of Americans don't support.
Some of us have been arguing that the polls are misleading. Among other things, most people don't seem to know what's in the bill. When pollsters have asked respondents whether they like particular provisions, like forcing insurers to take all customers regardless of medical condition or providing tax credits to small businesses, the response has been consistently positive.
But suppose people did learn about all of the good things reform would do. Would that really translate into more support for reform overall--and, no less important, more support for the legislators who voted for it?
There's no way to be certain. But a confidential poll, made available to TNR, should give nervous Democrats at least some reason to believe the answer is "yes."
The poll comes from Lake Research Partners and focuses on two of the population groups most skeptical of reform right now: Voters who identify as independent, rather than Democrat or Republican, and voters who are older than 50. Lake Research conducted the survey in January on behalf of an independent foundation, which chose not to make the results public. But a Democratic strategist passed along a PowerPoint summary of the findings late last week. Tresa Undem, vice president at Lake Research, has since confirmed the poll's results and explained the methodology behind it.
The pollsters began by asking respondents a straightforward question: Do you support health care reform? The answers were consistent with what published surveys have shown. Among the older voters, just 36 percent supported reform while 47 percent opposed it. Among the self-described independents, the response was even more negative: just 30 percent supported it while 51 percent opposed it.
Then the pollsters told the respondents about some of the features reform included--like guaranteeing insurance access for people between 55 and 64, prohibiting insurers from denying coverage to children because of pre-existing conditions, expanding home- and community-based services, ending lifetime caps on benefits, and providing tax credits to small business.
After explaining these features, the pollsters returned to the original question: Do you support health care reform? The numbers jumped dramatically, with older voters saying they approved of reform legislation by 47 to 37 percent:
Opinion among independent voters moved, too, with 44 supporting and 39 percent opposing it once they'd heard about the benefits:
Lake Research also asked respondents about whether they'd be more likely, or less likely, to re-elect a member of Congress who had supported health care reform. And, again, they asked the question twice--once before explaining what's in the bill and once after.
The results were similar, although less clear-cut. Among older voters, support for pro-reform members of Congress increased by 15 points once the voters heard about the plan's details. Among independents, the increase was 17 points. Even after hearing the results, the independents remained less likely to vote for such a representative, by a margin of 9 points. (Originally it was 26 points.) But the older voters were more likely to support such a representative by 1 point. Says Undem:
We rarely see such a large swing in a single poll. Respondents’ naturally want to stick with the opinion they stated at the outset of survey. This shift underscores the lack of knowledge about the facts of health care reform. Once people hear the facts, they become more positive, whether we’re talking support for health reform overall, or likelihood to re-elect.
(The finding about independents may help explain why the foundation didn't want to release the poll. Neither my strategist contact nor Lake Research would identify, or speak for, the foundation. But keep in mind these voters were responding at the very moment when their fury at the Cornhusker Kickback and legislative deal-making was at its peak; it's not hard to imagine how that number could improve still further with even a modest change in the political environment.)
There's one other intriguing result. Lake Research found that 21 percent of respondents remained undecided about a candidate even after hearing the bill's description. These people said either they "aren't sure" how they'd vote or that reform would "make no difference" in their vote.
But when Lake Research asked this subgroup of people if they thought "Democrats are doing the right thing by passing health reform now, even if Republicans are not on board," 35 percent said they agreed while 28 percent said they disagreed. When Lake Research asked if these people thought "Republicans are doing the right thing by trying to stop health care reform and repeal it," 21 percent said they agreed while 44 percent said they disagreed.
To be clear--you knew there was a "to be clear" coming, didn't you?--I'm generally leery of over-interpreting polls. And I'm certainly leery here. Public understanding of health care policy is fuzzy at best. Even in the context of a detailed survey, people may not understand exactly what they are saying. The whole point of this survey is to gauge how people will feel several months from now, which is extraordinarily difficult to do. And, of course, this poll gave respondents a pretty one-sided view of the bill. It happens to be a truthful description of the bill's features, while many of the attacks on the bill are disingenuous. But this presentation is one-sided all the same.
Still, these results do seem to tell us something--particularly since they are consistent both with surveys that have shown voters support the substance of reform as well as some more recent polling suggesting voters are starting look upon the reform enterprise, and its proponents, a bit more favorably. Besides, what a lot of us have been saying all along remains relevant: If reform legislation actually passes, voters will start to see for themselves how off-base Republican attacks have been. There will be no death panels, no destruction of Medicare, no long lines for services. There will be, instead, assistance for seniors buying drugs, insurance access for children regardless of pre-existing condition, first-dollar coverage of preventative services, and other benefits.
In short, this poll doesn't prove that voting for reform is a sure winner. No poll could. But it should call into question the assumption, so widely shared, that reform is a sure loser.