MENLO PARK, Calif. – The requirement that nearly everyone obtain health insurance or pay a fine has long been Americans' least favorite part of the health reform law, and their views on what the Supreme Court should do about that key provision, known as the "individual mandate," mirror that sentiment, according to a new Kaiser Family Foundation poll, http://www.kff.org/kaiserpolls/8285.cfm.
The poll finds that half of all Americans (51%) think the Court should rule the mandate unconstitutional and about the same number (53%) expect the justices to do so. Those views about what the Court should do reflect public opinion about the Affordable Care Act (ACA) more generally. Those who favor the law say two-to-one (50% to 26%) that the Court should uphold the mandate, and those who oppose the law say twelve-to-one (83% to 7%) that it should strike the mandate down. Americans have not yet tuned in to the high court case, with more than six in ten saying they are not following it closely. And many are confused -- 42 percent either think the Court has overturned the law or do not know whether it has.
The public also does not see the mandate as the linchpin of the entire law. Sixty-two percent say other parts of the law still will be implemented if the Court rules the mandate unconstitutional, compared to 28 percent who say such a ruling will scuttle the whole effort. The poll also finds substantial public skepticism towards the Court; about as many people say the justices' ideological views will play a major role in their decision (51%) as say their analysis and interpretation of the law (54%) will play a major role.
These and other findings of the March Kaiser Health Tracking Poll come just weeks before the Court is set to hear oral arguments in the legal challenges to the health reform law, which turns two years old on March 23rd and over which public opinion has been chronically divided. At the two year mark the public is almost perfectly split: 41 percent of Americans hold a favorable view of the law this month, while 40 percent hold an unfavorable one – not terribly different from the 46 percent who favored it and 40 percent who did not in April 2010. Opinions divide sharply along partisan lines, with Republicans disliking the law (75% have an unfavorable view this month), Democrats favoring it (66% favorable) and independents more divided (40% favorable vs. 42% unfavorable).
"The public's views on the health reform law mirror the partisan and ideological divide in the country, and the public's views on the Supreme Court case do too," said Kaiser President and CEO Drew Altman. "People either like or do not like the ACA, but they have not weighed the legal issues before the Court," Altman added.
The public also does not think the Court case will have a big impact on them and their families. Just under three in ten (28%) say the decision will have "a lot of impact" on them and their family, and about a third (36%) say it will have "some impact."
So far, Americans are not focused on the legal challenges to health reform. Under ten percent (9%) say they are following it "very closely" and another 28 percent "fairly closely," while most report following it "not too closely" (38%) or "not at all" (25%). More than four in ten either think the law has already been overturned by the Supreme Court (14%) or are unsure (28%).
Sharply divided along partisan lines, generally skeptical of the Court and focusing little on the health reform case, apparently in the belief that it will not affect them, opponents and supporters of the law alike report that the Court's decision – whatever it is – is not likely to change their views of the ACA. Just 14 percent of supporters say they would feel more negatively about the law if the Court strikes down the individual mandate, for instance, and just 9 percent of opponents say they would feel more positively about the law if the justices uphold it.
"The public is not tuned in to the Supreme Court case yet," said Mollyann Brodie, Senior Vice President for Executive Operations who leads the Foundation's polling and survey research team. "When it grabs the headlines in a few weeks and again in June more people will focus on it, and there is an obvious need for public education about the issues and the stakes in this historic case."
In other findings, confusion about the law still abounds, with six in ten (59%) Americans saying they don't currently have enough information to understand how the law will impact them personally, almost identical to the 56 percent who said so shortly after passage in 2010. With many provisions not taking effect until 2014, two-thirds of the public say they do not feel they have been concretely affected by the law one way or the other thus far.
Finally, several misperceptions about the law endure: over half of Americans, including majorities of Republicans and independents, either believe the law allows a government panel to make decisions about end of life care for those on Medicare (36%) or are not sure whether it does (20%). Even more – seven in ten – are not aware that the ACA does not create "a new government run insurance plan to be offered along with private plans."
The full question wording, results, charts and a brief on the poll can be viewed online at http://www.kff.org/kaiserpolls/8285.cfm. Also available is a new "Pulling It Together" analysis from Drew Altman which draws on the poll findings to examine the role the health reform law plays as a political symbol, online at http://www.kff.org/pullingittogether/altman_aca_flouridation.cfm. A new interactive Kaiser chart allows users to track public opinion on the ACA, from the inception of the law to the present, for subgroups based on age, race, income, gender, party identification and insurance status. The interactive chart, available at http://www.kff.org/kaiserpolls/health-tracking-poll-interactive.cfm , can be embedded on websites and blogs.