Obama’s Health Reform Popularity Bind

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After hovering around split support since its passage, Obama’s health care overhaul has taken a sizable popularity hit this month according to new data form the excellent Kaiser Family Foundation, with just 34% of Americans now expressing a favorable opinion of the law. The drop appears to be primarily driven by Democrats, whose approval has decreased from 65% to 52% since September, and a 10-point increase, 18% to 28%, of Americans who feel the law won’t make much of a difference in their lives. Unchanged is the level of intensity that the law’s opponents feel — 6 in 10 Republicans express a very unfavorable view — and the relative sparse enthusiasm among its supporters, only 20% of which hold a very favorable impression of the ACA.

One possible explanation for the drop in support is a sense of stagnation when it comes to progress on the law. Many of its most popular elements, including parents’ ability to keep their offspring on their health insurance until 26 and a ban on denying children coverage because of pre-existing conditions, were front-loaded to be enacted as early as possible, giving the law an early sugar rush. The largest structural changes, including the health insurance mandate and the end of pre-existing conditions for all health insurance customers, are scheduled to kick in 2014, meaning that we’re currently in a bit of an ACA deadzone. With many Americans out of work and economic angst still running high, impatience for new care options would be understandable.

Individual elements of the ACA still poll well and it’s entirely possible that Obama’s hope that the law will become popular over time could bear out. But if the short-term trend continues, it could cause what would be Obama’s biggest victory on health care in 2012 to backfire in a major way. The Obama administration has made a high-risk play to get the Supreme Court to take up legal challenges to the ACA in the middle of next year’s election. Emboldened by a few key rulings from conservative judges at the district and appellate levels, the White House seems confident that the Roberts Court will uphold the individual mandate or defer a ruling until the measure goes into effect. But with Democrats becoming increasingly unenthused by the law and Republican opposition remaining highly charged, a SCOTUS victory might only serve to ignite the Republican base in November while Obama supporters yawn. If the law is struck down, it is now less likely to spark outrage among Democrats, which could have offered Obama a consolation prize of a boost at the polls. In short, if opinion on the ACA remains the same, Obama will likely face the worst of both worlds in 2012.