On July 2, GEB International conducted a national survey of 800 randomly selected likely female voters, to determine attitudes towards the Affordable Care Act in the wake of the Supreme Court decision. The survey has a margin of error of plus or minus 3.5 percent at the 95 percent confidence interval.

45 percent of the survey respondents identified themselves as Democrats, 31 percent as Republicans, and 21 percent as Independents.

Highlights include:

  • Healthcare remains a significant issue in the November election. Fully 14 percent of the survey sample – one in seven voters – said healthcare would be “the single most important issue when deciding how you will vote for President in November;” responding to a separate question, 36 percent said the Affordable Care Act will be either the “most important issue” or “one of the most important issues” determining their November vote. In fact, health care was one of only three issues to break the 10-percent threshold, following “the economy” and “creating jobs.”
  • A significant majority still wants to repeal the Affordable Care Act either in whole or in part. When asked, “Thinking about the nation as a whole, do you think we are better off with the Affordable Care Act in place as it is, should we repeal parts of it, or should we repeal all of it and start over again?” 38 percent wanted to keep the ACA as is, and 56 percent want to repeal all or parts of it. Only 28 percent of Independents want to keep it as is; 63 percent want to see it repealed in whole or in part.
  • Two key drivers for those wanting repeal are the belief that requiring Americans to purchase a product they might otherwise choose to forego is “un-American,” and the understanding that the ACA puts bureaucrats between patients and their doctors. Fully 25 percent of Independents and 25 percent of those who were undecided on the ballot test listed the “un-American” nature of the Individual Mandate as their top reason to oppose the ACA; 23 percent of those who were undecided on the ballot and 20 percent of Independents listed putting bureaucrats between patients and their doctors as their top reason to oppose the ACA.
  • The Repeal Pledge maintains its significance as a key indicator for voters. When asked, “Given the Supreme Court’s recent decision, would you be more or less likely to vote for a candidate for public office who refused to sign a pledge vowing to repeal the Affordable Care Act, even though they say they favor repeal?” 18 percent said they would be more likely, against 41 percent who said they would be less likely. Further, the intensity is all on the side of the Repeal Pledge: Just 10 percent said they would be “much more likely,” against 29 percent who said they would be “much less likely.”

Nancy Pelosi’s famous declaration that we would have to pass the bill so we could find out what’s in it has proven to be a fiction – shockingly high percentages of the survey sample were not aware of the consequences of the Affordable Care Act more than two years after its enactment. We asked a series of “True/False” questions to determine what respondents understood about the consequences of the ACA. Highlights:

  • Only 35 percent knew that the ACA provision requiring insurance companies to offer health insurance to children up to age 26 as part of their parents’ coverage would increase premiums, even for people who didn’t add adult children.
  • Only 25 percent knew that this provision has already increased costs for the average family between $150 and $450.
  • Only 36 percent knew that this provision has already resulted in some employers dropping all types of dependent coverage to avoid these additional costs.
  • Only 21 percent knew that despite the promise that the ACA provision prohibiting insurance companies from denying health care coverage to people with pre-existing health conditions would lead to an enrollment of 700,000 in the program, only 56,000 people have enrolled.
  • Only 12 percent knew that the program requires that people with pre-existing conditions go six months without any insurance before becoming eligible.
  • Only 18 percent knew that spending on the program is more than double what was promised.
  • Only 22 percent knew that insurance companies are already abandoning child-only policies because they cannot afford to comply with the pre-existing condition provision.
  • Only 32 percent knew that even after the ACA is fully implemented, it would still leave 23 million people – almost half the total number of uninsured – without coverage.

Finally, we asked a question about the Individual Mandate. Highlights:

  • When asked, “One of the key features of the Affordable Care Act is what’s called ‘the Individual Mandate,’ which is a requirement that every individual purchase health insurance, or pay a penalty. Do you approve or disapprove of the Individual Mandate?” 38 percent approved, while 53 percent disapproved. Again, the intensity is on the side opposing the measure: While 24 percent said they “strongly approve” of the Individual Mandate, fully 43 percent said they “strongly disapprove.”

Conclusion:  The Affordable Care Act remains unpopular. The likely female voters in this survey say health care will be a key issue to them in the fall election, and the majority wants to see the Affordable Care Act repealed in whole or in part. The Repeal Pledge maintains its significance as key index for voters. Knowledge of the consequences of the ACA is shockingly low – and, as voter knowledge of its consequences increases, support for repeal increases even further.

They key driver for opposition to the Affordable Care Act, ironically, appears to be a small but growing understanding among the electorate of its cost to both the nation and to individual families. That is, a significant number of voters who support repeal believe the ACA is unaffordable. A second key driver of opposition to the ACA is the belief that forcing Americans to purchase a product they would otherwise choose to forego is simply “un-American.”

A communications program designed to inform likely voters of the most salient consequences of the ACA (read: the cost curve bends UP) would likely result in even greater support for its repeal – and in greater support for candidates pledging themselves to repealing it.