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Parsing the Polls on Health Reform

The last few polls on health care reform have been discouraging. Public support for the Affordable Care Act does not seem to be rising. If anything, it seems to be falling, as a quick glance at will confirm. 

The decline is relatively modest and you could plausibly explain it away as a reflection of views on other issues. (I.e., if people weren't so down on the economy, they wouldn't be so down on health care reform.) But you certainly can't argue that people are enthusiastic about reform these days, since the numbers were tepid even before the decline. In the latest CBS/New York Times poll, published on Wednesday, just 37 percent of respondents said they approved of the law, while 49 percent said they disapproved. 

Still, if you dig deeper into the same poll, you'll find that public sentiment on health care reform is more complicated than those figures suggest. While 40 percent of respondents said they supported repealing the Affordable Care Act, more than half changed their minds (leaving just 19 percent in favor of repeal) when pollsters mentioned that it'd mean letting insurance companies exclude people with pre-existing conditions.

This isn't hard to figure out. The actual substance of health care reform has always been popular. To varying degrees, Americans want to regulate insurers, to strengthen consumer protections, and to expand coverage. Some of these people (not all, obviously, but quite a few) now oppose the Affordable Care Act because opponents have lied to them about what's actually in it. 

One other thing: When pollsters asked respondents if they'd be more or less likely to vote for a member of Congress that supported reform, 28 percent said more likely, 28 percent less likely, and 41 percent said it'd make no difference. One poll question obviously can't capture the full political impact of health care reform, but that result suggests that it is not the electoral liability many critics predicted it would be.