Why Debate Over Obamacare May Never End: Viewpoint

By | August 7, 2014

At the end of last year, I wrote that the debate over Obamacare’s impact would be settled once its main provisions took effect. Republicans thought out-of-pocket health costs would rise and access to their doctors would decrease; Democrats didn’t. “One of two things will happen in 2014,” I predicted:

The first is that access to doctors will fall and the cost of care will go up for most Americans; Democrats will (gradually) realize they’ve been misled, and support for the law will collapse. The second possibility is that access to doctors and the cost of care won’t change for most Americans; Republicans will (gradually) realize they’ve been misled, and the case against Obamacare will disintegrate for the average voter.

It turns out there was a third option: Reality would be no match for people’s partisan predispositions, and Democrats and Republicans would continue to disagree — even about changes in their personal access to health care. That’s exactly what’s happened, according to a new survey from Bankrate.

In a telephone survey of 3,565 people conducted in mid-July, Bankrate asked people variations on the same question: How has their access to health care changed over the last year? Note, that’s not a predictive question (What will happen?) or a question of opinion (What should happen?). The pollsters just asked people what had happened to their own situation since Obamacare’s main provisions kicked in.

From their answers, Republicans and Democrats seem to be living in two different universes. When Bankrate asked how people’s health insurance situation had changed, 38 percent of Republicans said it had worsened, compared with just 15 percent of Democrats.

You could argue that defining your health-insurance situation is inherently subjective, so maybe it’s not surprising that different people would interpret the question differently. But the contrast was just as pronounced for a strictly objective measure: Have respondents’ health-care costs, including premiums, copayments and prescription drug costs, increased in the last year? Republicans were twice as likely as Democrats to say they had.

The biggest gap was in people’s opinions of whether Obamacare had helped or hurt their own health care. When asked whether their view of the law had gotten better or worse in the past year, strictly in terms of its effect on their own health care, 60 percent of Republicans said their view had worsened. That’s more than four times the share of Democrats who said the same.

What makes these responses so bizarre, obviously, is that Democrats and Republicans don’t have different types of health insurance, at least not to the degree implied here. Sure, people who qualify for Medicaid are more likely to identify as Democrats. But that doesn’t explain why almost two in three Republicans think their costs have gone up, but just one in three Democrats.

It also doesn’t explain why the majority of Republicans think the law is hurting their personal health care, while very few Democrats think the same way. We could debate whether U.S. health care is, on balance, better or worse than it was a year ago. But whatever the answer, the changes should be positive or negative to roughly the same degree for Democrats and Republicans alike.

Instead, these latest numbers from Bankrate suggest that people’s opinions of the law aren’t subject to experience. Whether you’re paying more money for health care or not, you’re going to think one way or the other based on whether you like Obamacare. Whether your insurance has gotten better or worse depends on your political views, not whatever changed (if anything) with your coverage.

There are two lessons here. First, the politicization of Obamacare has been mindbendingly thorough. Second, people’s opinions on the law might not improve once the warnings they’ve heard turn out to be bogus, because they’ll just refuse to notice.

That, in turn, means the argument over the law’s perceived effects won’t end, even after its actual effects are clear to anyone who’s looking. Getting tired of the debate over Obamacare’s impact? Too bad, because it may go on forever.

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