Health care legislation was undoubtedly at the heart of the biggest losses in the 2010 and 2014 midterms for Obama’s party. The first half term of Obama’s presidency resulted in the Democrats losing the majority in the House. The second resulted in the loss of the party’s Senate majority. (And that’s not even about the massive setbacks those two elections dealt Democrats at the state and local levels.)
Bottom line: Public perception of the ACA has changed dramatically.
That first poll found that 46% of Americans had a favorable view of the law, while 40% viewed it unfavorably.
That popularity did not last long. In the mid-2010s, the law was consistently unpopular. In October 2011, 51% viewed it unfavourably, compared to 34% who viewed it favourably. By July 2014, the unfavorable number was at 53% while the favorable number was only 37%.
For much of this time, Republicans ran on a platform that put repeal and replacement of the ACA at the center. The Republicans were never able to make that happen, and it was never clear what their replacement plan would have been anyway.
Then, gradually, something that seemed very strange began to happen: the ACA became more and more popular.
As of 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. As of February 2018, 54% viewed the law favorably, while 42% viewed it unfavourably. In the latest Kaiser poll on the ACA from March, 55% of respondents 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 Kaiser polling was in December 2016.)
What happened? Well, two things:
1. People got used to the law, which meant the biggest reorganization of the health system in decades. Popular features such as an end to discrimination based on pre-existing conditions prevailed.
2. Obama left office. What became clear during the lifetime of the ACA polls is that it reflected Obama’s approval rating. Obamacare was so inseparable from the president in the minds of most Americans that no matter how they thought about it, it largely determined how they thought about the law.
All of which means that what the ACA means to the average person today is very 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 majorities in the House and Senate, is coming to the White House on Tuesday for a (long-overdue) victory lap.