Health care legislation was, without a doubt, at the center of major losses in the 2010 and 2014 midterm elections for Obama’s party. The first midterm of Obama’s presidency saw Democrats lose a majority in the House. The second resulted in the loss of the party’s senatorial majority. (And that’s not even addressing the massive setbacks those two elections have inflicted on Democrats nationally and locally.)
Simply put: the public perception of the ACA has changed – drastically.
That first poll found that 46% of Americans had a favorable view of the law, while 40% viewed it unfavorably.
This popularity did not last long. By the mid-2010s, the law was consistently unpopular. In October 2011, 51% judged it unfavorably, against 34% who judged it favourably. In July 2014, the unfavorable number was 53% while the favorable number was only 37%.
For much of that time, Republicans ran on a platform that put the repeal and replacement of the ACA at its heart. The Republicans were never quite able to make that happen — and it was never clear what their replacement plan would have been anyway.
Then, little by little, something that seemed very strange started to happen: the ACA started to become more and more popular.
In February 2017, 48% of Americans had a favorable opinion of the law, compared to 42% who had an unfavorable opinion. The law only became more popular from there. In February 2018, 54% viewed the law favorably, while 42% viewed it unfavorably. In Kaiser’s latest ACA poll from March, 55% of those polled had a favorable view of the law, compared to 42% who viewed it unfavorably. (The last time more Americans viewed the law unfavorably than favorably in the Kaiser poll was in December 2016.)
What happened? Well, two things:
1. People got used to the law, which was the biggest overhaul of the healthcare system in decades. Popular features like ending discrimination based on pre-existing conditions won out.
2. Obama left office. What has become clear over the lifetime of the ACA polls is that it reflected Obama’s approval rating. Obamacare was so tied to the president in the minds of most Americans that how they thought of him largely determined their opinion of the law.
All of this means that what the ACA means to the average person today is vastly different from what it meant 12 years ago when Obama signed it into law. And why Obama, who saw the ACA cost him and his party House and Senate majorities, is coming to the White House on Tuesday for a (much delayed) victory lap.