What Healthcare Poll Results Really Show

The Providence Journal’s headline: “Public split on health-care law.” The source, McClatchy Newspapers, states the implication more boldly: “New poll undercuts GOP claims of a midterm mandate.”

A majority of Americans want the Congress to keep the new health care law or actually expand it, despite Republican claims that they have a mandate from the people to kill it, according to a new McClatchy-Marist poll.
The post-election survey showed that 51 percent of registered voters want to keep the law or change it to do more, while 44 percent want to change it to do less or repeal it altogether. …
On the side favoring it, 16 percent of registered voters want to let it stand as is.
Another 35 percent want to change it to do more.

On their face, though, the available answers to the question of “what Congress should do with the 2010 Health Care Law” are confusing. The first evidence that this is a factor comes later in the article:

Independents, who swung to the Republicans in the Nov. 2 elections, are evenly divided on how to handle the health care law, with 36 percent for repealing it and 12 percent for restraining it — a total of 48 percent negative — while 34 percent want to expand it and 14 percent want to leave it as is — also totaling 48 percent.

McClatchy’s summary of these results isn’t anywhere near plausible. According to the analysis, folks who responded to Obama and the Democrats by switching to Republicans are more likely than the average to “favor” the healthcare law, as defined as “wanting to change it to do more.” Looking at the raw data (PDF), more Tea Party supporters want to “change it so it does more” than “change it so it does less.” The question is clearly ambiguous. What if I want healthcare laws to allow more high-deductible plans with health savings accounts? Or to enable individual purchase of health insurance across state lines? Or to reform tort law? On the scoreboard, those policies are on the opposite end of the spectrum from ObamaCare, yet some poll respondents almost certainly were thinking of such things when they said they want the law to “do more.”
To bolster its analysis, McClatchy considered responses to individual components of the law. Respondents liked the facts that it “stops insurance companies from denying coverage because of pre-existing conditions” (59% to 36%), “allows children up to age 26 to stay on their parents’ health insurance policies” (68% to 29%), and “closes the so-called donut hole in Medicare prescription drug coverage by providing assistance to pay for costs” (57% to 32%). But respondents flip their opinions on the signature aspect of the law that defines ObamaCare. Only 29% think “Americans should be required to buy health insurance,” while 65% believe “it is unconstitutional to require it.” (Note that the poll is sloppy even at this level of detail: Why must the choices be support for the insurance mandate or unconstitutionality? Surely it’s possible to think it’s constitutional but still oppose it.)
Clearly a case can be made that:

  1. A more choice-driven health insurance regime would enable Americans to choose policies that suit them (e.g., covering adult children).
  2. Less-expensive high-deductible and catastrophic coverage plans with health savings accounts would be more broadly affordable and, therefore, translate into fewer Americans caught with “pre-existing” conditions, because they wouldn’t be without insurance for periods of time or lose it when they switch employers.
  3. All of the benefits that Americans wish to derive from healthcare law can (perhaps must) be sought only after all of the obscure and detrimental aspects of ObamaCare have been stricken wholesale from the legal code.
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