The Obama administration has tried to convince Americans that they will like the new health law once they understand its effects. According to a new poll, they understand the law pretty well—and they don't like what they see.
At the end of last month, we asked a sample of 1,000 adults about health reform. The big picture: A majority (55%) believe the new law will cause them to get lower-quality care, pay more in insurance premiums or taxes, or both. Consistent with other surveys, 42% favor repeal, 36% don't, and 22% aren't sure.
Our poll also asked about specific provisions. The mandate that individuals buy insurance or face a tax penalty generated the greatest opposition, with 55% opposed and only 25% in favor. Other aspects of the law received more mixed reviews. The provision requiring employers to offer their employees health insurance or pay a tax penalty had plurality support, with 47% in favor and 36% opposed.
On the surface, these findings might seem to support the administration's view. People are less negative about some of the specifics than they are about the package as a whole. But does this imply that those who understand the law like it better?
To investigate, we asked people about their perceptions of the link between reform, insurance premiums, and wages—in particular, "if employer insurance costs increase as a result of the health reform plan, do you think the take-home pay of employees will decrease or not?" Policy analysts on the left and the right agree that workers bear the costs of insurance through wage offsets; numerous empirical studies have found this to be true. We therefore used people's answer to this question as a proxy for their understanding of the effects of health reform.
Fully 49% answered the question correctly, saying that employee pay would decrease by approximately any additional amount that employers have to spend. Thirty-one percent believe employee pay would decrease but by less than the full amount; 19% believe the extra costs would have no effect on pay.
People who understand the economic consequences of health reform span the political spectrum. Although these respondents were somewhat more likely to identify themselves as Republicans than the overall population (37% versus 28%), fully 25% identified themselves as Democrats (versus 34% in the population), and 29% as independents (versus 28% in the population).
Despite their political views, the well-informed share a strong opposition to the new law. They advocate repeal 56/25; oppose the individual mandate 73/13; and oppose the employer mandate 52/36. Such numbers do not bode well for the administration's claims that to know reform is to like it.
We also asked about three other provisions in the law: the ban on charging more for insurance based on a person's health ("community rating"), the mandate that employers cover "children" up to age 26, and the ban on lifetime limits on benefits. We told people that these provisions would increase insurance costs by $700, $200, and $100 per year, respectively—approximately what health economists and actuaries have estimated as the added cost to an average employer-sponsored family insurance policy.
People who thought they could enjoy these benefits while someone else picked up the tab generally supported them. Those who believed that there is no "free lunch" opposed community rating (by 43% to 32%) and mandated coverage of children to age 26 (by 48% to 32%). However, they supported the new law's ban on lifetime limits on benefits by 43% to 33%. These responses are consistent with a poll we conducted in January 2009, published in Health Affairs, which found widespread political support for a more moderate package of reforms.
As the midterm elections approach, one can expect candidates opposed to the new health reform law to point out how its effects on health costs will translate into people's paychecks. Our poll suggests this message will resonate with voters of all stripes.
Mr. Brady is professor of political science at Stanford University and deputy director of the Hoover Institution. Mr. Kessler is professor of business and law at Stanford and a senior fellow at the Hoover Institution. Mr. Rivers is professor of political science at Stanford, senior fellow at the Hoover Institution, and president of YouGov Polimetrix.
http://online.wsj.com/article/SB10001424052748704361504575552490899677152.html
ObamaCare in Court
A Florida judge allows the major state lawsuit to proceed to trial.
Even the legal left now grudgingly concedes that the constitutional challenges to ObamaCare aren't frivolous, and an important decision in Florida yesterday shows why. Federal District Judge Roger Vinson refused to throw out the core challenge to the law made by 20 state Attorneys General and other plaintiffs, overruling the arguments by the Obama Justice Department.
The lawsuit's bedrock claim is that ObamaCare's individual mandate that people buy health insurance or else pay a penalty exceeds Congress's authority under the Commerce Clause, while Justice contended that this is nothing out of the ordinary. But as Judge Vinson writes in his 65-page ruling, "this is not even a close call. . . . The power that the individual mandate seeks to harness is simply without prior precedent."
Congress is attempting to regulate not interstate commerce but economic inactivity by requiring individuals to purchase a private product "based solely on citizenship and on being alive." Judge Vinson ruled that the plaintiffs "have at least stated a plausible claim that the line has been crossed" concerning the outermost bounds of federal power under the Constitution.
He also undertook some useful spadework into the legislative and political history of ObamaCare as to whether the individual mandate counts as a "penalty" or a "tax." Liberals are now arguing that the mandate is permissible under the broader taxing powers for the general welfare, despite vehemently denying this notion before the bill passed—including President Obama's claim on national TV that he "absolutely" rejected the argument that the penalty is a tax.
But Judge Vinson notes that legally there are "clear, important, and well-established differences between the two," and in a meticulous examination of the plain language of the bill itself he finds that it "contains no indication that Congress was exercising its taxing authority or that it meant for the penalty to be regarded as a tax." He pointedly notes that defenders of the law can't now take the "'Alice in Wonderland' tack" of claiming that Congress really meant something else.
The legal upshot is that Justice lawyers will have to defend the individual mandate under the Commerce Clause, and Judge Vinson's ruling seems to indicate that they will need better arguments than they've made so far. And rightly so, given the violence ObamaCare does to the government of limited and enumerated powers as envisioned in Article I. Oral arguments will be heard in December.
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