Support for Government Provision of Health Care and the Patient Protection and Affordable Care Act

Abstract

Since the 1930s, US politicians have argued about whether healthcare should be the responsibility of the federal government. Both major political parties have cited public opinion concerning Americans’ support for or rejection of government provision of healthcare to support their position. With the passage of the Patient Protection and Affordable Care Act (ACA) in 2010, however, the political debate has changed. Where it had been about the government provision of healthcare as an abstract principle, it became a debate imbued with evaluations of the implementation of the ACA itself. This spawned a new line of research examining the consequences of the ACA’s implementation on public attitudes toward government provision of healthcare. The change in support for government provision of healthcare and the new post-ACA research highlight a need for a long-term examination of trends in support over the past two decades that will provide context for the new studies. This study provides that examination.

It is time for a reinvestigation of the trends in Americans’ views on government involvement in healthcare. In previous articles on this topic, Jacobs, Shapiro, and Schulman (1995) examined public opinion spanning the 1980s through 1993. Shaw and Mysiewicz (2004) discussed the National Election Studies (NES) measure of support for national health insurance between 1994 and 2000. Shapiro and Arrow (2009) compared measures of support for government provision of healthcare in 1994 and 2008, finding no major changes. These works predate the significant potential for changes generated by the debate, passage, and implementation of the Patient Protection and Affordable Care Act (ACA) of 2010.

Since 2000, a great deal has changed in healthcare politics and policy. The Medicare Modernization Act (MMA) of 2003 and the ACA of 2010 expanded the provision of government healthcare services, setting new baselines against which increased provision of healthcare is measured. The 2008 economic recession is generally thought to have curtailed support for additional expansion of federal services (Kenworthy and Owens 2012). However, in bad economic times, the proportion of Americans needing government assistance with healthcare increases (Jacobs and Mettler 2011a). The 2013–2014 launch of several gradually phased ACA provisions, notably the www.healthcare.gov website, was deeply troubled, perhaps reducing public trust or expectations that the federal government is the best entity to organize health services and financing.

This review of polls addresses two questions and sets the table for a third. First, are Americans now more or less supportive of government provision of healthcare than they were prior to the healthcare debate of 2008 to 2010? Second, did the ACA’s enactment lead to a reduction in public support for expanding government provision of healthcare services? Third, has the ACA shaken off the negative valence associated with its difficult 2013 launch?

Theories of Support for Government Provision of Healthcare

Numerous theories exist on how public opinion develops longitudinally. Elite signaling theories (e.g., Zaller 1992; Jacobs and Shapiro 2000) indicate that elites frame issues and cue publics for support. Druckman and Jacobs (2014) suggest that presidents often can shift public opinion more than other elite actors. Others take a more measured view of the influence of elites on public opinion. In this view, policy impacts and an active mass public can override elite framing effects, particularly when the issue is an “easy issue” that is well covered and has been debated for years (Carmines and Stimson 1980). Since healthcare is an “easy issue,” theories that allow for the public to have dynamic opinions heavily based on prior opinions and policy impacts appear to be the most suitable for explaining trends in support for government provision of healthcare. For example, Chard (2004) sees public opinion on healthcare as a path-dependent function of policy, prior opinion, and elite/media persuasion. This article considers two such models when attempting to describing poll trends: structural framing and thermostatic.

The structural framing model is a healthcare policy-specific model featuring framing theory. A more general line of support for government spending and intervention is the thermostatic model. The structural framing approach combines situational framing with policy structures. The partisan debate over the ACA is supposed to have shaped most Americans’ views of government provision of healthcare. The competing frames of Republicans and Democrats dominated the pre-enactment period (Jacobs and Skocpol 2010; Fein 2011; Jacobs 2011; Jacobs and Mettler 2011a, Jacobs and Mettler 2011b). However, as more time passes since the implementation of the ACA, the benefits of the ACA were expected to dominate the formation of public opinion toward government provision of healthcare (Jacobs and Mettler 2011a, Jacobs and Mettler 2011b). We should expect that ACA support will have increased since the law now covers an increased number of Americans.

In contrast, Wlezien’s (1995) work postulates a thermostatic (reciprocal) relationship between government activity in a policy area and public support for future government expansion of activity in that policy area. We therefore expect a thermostatic relationship between the expansion of government provision of healthcare and public support for government provision of healthcare. During the 2013 to 2015 implementation period of the ACA, we should expect that support for the ACA and government provision of healthcare would have declined. Only after the government provision of healthcare services reaches a relatively steady state should we expect public support to potentially return to pre-implementation levels.

Support for Government Provision of Healthcare

ROLE OF GOVERNMENT

Prior to the latest period of debate over healthcare, surveys often framed government provision of healthcare as questions about the role of government. Gallup (table 1), the General Social Survey (GSS/NORC) (tables 2 and 3), and CBS/New York Times (table 4) each asked such questions over the 2000 to 2008 period. In general, there is a rise in the expectation that the government should provide healthcare coverage/insurance from 2000 to 2006, with a leveling off thereafter, and in the longer series, a decline from 2009 onward. A typical formulation of this question is Gallup’s “Do you think it is the responsibility of the federal government to make sure all Americans have healthcare coverage, or is that not the responsibility of the federal government?” Between 2000 and 2008, we see a rise in the proportion of Americans saying “yes, government responsibility,” from the upper 50 percent range (59 percent in 2000) to a high of 69 percent in 2006. With the start of the 2008 election cycle, polls showed a decline in this figure to a low of 42 percent in 2013 (table 1).

Table 1.

Role of Federal Government

Gallup: “Do you think it is the responsibility of the federal government to make sure all Americans have healthcare coverage, or is that not the responsibility of the federal government?”

	1/13/00–1/16/00	9/11/00–9/13/00	11/08/01–11/11/01a	11/11/02–11/14/02	11/3/03–11/5/03a
	%	%	%	%	%
Yes, government responsibility	59	64	62	62	59
No, not government responsibility	38	31	34	35	39
No opinion	3	5	4	3	2
N	1,002	1,008	1,005	1,001	1,007
	11/07/04–11/10/04a	11/07/05–11/10/05a	11/09/06–11/12/06a	11/11/07–11/14/07a	11/13/08–11/16/08a
	%	%	%	%	%
Yes, government responsibility	64	58	69	64	54
No, not government responsibility	34	38	28	33	41
No opinion	2	4	3	3	5
N	1,016	1,011	1.004	1,014	1,009
	11/05/09–11/08/09	11/04/10–11/07/10	11/03/11–11/06/11	11/15/12–11/18/12	11/07/13–11/10/13
	%	%	%	%	%
Yes, government responsibility	47	47	50	44	42
No, not government responsibility	50	50	46	54	56
No opinion	3	3	4	2	2
N	1,008	1,021	1,012	1,015	1,039

^aAsked of a half sample.

Table 2.

Government Responsibility to Help Pay for Doctors and Hospital Bills

GSS/NORC: “In general, some people think that it is the responsibility of the government in Washington to see to it that people have help in paying for doctors and hospital bills. Others think that these matters are not the responsibility of the federal government and that people should take care of these things themselves. Where would you place yourself on this scale, or haven’t you made up your mind on this?” (Respondents shown card with 1 to 5 scale on which point 1 indicates “I strongly agree it is the responsibility of the government to help” and point 5 indicates “I strongly agree people should take care of themselves.” Point 3 indicates “I strongly agree with both answers.”)

	2000	2002	2004	2006	2008
	%	%	%	%	%
1–Strongly agree responsibility of government to help	28	32	32	33	34
2	22	19	21	19	18
3–Agree with both	30	34	30	32	29
4	11	7	8	9	9
5–Strongly agree people should take care of themselves	6	7	8	7	7
Don’t know	3	2	1	1	3
No answer	*	*	*	*	*
N	1,897	893	880	2,002	1,349
	2010	2012
	%	%
1–Strongly agree responsibility of government to help	30	28
2	16	18
3–Agree with both	31	31
4	11	12
5–Strongly agree people should take care of themselves	10	9
Don’t know	3	3
No answer	*	*
N	1,378	1,330

*Less than .5%.

Table 3.

Government Should Be Responsible for Providing Healthcare for the Sick

GSS/NORC: “Government on the whole, do you think it should or should not be the government’s responsibility to [ITEM]? Provide healthcare for the sick.”

	1985	1990	1996	2006
	%	%	%	%
Definitely should be	34	39	35	55
Probably should be	47	46	44	35
Probably should not be	12	7	11	7
Definitely should not be	4	3	3	3
No answer	2	2	3	1
N	666	1,228	1,332	1,513

Table 4.

Approval of Creating a Public Healthcare Insurance Option

CBS/NYT: “On another subject, do you think the federal government should guarantee health insurance for all Americans, or isn’t this the responsibility of the federal government?”

		7/13/00– 7/16/00		1/20/06–1/25/06		2/23/07–2/27/07		3/12/09–3/16/09		6/12/09–6/16/09
		%		%		%		%		%
Guarantee insurance/Should guarantee		62		62		64		62		64
Not responsibility		29		31		27		30		30
Don’t know/No answer		9		7		9		8		6
N		954		1,229		1,281		1,142		895
		7/24/09–7/28/09		9/19/09–9/23/09
		%		%
Guarantee insurance/Should guarantee		55		51
Not responsibility		38		40
Don’t know/No answer		7		9
N		1,050		1,042

Gallup (table 5), the National Election Studies (tables 6 and 7), and NBC/WSJ (table 8) tracked preferences for a government-run healthcare system to a private health insurance system. Gallup’s tracking shows a rise in preference for a government-provided system between 2001 and late 2008 (from 33 to 41 percent), with a decline from 2009 to 2010, a slight rebound in 2011, and then a drop back to roughly where Gallup started tracking the series in 2001, at 34 percent (table 5). The ANES suggests there may be an economic connection. In 1992, 44 percent of Americans favored a government insurance plan over private insurance plans, but during the economic boom of 1994 to 2000 the proportion hovered between 35 and 40 percent. As the economy stagnated, support rose to 42 percent in 2004 and 43 percent in 2008 (table 6). But a stagnant economy is also contemporaneous with the remarkable drop in support for the government’s role in providing healthcare between 2008 and 2012 as measured by the ANES in 2008; 50 percent favored the US government paying for all necessary medical care for all Americans, while by 2012 only 38 percent did (table 7). Given this, recessions do not reliably boost support for government provision of healthcare.

Table 5.

Preferred Healthcare Systems

Gallup: “Which of the following approaches for providing healthcare in the United States would you prefer [ROTATED: a government-run healthcare system, (or) a system based mostly on private health insurance]?”

	11/04/10–11/07/10	11/03/11–11/06/11	11/15/12–11/18/12	11/07/13–11/10/13
	%	%	%	%
Government-run system	34	39	36	34
System based on private insurance	61	56	57	61
No opinion	5	6	6	5
N	1021	1,012	1,015	1,039

Table 6.

Support for Government Insurance Plan or Private Health Insurance Plan

NES: “There is much concern about the rapid rise in medical and hospital costs. Some people feel there should be a government insurance plan which would cover all medical and hospital expenses for everyone. Suppose these people are at one end of a scale, at point 1. Others feel that all medical expenses should be paid by individuals through private insurance plans like Blue Cross or other company-paid plans. Suppose these people are at the other end, at point 7. And, of course, some other people have opinions somewhere in between, at points 2, 3, 4, 5, or 6. Where would you place YOURSELF on this scale, or haven’t you thought much about this?”

	1992	1994	1996	2000	2004	2008
	%	%	%	%	%	%
Government insurance plan	20	16	13	16	19	18
2	12	8	10	10	11	13
3	12	11	22	14	12	12
4	18	19	19	19	17	17
5	10	12	14	13	13	12
6	7	12	11	9	10	9
Private insurance plan	7	13	10	10	8	10
Don’t know/Haven’t thought much about it	14	9	12	9	9	10
N	2,474	1,773	1,712	1,006	1,211	1,156

Table 7.

Approval of Government Payment of Healthcare for All

NES: “Do you favor, oppose, or neither favor nor oppose the US government paying for all necessary medical care for all Americans?”

	2008	2012
	%	%
Favor a great deal	35	17
Favor moderately	13	17
Favor a little	2	4
Neither favor nor oppose	12	24
Oppose a little	4	3
Oppose moderately	11	11
Oppose a great deal	21	24
Don’t know/Refused	2	1
Break-off	*	*
N	1,167	5,916

*Less than .5%.

Table 8.

Approval of Creating a Public Healthcare Plan

NBC/WSJ: “Would you favor or oppose creating a public healthcare plan administered by the federal government that would compete directly with private health insurance companies?”

	7/24/09– 7/27/09	8/15/09–8/17/09	9/17/09–9/20/09	10/22/09–10/25/09
	%	%	%	%
Favor	46	43	46	48
Oppose	44	47	48	42
Not sure	10	10	6	10
N	1,011	805	1,005	1,009

“For comparison: Which of the following approaches for providing healthcare in the United States would you prefer [ROTATED: replacing the current healthcare system with a new government-run healthcare system, (or) maintaining the current system based mostly on private health insurance]?”

	11/08/01–11/11/01a	11/03/03–11/05/03a	11/07/04–11/10/04a	11/07/05–11/10/05a	11/09/06–11/12/06a
	%	%	%	%	%
Replacing the current system	33	38	32	41	39
Maintaining the current system	61	57	63	49	51
No opinion	6	5	5	10	10
N	1,005	1,007	1,016	1,011	1,004
	11/11/07–11/14/07a	11/13/08–11/16/08a	3/27/09–3/29/09	11/05/09–11/08/09
	%	%	%	%
Replacing the current system	41	41	39	32
Maintaining the current system	48	49	56	61
No opinion	11	10	5	7
N	1,014	1,009	1,007	1,008

^aAsked of a half sample.

The Taxes versus Healthcare Trade-Off

The Kaiser Family Foundation (KFF) and CBS/New York Times tracked the trade-off between taxes and healthcare provision during the pre-2008 period (tables 9 and 10). KFF charted the steady rise between 2003 and late 2008 in the proportion of Americans responding positively to the question “Would you be willing to pay more—either in higher health insurance premiums or higher taxes—in order to increase the number of Americans who have health insurance, or not?” In 2003, only 23 percent said yes, while by late 2008, this figure stood at 47 percent (table 10). NBC/Wall Street Journal also followed the decline in support for trading lower taxes for healthcare. There was a small drop between 2007 and 2009 from 53 to 49 percent (table 11). The GSS/NORC charted a rise in the fraction of Americans wanting to increase spending on healthcare from 69 percent in 2000 to 77 percent in 2004. This declined in 2006 and 2008 to the low- to mid-70 percent range, and dropped further between 2010 and 2012 to 59 percent (table 12).

Table 9.

Willing to Pay Taxes for Health Insurance

CBS/NYT: “Would you be willing or not willing to pay higher taxes so that all Americans have health insurance they can’t lose, no matter what?”

	2/23/07– 2/27/07	4/01/09–4/05/09	6/12/09–6/16/09
	%	%	%
Willing	60	57	57
Not willing	34	38	37
Don’t know/No answer	6	5	6
N	1,261	998	895

Table 10.

Taxes for Healthcare

Kaiser Family Foundation: “Would you be willing to pay more—either in higher health insurance premiums or higher taxes—in order to increase the number of Americans who have health insurance, or not?”

	2/06/03– 2/10/03a	11/04/04–11/28/04a	5/31/07–6/05/07	9/08/08–9/13/08a	12/04/08–12/14/08
	%	%	%	%	%
Yes, would	24	45	39	42	47
No, would not	73	51	58	53	49
Don’t know/Refused	3	4	2	5	3
Refused	–	*	1	–	1
N	1,201	1,396	2,140	1,207	1,628

*Less than .5%.

^aRefuse option not available.

Table 11.

Trade-Off—Higher Taxes for Health Insurance

NBC/WSJ: “Please tell me whether you agree or disagree with the following statement. I would be willing to pay higher taxes so that everyone can have health insurance.”

		1/24/07– 1/27/07		3/02/07–3/05/07		2/26/09–3/01/09a
		%		%		%
Agree		53		52		49
Disagree		40		41		45
Not sure		7		7		6
N		1,007		1,007		1,007

^aAsked of one-half the respondents (FORM A).

Table 12.

Improving and Protecting the Nation’s Health/Health

GSS/NORC: “We are faced with many problems in this country, none of which can be solved easily or inexpensively. I’m going to name some of these problems, and for each one I’d like you to tell me whether you think we’re spending too much money on it, too little money, or about the right amount. First, improving and protecting the nation’s health/health, are we spending too much, too little, or about the right amount on … Improving and protecting the nation’s health/health?”

		2000		2002		2004		2006		2008
		%		%		%		%		%
Too little		69		72		77		72		74
About right		22		20		14		17		13
Too much		6		7		7		9		11
Don’t know		3		1		1		2		1
N		1,414		1,401		1,415		1,529		1,042
		2010		2012
		%		%
Too little		59		59
About right		17		21
Too much		21		17
Don’t know		3		3
N		1,020		965

Reform Proposals

Throughout the healthcare reform debates from 2008 to 2010, the major survey houses used numerous questions to track public attitudes toward various proposals. KFF fielded three series on legislative proposals. A KFF question tracking support for options showed consistent levels of support for expanding healthcare via the government between 2006 and 2008, with over 50 percent desiring to see “A new health plan that would make a major effort to provide health insurance for all or nearly all of the uninsured but would involve a substantial increase in spending” (table 13). In 2009, KFF asked about support for the individual mandate, which remained steady at 66 to 67 percent between December 2008 and October 2009. After October 2009, KFF asked a general support/oppose question and found a rise in support for the proto-ACA from 42 percent in January 2010 to 46 percent by March 2010 (table 14). Pew asked about the “healthcare bills being discussed in Congress” (table 15) and found that throughout 2009 and 2010 there was little change in the proportion of Americans favoring the bills—varying between 38 and 42 percent, ending the question series at 40 percent. During 2009 and 2010, ABC/Washington Post and CNN tracked the slight erosion of support for “a public health insurance option administered by the federal government that would compete with plans offered by private health insurance companies” (table 16). The fraction of Americans favoring such an option declined from 56 percent in November 2009 to 51 percent in February 2010. CBS/New York Times showed a clear decline in the level of support Americans had for a Medicare-like option for healthcare. Between June and December 2009, the fraction of Americans favoring such a healthcare proposal dropped from 72 to 59 percent (table 17). ABC/Washington Post found that once the initial drop in July 2009 occurred with the commencement of the legislative debate, the proportion supporting a government-administrated healthcare option hovered between 52 and 57 percent (table 18). Ipsos tracked support for the legislation from August 2009 to July 2012, finding that support declined from August 2009 (40 percent) to January 2010 (37 percent). Support rose to 45 percent in June 2012 (table 19).

Table 13.

Preferences for Health Reform Proposals

Kaiser Family Foundation: “Which one of the following three things would you like to see in a healthcare reform proposal from a presidential candidate? Would you want your candidate to propose ... a new health plan that would make a major effort to provide health insurance for all or nearly all of the uninsured but would involve a substantial increase in spending, a new health plan that is more limited and would cover only some groups of the uninsured but would involve less new spending, or keeping things basically as they are? (Read if necessary:) Which would you want your presidential candidate to propose—a major plan or a more limited plan or to keep things as they are?”

	11/09/06–11/19/06	3/08/07–3/13/07	8/02/07–8/08/07	10/01/07–10/10/07
	%	%	%	%
A new health plan that would make a major effort to provide health insurance for all or nearly all of the uninsured but would involve a substantial increase in spending	57	52	54	51
A new health plan that is more limited and would cover only some groups of the uninsured but would involve less new spending	24	24	23	25
Keeping things basically as they are	14	14	13	15
Don’t know/Refused	5	11	10	9
N	1,867	1,233	1,500	1,204
	11/01/07–11/11/07	2/07/08–2/16/08	10/08/08–11/13/08
	%	%	%
A new health plan that would make a major effort to provide health insurance for all or nearly all of the uninsured but would involve a substantial increase in spending	48	47	52
A new health plan that is more limited and would cover only some groups of the uninsured but would involve less new spending	27	28	23
Keeping things basically as they are	15	15	16
Don’t know/Refused	10	10	9
N	1,486	2,007	1,217

Table 14.

Support of Reform Proposals

Kaiser Family Foundation: “As of right now, do you generally (support) or generally (oppose) the healthcare proposals being discussed in Congress? [ROTATE] (Is that strongly support/oppose or somewhat support/oppose?)”

	1/07/10–1/12/10	2/11/10–2/15/10	3/10/10–3/15/10
	%	%	%
Strongly support	19	24	28
Somewhat support	23	19	18
Somewhat oppose	10	11	9
Strongly oppose	31	32	33
Depends on which proposal (House/Senate, Dems/Reps) (Vol.)	N/A	3	3
Don’t know/No answer	16	12	9
N	2,002	1,201	1,208

Table 15.

Approval of Healthcare Bill Being Debated in Congress

Pew: “As of right now, do you generally favor or generally oppose the healthcare bills being discussed in Congress?”

	7/22/09– 7/26/09	8/20/09–8/27/09	9/10/09–9/15/09	9/30/09–10/04/09	10/28/09–11/08/09
	%	%	%	%	%
Generally favor	38	39	42	34	38
Generally oppose	44	46	44	47	47
Don’t know/Refused	18	15	14	19	15
N	1,506	2,003	1,006	1,500	2,000
	11/12/09– 11/15/09	12/09/09–12/13/09a	1/06/10–1/10/10	2/03/10–2/09/10	3/10/10–3/14/10
	%	%	%	%	%
Generally favor	42	35	39	38	38
Generally oppose	39	48	48	50	48
Don’t know/Refused	19	17	13	12	13
N	1,003	1,504	1,504	1,383	1,500
	3/11/10– 3/21/10
	%
Generally favor	40
Generally oppose	47
Don’t know/Refused	13
N	2,505

^aPrior to January 2010, the question asked about “healthcare proposals” rather than “healthcare bills.”

Table 16.

Approval of Creating a Public Healthcare Insurance Option

CNN/ORC: “Now thinking specifically about the health insurance plans available to most Americans, would you favor or oppose creating a public health insurance option administered by the federal government that would compete with plans offered by private health insurance companies?”

	7/28/09– 7/31/09	11/13/09–11/15/09	12/02/09–12/03/09	2/12/10–2/15/10
	%	%	%	%
Favor	55	56	53	51
Oppose	41	42	46	48
No opinion	4	2	1	1
N	1,010	1,014	1,041	1,023

Table 17.

Approval of Government Offering a Government Administrated Healthcare Insurance Option

CBS/NYT: “Would you favor or oppose the government offering everyone a government-administered health insurance plan—something like the Medicare coverage that people 65 and older get—that would compete with private health insurance plans?”

	6/12/09– 6/16/09	7/24/09–7/28/09	8/27/09–8/31/09a	8/27/09–8/31/09b
	%	%	%	%
Favor	72	66	60	53
Oppose	20	27	34	36
Don’t know/No answer	8	7	6	11
N	895	1,050	1,097	1,097
	9/10/09c	10/05/09– 10/08/09	11/13/09–11/16/09d	12/04/09–12/10/09
	%	%	%	%
Favor	68	62	61	59
Oppose	27	31	28	29
Don’t know/No answer	5	7	11	12
N	648	829	1,167	1,031

^aSubpopulation: Asked of Form A half sample.

^bSubpopulation: Asked of Form B half sample.

^cA national adult re-interviewed sample of 648. Respondents were originally interviewed 8/27/09–8/31/09 as part of a national adult sample of 1,097 and agreed to be re-interviewed.

^d”Would you favor or oppose the government offering some people who are uninsured the choice of a government-administered health insurance plan—also known as a ‘public option’—that would compete with private health insurance plans?”

Table 18.

Approval of Government Offering a Government-Administrated Healthcare Insurance Option

ABC/WP: “Would you support or oppose having the government create a new health insurance plan to compete with private health insurance plans? (If Support/Oppose, ask:) Do you feel that way strongly or somewhat?”

	6/18/09–6/21/09a	8/13/09–8/17/09a	9/10/09– 9/12/09	10/15/09–10/18/09	11/12/09–11/15/09
	%	%	%	%	%
Support strongly	–	–	33	36	34
Support somewhat/Support	62	52	22	21	19
Oppose somewhat/Oppose	33	46	11	9	12
Oppose strongly	–	–	31	31	32
No opinion	5	2	3	3	3
N	1,001	1,001	1,007	1,004	1,001

^aComplete question format not available.

Table 19.

Support or Opposition to the Healthcare Reform Law

Ipsos/Reuters: “As of right now, do you favor or oppose the healthcare reform bill passed by Congress and signed into law by the president in 2010?”

	8/27/09–8/31/09a	10/01/09–10/05/09a	10/29/09–11/01/09a	11/19/09–11/21/09a	1/28/10–1/31/10a
	%	%	%	%	%
Favor	40	40	39	34	37
Oppose	45	42	49	46	51
Don’t know	15	18	12	20	12
N	1,057	1,096	1,077	1,176	1,127
	2/26/10–2/28/10a	4/01/10–4/05/10	6/07/12–6/11/12	7/05/12–7/09/12
	%	%	%	%
Favor	41	44	45	44
Oppose	47	45	44	56
Don’t know	11	11	12	7
N	1,076	1,076	1,099	1,154

^a “As of right now, do you favor or oppose the healthcare reform proposals presently being discussed?”

Support for the Affordable Care Act

Since the passage of the ACA in March 2010, the proportion of Americans supporting the ACA has modestly declined, the proportion of undecided/don’t knows has declined, and the proportion of those opposing the ACA has increased. ABC/Washington Post, AP/GfK, CBS/New York Times, CNN/ORC, Gallup, KFF, NBC/Wall Street Journal, and Pew captured a surge in support associated with the 2012 election campaign, a decline in support associated with the 2013 implementation of the www.healthcare.gov website, and a return to the pre-implementation level of support during 2014 (tables 20 through 27). All of these series estimated the proportion of supporters as hovering between 45 and 35 percent, while the proportion of those opposed stood between 50 and 57 percent. KFF has the most detailed series, and its findings are typical of the polls fielded by other organizations. KFF tracked the proportion of supporters as hovering around 40 to 43 percent during 2010, with more variation in 2011 (between 34 and 42 percent). The election year of 2012 saw a peak in support of 45 percent in September 2012. After the election, support declined to 33 percent by November 2013 and the troubled launch of the www.healthcare.gov site. Since the website opened, support has hovered between 34 and 38 percent (table 20).

Table 20.

Sentiment Regarding Health Reform Bill

Kaiser Family Foundation: “As you may know, a health reform bill was signed into law in 2010. Given what you know about the health reform law, do you have a generally (favorable) or generally (unfavorable) opinion of it? [GET ANSWER, THEN ASK: Is that a very (favorable/unfavorable) or somewhat (favorable/unfavorable) opinion?] [ROTATE OPTIONS IN PARENTHESES]”

	4/09/10–4/14/10	5/11/10–5/16/10	6/17/10–6/22/10	7/07/10–7/13/10	8/16/10–8/22/10
	%	%	%	%	%
Very favorable	23	14	20	21	19
Somewhat favorable	23	27	28	29	24
Somewhat unfavorable	10	12	16	10	13
Very unfavorable	30	32	25	25	32
Don’t know/Refused	14	14	10	14	12
N	1,208	1,210	1,207	1,504	1,203
	9/14/10–9/20/10	10/05/10–10/10/10	11/03/10–11/06/10	12/01/10–12/06/10	1/04/11–1/16/11
	%	%	%	%	%
Very favorable	19	18	19	22	19
Somewhat favorable	30	24	23	20	22
Somewhat unfavorable	15	15	12	14	16
Very unfavorable	25	29	28	27	34
Don’t know/Refused	11	15	18	18	9
N	1,200	1,202	1,502	1,207	1,502
	2/08/11–2/13/11	3/08/11–3/13/11	4/07/11–4/12/11	5/12/11–5/17/11	6/09/11–6/14/11
	%	%	%	%	%
Very favorable	16	21	20	19	15
Somewhat favorable	27	21	21	23	27
Somewhat unfavorable	19	15	14	15	16
Very unfavorable	29	31	27	29	30
Don’t know/Refused	8	13	18	14	12
N	1,202	1,202	1,207	1,203	1,203
	7/13/11–7/18/11	8/10/11–8/15/11	9/07/11–9/12/11	10/13/11–10/18/11	11/10/11–11/15/11
	%	%	%	%	%
Very favorable	20	16	18	12	17
Somewhat favorable	22	23	23	22	20
Somewhat unfavorable	12	17	14	20	15
Very unfavorable	31	27	29	31	29
Don’t know/Refused	15	17	16	15	19
N	1,201	1,201	1,207	1,223	1,209
	12/08/11–12/13/11	1/12/12–1/17/12	2/13/12–2/19/12	2/29/12–3/05/12	4/06/12–4/10/12
	%	%	%	%	%
Very favorable	19	18	17	18	20
Somewhat favorable	22	19	25	23	22
Somewhat unfavorable	15	14	16	11	9
	12/08/11–12/13/11	1/12/12–1/17/12	2/13/12–2/19/12	2/29/12–3/05/12	4/06/12–4/10/12
	%	%	%	%	%
Very unfavorable	28	30	27	29	34
Don’t know/Refused	17	19	15	19	15
N	1,212	1,206	1,519	1,208	1,210
	5/08/12–5/14/12	6/28/12–6/30/12	7/17/12–7/23/12	8/07/12–8/12/12	9/13/12–9/19/12
	%	%	%	%	%
Very favorable	17	25	20	21	25
Somewhat favorable	20	16	18	17	20
Somewhat unfavorable	12	11	13	13	12
Very unfavorable	32	30	31	30	28
Don’t know/Refused	19	18	17	19	14
N	1,218	1,239	1,227	1,208	1,534
	10/18/12–10/23/12	11/07/12–11/10/12	2/14/13–2/19/13	3/05/13–3/10/13	4/15/13–4/20/13
	%	%	%	%	%
Very favorable	20	19	18	17	16
Somewhat favorable	18	24	18	20	19
Somewhat unfavorable	14	12	13	13	12
Very unfavorable	29	27	29	27	28
Don’t know/Refused	19	19	23	23	24
N	1,215	1,233	1,209	1,204	1,203
	6/04/13–6/09/13	8/13/13–8/19/13	9/12/13–9/18/13	10/17/13–10/23/13	11/13/13–11/18/13
	%	%	%	%	%
Very favorable	15	17	20	21	15
Somewhat favorable	20	20	19	17	18
Somewhat unfavorable	13	14	13	13	13
Very unfavorable	30	28	30	31	36
Don’t know/Refused	23	20	17	18	18
N	1,505	1,503	1,503	1,513	1,204
	12/10/13–12/15/13	1/14/14–1/21/14	2/11/14–2/17/14	3/11/14–3/17/14	4/15/14–4/21/14
	%	%	%	%	%
Very favorable	17	17	16	18	19
Somewhat favorable	17	17	19	20	19
Somewhat unfavorable	12	15	14	14	16
Very unfavorable	36	35	33	32	30
Don’t know/Refused	18	16	18	15	16
N	1,206	1,506	1,501	1,504	1,504
	5/13/14–5/19/14	6/12/14–6/18/14	7/15/14–7/21/14	8/25/14–9/02/14	10/08/14–10/14/14
	%	%	%	%	%
Very favorable	19	19	15	15	16
Somewhat favorable	19	20	22	20	20
Somewhat unfavorable	12	15	18	15	16
Very unfavorable	33	30	35	32	27
Don’t know/Refused	17	16	11	19	20
N	1,505	1,202	1,507	1,505	1,503

Table 27.

Approval of Changes to the Healthcare System

ABC/WP: “Overall, given what you know about them, would you say you support or oppose the changes to the healthcare system that have been enacted by (Congress) and (the Obama administration)? Do you feel that way strongly or somewhat?”

	8/13/09–8/17/09	9/10/09– 9/12/09	10/15/09–10/18/09	11/12/09–11/15/09	12/10/09–12/13/09
	%	%	%	%	%
Support strongly	27	30	26	30	25
Support somewhat	18	16	19	18	19
Oppose somewhat	10	12	12	10	11
Oppose strongly	40	36	36	39	40
No opinion	5	6	7	3	5
N	1,001	1,007	1,004	1,001	1,003
	1/12/10–1/15/10	2/04/10–2/08/10a	3/23/10–3/26/10b	9/30/10–10/03/10	12/09/10–12/12/10
	%	%	%	%	%
Support strongly	22	22	32	26	22
Support somewhat	22	25	13	21	21
Oppose somewhat	12	11	10	13	14
Oppose strongly	39	38	40	35	37
No opinion	5	5	4	5	6
N	1,083	1,004	1,000	1,002	1,001
	1/13/11–1/16/11	3/07/12–3/10/12c	4/05/12–4/08/12	7/05/12–7/08/12	7/18/13–7/21/13
	%	%	%	%	%
Support strongly	25	24	23	27	25
Support somewhat	20	17	17	20	17
Oppose somewhat	14	11	13	14	13
	1/13/11–1/16/11	3/07/12–3/10/12c	4/05/12–4/08/12	7/05/12–7/08/12	7/18/13–7/21/13
	%	%	%	%	%
Oppose strongly	36	41	40	33	39
No opinion	5	7	8	6	9
N	1,053	1,003	1,103	1,003	1,002
	9/12/13–9/15/13	10/17/13–10/20/13	11/14/13–11/17/13	12/12/13–12/15/13	1/20/14–1/23/14
	%	%	%	%	%
Support strongly	26	25	27	28	25
Support somewhat	16	21	13	17	21
Oppose somewhat	13	13	11	13	11
Oppose strongly	39	36	46	37	38
No opinion	6	5	2	5	5
N	1,004	1,002	1,006	1,005	1,003
	3/26/14–3/30/14	4/04/14–4/27/14	9/04/14–9/07/14
	%	%	%
Support strongly	25	24	24
Support somewhat	24	20	19
Oppose somewhat	12	14	13
Oppose strongly	36	34	39
No opinion	3	8	5
N	1,017	1,000	1,001

^a2/04/10 and prior: “proposed changes ... that are being developed by.”

^b3/23/10 to 1/13/11: “Overall, given what you know about them, would you say you support or oppose the changes to the healthcare system that have been enacted by (Congress) and (the Obama Administration)?”

^cAs of 3/07/12: “On another subject, overall, do you support or oppose the federal law making changes to the healthcare system? Do you feel that way strongly or somewhat?”

Table 21.

Support or Opposition to Changes to the Healthcare System

AP/GfK: “In general, do you support, oppose, or neither support nor oppose the healthcare reforms that were passed by Congress in March of 2010? [IF ‘SUPPORT’] Would you say you support the healthcare reforms that were passed by Congress in March of 2010 strongly or do you support them just somewhat? [IF ‘OPPOSE’] Would you say you oppose the healthcare reforms that were passed by Congress in March of 2010 strongly or do you oppose them just somewhat?”

	9/08/10–9/13/10	10/13/10– 10/18/10	11/03/10–11/08/10	1/05/11–1/10/11	3/24/11–3/28/11
	%	%	%	%	%
Strongly support	20	17	17	21	17
Somewhat support	21	24	20	19	18
Somewhat oppose	11	12	13	11	14
Neither support nor oppose	12	11	12	16	17
Strongly oppose	35	33	33	30	31
Don’t know [Vol.]	1	3	4	3	2
Refused/Not answered	–	*	–	*	–
N	1,000	1,501	1,000	1,001	1,001
	6/15/11–6/20/11	2/16/12–2/20/12	6/14/12–6/18/12	10/03/13–10/07/13a	12/05/13–12/09/13
	%	%	%	%	%
Strongly support	16	17	17	16	16
Somewhat support	21	18	17	12	11
Neither support nor oppose	15	14	13	32	28
Somewhat oppose	13	11	14	9	10
Strongly oppose	32	36	32	29	34
	6/15/11–6/20/11	2/16/12–2/20/12	6/14/12–6/18/12	10/03/13–10/07/13a	12/05/13–12/09/13
	%	%	%	%	%
Don’t know [Vol.]	3	4	7	N/A	N/A
Refused/Not answered	–	*	*	2	1
N	1,001	1,000	1,007	1,227	1,367
	1/17/14–1/21/14	3/20/14–3/24/14	5/16/14–5/19/14	9/25/14–9/29/14
	%	%	%	%
Strongly support	17	13	17	14
Somewhat support	10	13	11	11
Neither support nor oppose	30	30	28	34
Somewhat oppose	9	12	11	13
Strongly oppose	33	31	32	28
Don’t know [Vol.]	N/A	N/A	N/A	N/A
Refused/Not answered	1	1	1	1
N	1,060	1,012	1,354	1,845

*Less than .5%.

Table 22.

Approval or Disapproval of the Affordable Care Act

Gallup: “Do you generally approve or disapprove of the 2010 Affordable Care Act, signed into law by President Obama, that restructured the US healthcare system?”

	11/15/12–11/18/12a,b	6/20/13–6/24/13a	8/17/13–8/18/13	10/18/13–10/20/13	10/26/13–10/28/13
	%	%	%	%	%
Approve	48	44	41	45	44
Disapprove	45	52	49	50	47
No opinion	7	4	11	6	9
N	1,015	2,048	1,021	1,528	1,530
	11/7/13–11/10/13a	11/23/13–11/24/13	12/11/13–12/12/13	1/03/14–1/04/14	1/31/14–2/01/14
	%	%	%	%	%
Approve	40	40	41	38	41
Disapprove	55	54	51	54	51
No opinion	4	6	8	8	9
N	1,039	1,034	1,011	1,020	1,017
	2/28/14–3/02/14	4/07/14–4/08/14	5/21/14–5/25/14	10/01/14–10/02/14
	%	%	%	%
Approve	40	43	43	41
Disapprove	55	54	51	53
No opinion	5	3	6	6
N	1,553	1,009	2,538	1,104

^aAsked on Gallup Poll News Service (non-tracking) poll or Gallup Daily Tracking Poll.

^b11/15/12: “Do you generally approve or disapprove of the 2010 Affordable Care Act, also known as ‘Obama-care,’ that restructured the US healthcare system?”

Table 23.

Think the Healthcare Law Is a Good Idea

NBC/WSJ: “Now as you may know, Barack Obama’s healthcare plan was passed by Congress and signed into law in 2010 … From what you have heard about the new healthcare law, do you think it is [ROTATE] a good idea or a bad idea? If you do not have an opinion either way, please just say so. (If Good idea/Bad idea, ask:) And, do you feel that way strongly, or not so strongly?”

	4/23/09–4/26/09a	6/12/09–6/15/09	7/24/09– 7/27/09	8/15/09–8/17/09	9/17/09–9/20/09
	%	%	%	%	%
Strongly good idea
Not so strongly good idea	33	33	36	36	39
Not so strongly bad idea	26	32	42	42	41
Strongly bad idea
Do not have an opinion	34	30	17	17	17
Not sure	7	5	5	5	3
N	1,005	1,008	1,011	805	1,005
	10/22/09–10/25/09	12/11/09–12/14/09	1/10/10–1/14/10	1/23/10–1/25/10	3/11/10–3/14/10
	%	%	%	%	%
Strongly good idea
Not so strongly good idea	38	32	33	31	36
Not so strongly bad idea	42	47	46	46	48
Strongly bad idea
Do not have an opinion	16	17	18	22	15
Not sure	4	4	3	1	1
N	1,009	1,008	1,002	800	1,000
	5/06/10–5/10/10	6/17/10–6/21/10b	10/14/10–10/18/10	1/13/11–1/17/11	12/07/11–12/11/11
	%	%	%	%	%
Strongly good idea	28	28	25	29	23
Not so strongly good idea	10	10	11	10	11
Not so strongly bad idea	6	7	5	5	8
Strongly bad idea	38	39	41	34	33
Do not have an opinion	17	15	16	21	24
Not sure	1	1	2	1	1
N	1,000	1,000	1,000	1,000	1,000
	4/13/12–4/17/12	6/20/12–6/24/12	7/18/12–7/22/12b	5/30/13–6/2/13	7/17/13–7/21/13
	%	%	%	%	%
Strongly good idea	27	25	31	28	26
Not so strongly good idea	9	10	9	9	8
Not so strongly bad idea	6	6	5	6	6
Strongly bad idea	39	35	39	43	41
Do not have an opinion	17	22	15	13	18
Not sure	2	2	1	1	1
N	1,000	1,000	1,000	1,000	1,000
	9/05/13–9/08/13	10/07/13–10/09/13	10/25/13–10/28/13	12/04/13–12/08/13	1/22/14–1/25/14
	%	%	%	%	%
Strongly good idea	24	31	28	27	27
Not so strongly good idea	7	7	9	7	7
Not so strongly bad idea	6	5	4	7	6
Strongly bad idea	38	38	43	43	42
Do not have an opinion	24	17	14	16	17
Not sure	1	2	2	*	1
N	1,000	800	800	1,000	800
	3/05/14–3/09/14	4/23/14–4/27/14	9/03/14–9/07/14b	10/08/14–10/12/14b
	%	%	%	%
Strongly good idea	26	27	27	26
Not so strongly good idea	9	9	7	10
Not so strongly bad idea	7	7	5	5
Strongly bad idea	42	39	43	43
Do not have an opinion	14	17	16	14
Not sure	2	1	2	2
N	1,000	1,000	1,000	1,000

*Less than .5%.

^aPrior to May 2010, the question did not ask “And, do you feel that way strongly, or not so strongly?”

^bResults shown reflect responses among registered voters.

Table 24.

Approval of the Healthcare Law

Pew: “Do you approve or disapprove of the healthcare law passed by Barack Obama and Congress in 2010?”

	4/01/10– 4/05/10	7/08/10–7/11/10	8/25/10–9/06/10	9/09/10–9/12/10	11/04/10–11/07/10
	%	%	%	%	%
Approve	40	35	44	38	43
Disapprove	44	47	46	45	47
Don’t know/Refused	16	17	10	17	10
N	1,001	1,001	3,509	1,001	1,255
	1/05/11– 1/09/11	3/07/12–3/11/12	4/04/12–4/15/12	6/07/12–6/17/12	6/28/12–7/09/12a
	%	%	%	%	%
Approve	41	47	41	43	47
Disapprove	48	45	49	48	43
Don’t know/Refused	11	8	10	9	9
N	1,503	1,503	3,008	2,013	2,973
	9/04/13– 9/08/13	10/09/13–10/13/13	12/03/13–12/08/13	2/27/14–3/16/14	4/03/14–4/06/14
	%	%	%	%	%
Approve	42	41	41	41	37
Disapprove	53	52	54	53	50
Don’t know/Refused	5	7	5	5	12
N	1,506	1,504	2,001	3,335	1,010
	4/23/14– 4/27/14	9/02/14– 9/09/14
	%	%
Approve	40	44
Disapprove	55	52
Don’t know/Refused	4	4
N	1,501	2,002

^aPrior to September 2013, the question asked about “the healthcare legislation.” In addition, the reference to when the law was passed has changed over time: January 2011 referenced the legislation passed “last year,” November 2010 used “earlier this year,” September through July, 2010 used “in March,” and April 2010 used “last month.”

Table 25.

Approval of the Healthcare Law

CNN/ORC: “As you may know, a bill that makes major changes to the country’s healthcare system became law in 2010. Based on what you have read or heard about that legislation, do you generally favor or generally oppose it?”

	3/19/10–3/21/10a	8/6/10–810/10b	12/17/10–12/19/10b	3/11/11–3/13/11c	6/03/11–6/07/11c
	%	%	%	%	%
Favor	39	40	43	37	29
Oppose	59	56	54	59	56
No opinion	2	4	3	5	5
N	1,030	935	1,008	1,023	1,015
	11/18/11–11/20/11	3/24/12–3/25/12	5/29/12–5/31/12	11/16/12–11/18/12	5/17/13–5/18/13
	%	%	%	%	%
Favor	38	43	43	42	43
Oppose	56	50	51	51	54
No opinion	6	7	6	6	3
N	N/A	1,014	1,009	1,023	923
	10/18/13–10/20/13	11/18/13–11/20/13	12/16/13–12/19/13	3/06/14–3/09/14
	%	%	%	%
Favor	41	40	35	39
Oppose	56	58	62	57
No opinion	3	2	3	4
N	841	843	1,035	801

^aPrior to 8/06/10: “As you may know, the US House of Representatives and the US Senate are trying to pass final legislation that would make major changes in the country’s healthcare system. Based on what you have read or heard about that legislation, do you generally favor it or generally oppose it?”

^b8/06/10 and 12/17/10: “As you may know, a bill that makes major changes to the country’s healthcare system became law earlier this year. Based on what you have read or heard about that legislation, do you generally favor or generally oppose it?”

^c3/11/11 and 6/03/11: “As you may know, a bill that makes major changes to the country’s healthcare system became law last year. Based on what you have read or heard about that legislation, do you generally favor or generally oppose it?”

Table 26.

Views of the Healthcare Law

CBS/NYT: “From what you’ve heard or read, do you approve or disapprove of the healthcare law that was enacted in (March) 2010?”

	5/20/10–5/24/10	7/09/10–7/12/10	9/10/10–9/14/10	10/01/10–10/05/10	1/05/11–1/09/11
	%	%	%	%	%
Strongly approve	19	17	15	16	16
Approve	24	19	22	23	20
Disapprove	13	16	15	16	18
Strongly disapprove	34	33	34	27	32
Don’t know/No answer	10	15	14	18	14
N	1,054	966	990	1,129	1,178
	2/11/11–2/14/11	6/03/11–6/07/11	12/05/11–12/07/11	3/21/12–3/25/12	4/13/12–4/17/12
	%	%	%	%	%
Strongly approve	14	14	12	16	18
Approve	19	23	23	20	21
Disapprove	17	15	16	17	13
Strongly disapprove	34	33	35	30	34
Don’t know/No answer	16	15	14	17	14
N	1,031	1,024	856	986	957
	7/11/12– 7/15/12	9/08/12–9/12/12	3/27/13–3/30/13	7/18/13–7/22/13	9/19/13–9/23/13
	%	%	%	%	%
Strongly approve	14	21	18	15	17
Approve	22	21	17	21	22
Disapprove	14	12	13	18	17
	7/11/12– 7/15/12	9/08/12–9/12/12	3/27/13–3/30/13	7/18/13–7/22/13	9/19/13–9/23/13
	%	%	%	%	%
Strongly disapprove	36	34	35	36	34
Don’t know/No answer	14	12	17	10	10
N	1,089	1,301	977	1,036	1,014
	10/18/13–10/21/13	11/15/13–11/18/13	12/05/13–12/08/13	1/17/14–1/21/14	3/20/14–3/23/14
	%	%	%	%	%
Strongly approve	23	15	16	21	20
Approve	20	16	23	20	21
Disapprove	14	15	13	16	14
Strongly disapprove	37	46	37	34	39
Don’t know/No answer	6	8	11	10	7
N	1,007	1,010	1,000	1,018	1,097
	7/29/14–8/04/14	9/12/14–9/15/14
	%	%
Strongly approve	20	20
Approve	21	21
Disapprove	12	15
Strongly disapprove	38	36
Don’t know/No answer	8	7
N	1,344	1,009

Perceptions of the Affordable Care Act’s Impact

Polls have measured impact perceptions in three ways: prospective egocentric, prospective sociotropic, and retrospective egocentric. Prospective assessments evaluate anticipated future policy impact. Retrospective assessments evaluate prior policy impact. Sociotropic assessments evaluate the national policy impact. Egocentric assessments evaluate policy impact on respondents and their immediate friends and families. The KFF tracked the perceptions of the ACA’s impact on the nation. During 2009, over 50 percent of Americans believed the ACA would improve the nation. However, as the pending bill moved closer to becoming law, this proportion dropped. By October 2011, support reached its nadir, at 28 percent. As the 2012 election cycle progressed, perceptions became more positive, cresting in September 2012 at 40 percent. After the election, perceptions declined to the 31 to 37 percent range (table 28). Several polls tracked prospective egocentric assessments (tables 29 through 33). The KFF’s series is typical. Respondents assessed the egocentric impact as lesser than the sociotropic impact, with between 30 and 47 percent seeing the ACA not making much difference. In contrast, the proportion of those saying the ACA would make no difference was usually less than 20 percent (table 32). Otherwise, the general trends of the prospective sociotropic and egocentric series are similar. KFF continued tracking Americans’ egocentric assessment of the impact of the ACA as a retrospective egocentric assessment in 2013 and 2014, as did Pew (tables 34 and 37). The two series showed stability throughout 2014, with nearly twice as many Americans believing the ACA hurt rather than helped them. However, the majority of Americans (over 55 percent) felt that the ACA had no impact on their families (table 34). From 2010 to 2014, KFF tracked retrospective assessments in two separate questions (tables 35 and 36). The trends for the two questions parallel the prospective assessments, but with larger proportions indicating that the ACA had no impact. Gallup conducted a prospective egocentric assessment over the same period as KFF’s retrospective assessment. Like KFF, the Gallup series shows that 20 to 24 percent of Americans thought the ACA would make their families’ lives better, so it appears that prospects for the ACA have not soured during 2014 (table 31).

Table 28.

Healthcare Law Effect on the Nation—Prospective

Kaiser Family Foundation: “Do you think (INSERT AND RANDOMIZE [the nation]) will be (better off) or (worse off) under the health reform law, or don’t you think it will make much difference? [ROTATE OPTIONS IN PARENTHESES ACROSS INTERVIEWS, BUT NOT WITHIN SAME INTERVIEW] [READ IF NECESSARY: “Will (INSERT ITEM) be (better off) or (worse off) under the health reform law, or don’t you think it will make much difference?]”

	2/03/09–2/12/09	4/02/09–4/08/09	6/01/09–6/08/09	7/07/09–7/14/09
	%	%	%	%
Better off	38	56	57	51
Worse off	11	15	16	23
Not much difference	43	21	19	16
Depends (Vol.)a	4	3	3	4
Don’t know/Refused	3	5	5	4
N	1,204	1,203	1,205	1,205
	8/04/09–8/11/09	9/11/09–9/18/09	10/08/09–10/15/09	11/05/09–11/12/09
	%	%	%	%
Better off	53	53	53	54
Worse off	26	26	28	27
Not much difference	14	14	12	11
Depends (Vol.) a	3	4	2	3
Don’t know/Refused	4	4	4	5
N	1,203	1,203	1,200	1,203
	12/07/09–12/13/09	1/07/10–1/12/10	2/11/10–2/15/10	3/10/10–3/15/10
	%	%	%	%
Better off	45	42	45	45
Worse off	31	37	34	34
Not much difference	17	12	14	14
Depends (Vol.) a	4	3	3	3
Don’t know/Refused	3	5	4	4
N	1,204	2,002	1,201	1,208
	4/09/10–4/14/10	5/11/10–5/16/10	6/17/10–6/22/10	7/07/10–7/13/10
	%	%	%	%
Better off	45	43	42	43
Worse off	35	35	32	35
Not much difference	11	15	19	15
Depends (Vol.) a	–	–	–	–
Don’t know/Refused	9	9	6	7
N	1,208	1,210	1,207	1,504
	8/16/10–8/22/10	9/14/10–9/20/10	10/05/10–10/10/10	11/03/10–11/06/10
	%	%	%	%
Better off	45	42	39	38
Worse off	35	34	34	36
Not much difference	11	15	18	16
Depends (Vol.) a	–	–	–	–
Don’t know/Refused	9	9	10	8
N	1,203	1,200	1,202	1,502
	12/01/10–12/06/10	1/04/11–1/16/11	2/08/11–2/13/11	3/08/11–3/13/11
	%	%	%	%
Better off	40	34	37	38
Worse off	37	38	39	35
Not much difference	15	22	19	19
Depends (Vol.) a	–	–	–	–
Don’t know/Refused	8	5	5	7
N	1,207	1,502	1,202	1,202
	4/07/11–4/12/11	5/12/11–5/17/11	6/09/11–6/14/11	7/13/11–7/18/11
	%	%	%	%
Better off	39	37	35	39
Worse off	35	38	39	35
Not much difference	18	19	20	20
Depends (Vol.) a	–	–	–	–
Don’t know/Refused	9	6	6	6
N	1,207	1,203	1,203	1,201
	8/10/11–8/15/11	9/07/11–9/12/11	10/13/11–10/18/11	11/10/11–11/15/11
	%	%	%	%
Better off	33	38	28	35
Worse off	37	36	36	36
Not much difference	21	18	29	22
Depends (Vol.) a	–	–	–	–
Don’t know/Refused	9	8	7	7
N	1,201	1,207	1,223	1,209
	12/08/11–12/13/11	1/12/12–1/17/12	2/13/12–2/19/12	2/29/12–3/05/12
	%	%	%	%
Better off	37	37	39	37
Worse off	37	36	32	38
Not much difference	19	19	22	18
Depends (Vol.) a	–	–	–	–
Don’t know/Refused	7	8	7	7
N	1,212	1,206	1,519	1,208
	4/06/12–4/10/12	5/08/12–5/14/12	7/17/12–7/23/12	8/07/12–8/12/12
	%	%	%	%
Better off	39	34	35	36
Worse off	38	35	41	37
Not much difference	17	20	18	17
Depends (Vol.) a	–	–	–	–
Don’t know/Refused	6	11	7	10
N	1,210	1,218	1,227	1,208
	9/13/12–9/19/12	10/18/12–10/23/12	2/14/13–2/19/13	6/04/13–6/09/13
	%	%	%	%
Better off	40	34	34	31
Worse off	33	35	38	40
Not much difference	17	21	19	20
Depends (Vol.) a	–	–	–	–
Don’t know/Refused	10	10	9	9
N	1,534	1,215	1,209	1,505
	8/13/13–8/19/13	9/12/13–9/18/13	10/17/13–10/23/13	11/13/13–11/18/13
	%	%	%	%
Better off	34	37	35	34
Worse off	40	39	38	43
Not much difference	19	16	21	15
Depends (Vol.) a	–	–	–	–
Don’t know/Refused	7	7	6	8
N	1,503	1,503	1,513	1,204
	12/10/13–12/15/13
	%
Better off	34
Worse off	40
Not much difference	18
Depends (Vol.) a	–
Don’t know/Refused	7
N	1,206

^a”Depends” not allowed as a volunteered answer after 3/10/10.

Table 29.

Will the 2010 Healthcare Law Help or Hurt You Personally

CBS/NYT: “From what you’ve heard or read, do you think the 2010 healthcare law will mostly help you personally, will mostly hurt you personally, or don’t you think it will have much of an effect on you personally?”

	8/27/09–8/31/09	9/19/09–9/23/09	10/05/09–10/08/09	11/13/09–11/16/09	12/04/09–12/10/09
	%	%	%	%	%
Help	18	23	18	19	16
Hurt	31	26	31	34	34
No effect	46	44	45	41	42
Don’t know/No answer	5	7	6	6	8
N	648	1,042	829	1,167	1,031
	5/20/10–5/24/10	7/09/10–7/12/10	10/07/10–10/14/10a	1/05/11–1/09/11	12/05/11–12/07/11
	%	%	%	%	%
Help	16	13	18	18	13
Hurt	36	33	17	30	32
No effect	41	48	63	47	46
Don’t know/No answer	7	6	N/A	5	9
N	1,054	966	1,077	1,178	856
	3/21/12–3/25/12	7/18/13–7/22/13	9/19/13–9/23/13	10/18/13–10/21/13	11/15/13–11/18/13
	%	%	%	%	%
Help	19	13	18	13	15
Hurt	31	38	39	38	39
No effect	43	43	40	43	43
Don’t know/No answer	7	6	3	6	3
N	986	1,036	1014	1,036	1,010
	12/05/13–12/08/13
	%
Help	16
Hurt	34
No effect	46
Don’t know/No answer	3
N	1,000

^a10/07/10 Online, Knowledge Networks, response options: Mostly help you personally, Mostly hurt you personally, Won’t have much of an effect on you personally.

Table 33.

Healthcare Law Effect on Your Family—Prospective

Pew: “And looking ahead, do you think the overall effect of the (2010) healthcare law on you and your family over the coming years will be mostly positive, mostly negative, or will it not affect you much either way?”

	9/04/13–9/08/13	12/03/13–12/08/13	4/03/14–4/06/14	9/02/14–9/09/14
	%	%	%	%
Mostly positive	25	26	29	27
Mostly negative	41	38	35	38
Not much of an effect	31	32	30	33
Don’t know/Refused	4	4	6	3
N	1,506	2,001	1,010	2,002

Table 32.

Healthcare Law Effect on You and Your Family—Prospective

Kaiser Family Foundation: “Do you think (INSERT AND RANDOMIZE [you and your family]) will be (better off) or (worse off) under the health reform law, or don’t you think it will make much difference? [ROTATE OPTIONS IN PARENTHESES ACROSS INTERVIEWS, BUT NOT WITHIN SAME INTERVIEW] [READ IF NECESSARY: “Will (INSERT ITEM) be (better off) or (worse off) under the health reform law, or don’t you think it will make much difference?]”

	2/03/09–2/12/09	4/02/09–4/08/09	6/01/09–6/08/09	7/07/09–7/14/09
	%	%	%	%
Better off	38	43	39	39
Worse off	11	14	16	21
Not much difference	43	36	36	32
Depends (Vol.)a	4	4	3	4
Don’t know/Refused	3	4	5	3
N	1,204	1,203	1,205	1,205
	8/04/09–8/11/09	9/11/09–9/18/09	10/08/09–10/15/09	11/05/09–11/12/09
	%	%	%	%
Better off	36	42	41	42
Worse off	31	23	27	24
Not much difference	27	28	28	27
Depends (Vol.) a	2	4	2	3
Don’t know/Refused	4	3	3	4
N	1,203	1,203	1,200	1,203
	12/07/09–12/13/09	1/07/10–1/12/10	2/11/10–2/15/10	3/10/10–3/15/10
	%	%	%	%
Better off	35	32	34	35
Worse off	27	33	32	32
Not much difference	32	29	26	28
Depends (Vol.) a	3	3	3	2
Don’t know/Refused	3	4	5	3
N	1,204	2,002	1,201	1,208
	4/09/10–4/14/10	5/11/10–5/16/10	6/17/10–6/22/10	7/07/10–7/13/10
	%	%	%	%
Better off	31	36	28	32
Worse off	32	12	28	29
Not much difference	30	46	39	33
Depends (Vol.) a	–	–	–	–
Don’t know/Refused	8	5	5	6
N	1,208	1,210	1,207	1,504
	8/16/10–8/22/10	9/14/10–9/20/10	10/05/10–10/10/10	11/03/10–11/06/10
	%	%	%	%
Better off	29	32	31	25
Worse off	30	28	29	31
Not much difference	36	33	32	34
Depends (Vol.) a	–	–	–	–
Don’t know/Refused	5	7	7	9
N	1,203	1,200	1,202	1,502
	12/01/10–12/06/10	1/04/11–1/16/11	2/08/11–2/13/11	3/08/11–3/13/11
	%	%	%	%
Better off	32	20	28	26
Worse off	33	32	31	30
Not much difference	28	44	38	39
Depends (Vol.) a	–	–	–	–
Don’t know/Refused	7	4	3	5
N	1,207	1,502	1,202	1,202
	4/07/11–4/12/11	5/12/11–5/17/11	6/09/11–6/14/11	7/13/11–7/18/11
	%	%	%	%
Better off	27	28	24	27
Worse off	28	28	34	29
Not much difference	37	38	35	39
Depends (Vol.) a	–	–	–	–
Don’t know/Refused	8	6	7	5
N	1,207	1,203	1,203	1,201
	8/10/11–8/15/11	9/07/11–9/12/11	10/13/11–10/18/11	11/10/11–11/15/11
	%	%	%	%
Better off	24	27	18	23
Worse off	33	32	31	31
Not much difference	37	34	44	41
Depends (Vol.) a	–	–	–	–
Don’t know/Refused	6	7	6	5
N	1,201	1,207	1,223	1,209
	12/08/11–12/13/11	1/12/12–1/17/12	2/13/12–2/19/12	2/29/12–3/05/12
	%	%	%	%
Better off	26	26	27	26
Worse off	31	33	25	33
Not much difference	39	35	41	34
Depends (Vol.) a	–	–	–	–
Don’t know/Refused	5	6	7	7
N	1,212	1,206	1,519	1,208
	4/06/12–4/10/12	5/08/12–5/14/12	7/17/12–7/23/12	8/07/12–8/12/12
	%	%	%	%
Better off	26	23	25	26
Worse off	32	31	32	30
Not much difference	34	37	37	37
Depends (Vol.) a	–	–	–	–
Don’t know/Refused	8	9	6	7
N	1,210	1,218	1,227	1,208
	9/13/12–9/19/12	10/18/12–10/23/12	2/14/13–2/19/13	6/04/13–6/09/13
	%	%	%	%
Better off	31	26	24	19
Worse off	26	32	32	33
Not much difference	33	33	36	40
Depends (Vol.) a	–	–	–	–
Don’t know/Refused	9	9	9	8
N	1,534	1,215	1,209	1,505
	8/13/13–8/19/13	9/12/13–9/18/13	10/17/13–10/23/13	11/13/13–11/18/13
	%	%	%	%
Better off	23	24	21	20
Worse off	34	32	33	32
Not much difference	37	37	40	41
Depends (Vol.) a	–	–	–	–
Don’t know/Refused	6	7	6	7
N	1,503	1,503	1,513	1,204
	12/10/13–12/15/13
	%
Better off	18
Worse off	29
Not much difference	47
Depends (Vol.) a	–
Don’t know/Refused	6
N	1,206

^a”Depends” not allowed as a volunteered answer after 3/10/10.

Table 34.

Healthcare Law Effect on Your Family—Retrospective

Kaiser Family Foundation: “(Thinking again about the healthcare law that passed in 2010, also referred to as the Affordable Care Act or Obamacare ...) So far, would you say the healthcare law has directly helped you and your family, directly hurt you and your family, or has it not had a direct impact?”

	5/13/13–5/19/13	7/15/14–7/21/14	8/25/14–9/03/14	10/08/14–10/14/14
	%	%	%	%
Helped	14	15	14	16
Hurt	24	28	27	26
No direct impact	60	56	56	56
Both helped and hurt (Vol.)	*	*	1	1
Don’t know/Refused	2	1	1	1
N	1,505	1,507	1,505	1,503

*Less than .5%.

Table 37.

Healthcare Law Effect on Your Family—Retrospective

Pew: “So far, that is up until today, has the (2010) healthcare law had a mostly positive, mostly negative, or not much of an effect on you and your family?”

		9/04/13–9/08/13		12/03/13–12/08/13		4/03/14–4/06/14		9/02/14–9/09/14
		%		%		%		%
Mostly positive		17		15		17		19
Mostly negative		20		23		24		26
Not much of an effect		63		60		57		54
Don’t know/Refused		1		2		2		1
N		1,506		2,001		1,010		2,002

Table 35.

Healthcare Law Effect on Your Family—Retrospective/Benefit

Kaiser Family Foundation: “So far, would you say you and your family have personally benefited from the health reform law, or not?”

	12/01/10–12/06/10	2/08/11–2/13/11	3/08/11–3/13/11	5/12/11–5/17/11
	%	%	%	%
Yes, have benefited	15	14	13	14
No, have not benefited	81	84	84	82
Don’t know/Refused	4	3	3	4
N	1,207	1,202	1,202	1,203
	7/13/11–7/18/11	11/10/11–11/15/11	2/29/12–3/03/12	8/07/12–8/12/12
	%	%	%	%
Yes, have benefited	15	11	14	19
No, have not benefited	83	85	83	77
Don’t know/Refused	2	4	3	4
N	1,201	1,209	1,208	1,208
	3/05/13–3/10/13	10/17/13–10/23/13	12/10/13–12/15/13	1/14/14–1/21/14
	%	%	%	%
Yes, have benefited	17	14	11	15
No, have not benefited	78	82	85	83
Don’t know/Refused	4	4	4	2
N	1,204	1,513	1,206	1,506
	2/11/14–2/17/14	3/11/14–3/17/14	4/15/14–4/21/14
	%	%	%
Yes, have benefited	17	19	18
No, have not benefited	79	79	79
Don’t know/Refused	3	2	3
N	1,501	1,504	1,504

Table 36.

Healthcare Law Effect on Your Family—Retrospective/Negative Impact

Kaiser Family Foundation: “So far, would you say you and your family have been negatively affected by the health reform law, or not?”

	12/01/10–12/06/10	2/08/11–2/13/11	3/08/11–3/13/11	5/12/11–5/17/11
	%	%	%	%
Yes, have negatively affected	20	17	20	18
No, have not negatively affected	76	82	77	78
Don’t know/Refused	4	2	3	4
N	1,207	1,202	1,202	1,203
	7/13/11–7/18/11	11/10/11–11/15/11	2/29/12–3/03/12	8/07/12–8/12/12
	%	%	%	%
Yes, have negatively affected	18	18	21	19
No, have not negatively affected	78	78	76	77
Don’t know/Refused	4	4	4	4
N	1,201	1,209	1,208	1,208
	3/05/13–3/10/13	10/17/13–10/23/13	12/10/13–12/15/13	1/14/14–1/21/14
	%	%	%	%
Yes, have negatively affected	22	23	26	27
No, have not negatively affected	74	75	72	71
Don’t know/Refused	4	2	2	2
N	1,204	1,513	1,206	1,506
	2/11/14–2/17/14	3/11/14–3/17/14	4/15/14–4/21/14
	%	%	%
Yes, have negatively affected	29	29	30
No, have not negatively affected	69	69	67
Don’t know/Refused	2	2	3
N	1,501	1,504	1,504

Table 31.

How the Healthcare Law Will Affect the Future of Your Family

Gallup: “In the long run, how do you think the healthcare law will affect your family’s health care situation? Will it [ROTATED: make things better, not make much difference, (or will it) make things worse]?”

	2/20/12–2/21/12a	6/20/13–6/24/13b	8/17/13–8/18/13	10/26/13–10/28/13
	%	%	%	%
Make better	24	22	24	25
Not make much difference	34	33	34	36
Make worse	38	42	38	34
No opinion	5	3	5	5
N	1,040	2,048	1,021	1,530
	11/23/13–11/24/13	1/03/14–1/04/14	1/31/14–2/01/14	2/28/14–3/02/14
	%	%	%	%
Make better	20	22	24	21
Not make much difference	34	35	34	36
Make worse	41	37	37	40
No opinion	5	5	5	3
N	1,034	1,020	1,017	1,553
	4/07/20l4–4/08/14
	%
Make better	24
Not make much difference	42
Make worse	32
No opinion	2
N	1,009

^a2/20/12: “Now suppose all of the provisions of the healthcare law go into effect in the next few years. In the long run, how do you think the healthcare law would affect your family’s health care situation? Would it [ROTATED: make things better, not make much difference, (or would it) make things worse]?”

^bAsked on Gallup Poll News Service (non-tracking) poll.

Table 30.

Will the Proposed Healthcare Law Help or Hurt You Personally

CNN/ORC: “Thinking about the healthcare and health insurance that is available to you and your immediate family, do you think the proposals in the Senate bill would change things for the better, change things for the worse, or not make any real changes at all?”

	12/16/09–12/20/09	3/19/10–3/21/10a	3/25/10–3/28/10	9/21/10–9/23/10	9/27/13–9/29/13b
	%	%	%	%	%
Change for the better	22	19	22	18	17
Change for the worse	37	47	39	37	40
Not make real changes	39	33	37	43	41
Unsure	2	*	1	3	2
N	1,160	1,030	1,009	N/A	803
	12/16/13–12/19/13c	7/18/14–7/20/14d
	%	%
Change for the better	16	18
Change for the worse	42	35
Not make real changes	40	46
Unsure	2	1
N	1,035	1,012

*Less than .5%.

^a3/19/10 onward: “From what you know of that legislation, do you think you and your family would, in general, be better off, worse off or about the same if it becomes law?”

^b9/27/13: “From what you know of that legislation, do you think you and your family would, in general, be better off, worse off, or about the same when the provisions of the healthcare law take effect?”

^c12/16/13: “From what you know of that legislation, do you think you and your family will, in general, be better off, worse off, or about the same when the provisions of the healthcare law take effect next year?”

^d7/18/14: “From what you know of that legislation, do you think you and your family are, in general, better off, worse off, or about the same now that the major provisions of the healthcare law have taken effect?”

Conclusion

While support for change in healthcare policy rose between 2000 and 2009, most Americans’ opinions likely crystallized prior to 2009. Since 2009, the public’s level of support for government provision of healthcare rarely crested the 50 percent mark, usually hovering in the 40 percent range. Despite the rhetoric of the 2009 to 2010 ACA legislative debates, once an initial drop in the proportion of supporters occurred in early 2009, further shifts of aggregated opinion were modest. Overall, the evidence more strongly supports the thermostatic perspective rather than the strategic framing perspective. First, as postulated by the thermostatic model, Americans appear to allow particular political framing of specific events (e.g., the debut of the www.healthcare.gov site) temporarily to push their preferences for government provision of healthcare up or down, but an “equilibrium range” exists, a zone of support for government provision of healthcare toward which Americans tend to gravitate. Second, long-term policy feedback processes drive change, not tactical framing. The 2000 to 2006 period shows the greatest increase in support for healthcare reform. This growth is inexplicable through the strategic framing approach, since there was limited mass public debate or systematic framing. While there was a new policy, the MMA of 2003, we have no data to indicate that most Americans viewed the benefits obtained from the MMA positively. The thermostatic model does not require policy-specific feedback for systematic opinion change. In the thermostatic model, equilibrium ranges can shift in response to repeated shocks and macro-trends, such as the 2008 economic recession and the gradual stalling of income growth during the 2000–2006 period (Eichenberg and Stoll 2012; Soroka and Wlezien 2010). Third, what shifts have occurred since the implementation of the ACA fit the thermostatic model. After the ACA’s implementation, Americans’ support for additional government activity declined—the thermostatic model post-implementation prediction. The strategic framing model assumed that Americans would connect new material benefits derived from the ACA with support for the ACA. However, a large minority of Americans do not perceive benefits from the ACA. Until most Americans perceive benefits from the ACA, we cannot fully examine this component of the strategic framing model.

Appendix. Sources

The data presented in this article were collected from the American National Election Studies website (http://www.electionstudies.org); the ABC News/Washington Post poll archive websites http://abcnews.go.com/blogs/politics/polls/, http://www.langerresearch.com/content.php?i=9, and http://www.washingtonpost.com/wp-srv/politics/polls/postpollarchive.html; the Gallup website (http://www.gallup.com); the CBS News poll website http://www.cbsnews.com/news/cbs-news-poll-database/; the General Social Survey website (http://www3.norc.org/GSS+Website); the Kaiser Family Foundation website http://kff.org/polling/; Ipsos poll website http://www.ipsos-na.com/news-polls/us/; the NBC News/Wall Street Journal poll websites http://online.wsj.com/articles/the-wall-street-journalnbc-news-poll-1378786510?tesla=y and http://pos.org/insights/latest-presentations/; the Pew Research Center for the People and the Press website (http://www.people-press.org); the Polling Report website (http://pollingreport.com); the Real Clear Politics website http://www.realclearpolitics.com/epolls/other/obama_and_democrats_health_care_plan-1130.html; and the Roper Center for Public Opinion Research’s iPOLL Databank (http://www.ropercenter.uconn.edu).

Further information about these data can be obtained from the organizations enumerated below. All surveys are general population surveys unless otherwise noted.

Abbreviations

ABC/WP: ABC News/Washington Post

AP/GfK: Associated Press/GfK

CBS/NYT: CBS News/New York Times

CNN/ORC: Cable News Network/Opinion Research Corporation

GALLUP: Gallup Organization

GSS/NORC: General Social Survey/NORC at the University of Chicago

Ipsos: Ipsos

KFF: Kaiser Family Foundation

NBC/WSJ: NBC News/Wall Street Journal

NES: American National Election Studies

PEW: Pew Center for the People and the Press

Response rates are as follows:

ABC/WP: National sample. Modes are landline and cellular telephone. Languages are English and Spanish for most surveys during the past decade. (AAPOR RR1) 6/09, 8.4% (L), 3.6% (C); 8/09, 9.5% (L), 3.4% (C); 9/09, 8.2% (L), 3.6% (C); 10/09, 8.5% (L), 3.6% (C); 11/09, 8.8% (L), 2.9% (C); 12/09, 9.4% (L), 3.7% (C); 1/10, 9.8% (L), 3.3% (C); 2/10, 9.6% (L), 3.7% (C); 3/10, N/A (L), N/A (C); 9/10, 10.3% (L), 4.0% (C); 12/10, 9.1% (L), 4.2% (C); 1/11, 10.0% (L), 4.0% (C); 3/12, 10.1% (L), 4.5% (C); 4/12, 9.7% (L), 4.7% (C); 7/12, 9.8% (L), 4.6% (C); 7/13, 8.7% (L), 4.3% (C); 9/13, 9.2% (L), 4.2% (C); 10/13, 9.7% (L), 4.6% (C); 11/13, 9.0% (L), 4.3% (C); 12/13, 9.7% (L), 4.7% (C); 1/14, 9.0% (L), 4.7% (C); 3/14, N/A (L), N/A (C); 4/14, 8.3% (L), 4.6% (C); 9/14, 6.9% (L), 4.1% (C). L = landline and C = cellular.

AP/GfK: For surveys between 2010 and October 2013: National sample. Modes are landline and cellular telephone. English language surveys. (AAPOR RR3) 9/10, 10% (L), 7% (C); 10/10, 9% (L), 5% (C); 11/10, 8% (L), 5% (C); 1/11, 9% (L), 10% (C); 3/11, 8% (L), 9% (C); 6/11, 9% (L), 9% (C); 3/12, 8% (L), 10% (C); 6/12, 14% (L), 12% (C); 10/13, 50% (CR); 12/13, 50% (CR); 1/14, 48% (CR); 3/14, 46% (CR); 5/14, 44% (CR); 9/14, 47% (CR). L = landline, C = cellular CR = cooperation rate. Surveys after October 2013 were conducted by the GfK KnowledgePanel after the purchase of Knowledge Networks by GfK. The method for calculating the cooperation rate for the GfK KnowledgePanel was not supplied by GfK.

CBS/NYT: National sample. Modes are landline and cellular telephone. Languages are English and Spanish for most surveys during the past decade. (AAPOR RR1) 7/00, N/A; 1/06, N/A; 2/07, 16%; 3/09, 12%; 6/09, 10%; 7/09, 9%; 8/09a&b, 10%; 9/09, N/A; 10/09, 8%; 11/09, 14%; 12/09, 15%; 5/10, 13%; 7/10, 8%; 9/10, 9%; 10/10, 10%; 10/10b, N/A (Knowledge Networks online poll); 1/11, 10.%; 2/11, 10%; 6/11, 10%; 12/11, 7%; 3/12, 9%; 4/12, 8%; 7/12, 9%; 9/12, 10%; 10/12, 6%; 1/13, 9%; 3/13, 7%; 7/13, 7%; 9/13, 7%; 10/13, 9%; 11/13, 7%; 12/13, 8%; 1/14, 7%; 3/14, 7%; 7/14, %; 9/14, 6%.

CNN/ORC: Not available. ORC requires fee for service.

GALLUP: National sample. Modes are landline and cellular telephone. Languages are English and Spanish for most surveys during the past decade. (AAPOR RR3) Cross Section surveys: 5/93, N/A; 9/94 N/A; 1/00, 27%; 9/00, 20%; 11/01, 20%; 11/02, 16%; 11/03, 16%; 11/04, 18%; 11/05, 17%; 11/06, 15%; 11/07, 13%; 11/08 12%; 3/09, 12%; 11/09, 12%; 11/10, 10%; 11/11, 10%; 11/12, 9%; 6/13, 6%; 11/13, 6%. Tracking surveys: 2012, 11%; 2013, 12%; 2014, 11%.

NORC/GSS: National sample. Mode is face to face, CAPI beginning in 2002. English only until 2004, English and Spanish beginning in 2006. (AAPOR RR5) 1985, 78.7%; 1990, 73.9%; 1996, 76.1%; 2000, 70.0%; 2002, 70.1%; 2004, 70.4%; 2006, 71.2%; 2008, 70.4%; 2010, 70.3%; 2012, 71.4%.

Ipsos: National sample. Mode is telephone. Languages are English and Spanish. (AAPOR RR2) “We do not still have the fieldwork records for those surveys easily accessible. Our response rate (AAPOR RR2) tended to come in around 5% during that time period.” E-mail communication with Ipsos on 11/21/2014.

KFF: National sample. Modes are landline and cellular. Languages are English and Spanish for most surveys during the past decade. (AAPOR RR3) 2/03, 30%; 11/04, 71.4%; 11/06, 27%; 3/07, 28%; 8/07, 20%; 10/07, 25%; 11/07, 38%; 5/07, 19%; 2/08, 22%; 9/08, 25%; 10/08, 25%; 12/08, 34%; 2/09, 22% (L), 21% (C); 4/09, 22% (L), 23% (C); 6/09, 24% (L), 26% (C); 7/09, 22% (L), 25% (C); 8/04/09, 22% (L), 23% (C); 8/27/09, 31%; 9/09, 24% (L), 24% (C); 10/09, 21% (L), 19% (C); 11/09, 23% (L), 23% (C); 12/09, 23% (L), 22% (C); 1/10, 24% (L), 26% (C); 2/10, 23% (L), 23% (C); 3/10, 23% (L), 22% (C); 4/10, 22% (L), 22% (C); 5/10, 22% (L), 21% (C); 6/10, 21% (L), 20% (C); 7/10, 23% (L), 20% (C); 8/10, 22% (L), 20% (C); 9/10, 22% (L), 21% (C); 10/10, 23% (L), 19% (C); 11/10, 23% (L), 18% (C); 12/10, 22% (L), 18% (C); 1/11, 22% (L), 21% (C); 2/11, 22% (L), 19% (C); 3/11, 22% (L), 20% (C); 4/11, 22% (L), 20% (C); 5/11, 21% (L), 20% (C); 6/11, 22% (L), 29% (C); 7/11, 22% (L), 29% (C); 8/11, 21% (L), 19% (C); 9/11, 22% (L), 19% (C); 10/11, 21% (L), 20% (C); 11/11, 22% (L), 21% (C); 12/11, 22% (L), 21% (C); 1/12, 21% (L), 22% (C); 2/13/12, 26% (L), 20% (C); 2/11, 22% (L), 19% (C); 2/29/12, 25% (L), 21% (C); 4/12, 24% (L), 21% (C); 5/12, 24% (L), 21% (C); 6/12, 17% (L), 14% (C); 7/12, 13% (L), 12% (C); 8/12, 13% (L), 12% (C); 9/12, 12% (L), 11% (C); 10/12, 12% (L), 9% (C); 11/12, 13% (L), 11% (C); 2/13, 10% (L), 9% (C); 3/13, 11% (L), 13% (C); 4/13, 10% (L), 11% (C); 6/13, 10% (L), 9% (C); 8/13, 10% (L), 9% (C); 9/13, 9% (L), 9% (C); 10/13, 9% (L), 10% (C); 11/13, 10% (L), 11% (C); 12/13, 10% (L), 10% (C); 1/14, 9% (L), 10% (C); 2/14, 8% (L), 9% (C); 3/14, 8% (L), 11% (C); 4/14, 8% (L), 9% (C); 5/14, 8% (L), 9% (C); 6/14, 8% (L), 9% (C); 7/14, 8% (L), 8% (C); 8/14, 8% (L), 8% (C); 10/14, 8% (L), 9% (C). L = landline and C = cellular.

NBC/WSJ: National Sample. Modes are telephone, landline, and cell phone. English language surveys. (AAPOR RR3) NBC/WSJ/Public Opinion Strategies (POS) declined to give full disclosure of their response rates. POS opted to send us response rates for one survey from 2012 and one survey from 2013 as examples of their response rates. E-mail communications 12/1/2014–12/15/2014. Sadly, the response counts provided do not match any survey response counts available from the surveys we provided POS during 2012 or 2013. As a result, we do not have response rates to report.

NES: National sample. Modes are face to face, telephone, and online. Languages are English and Spanish (Spanish interviewing began in 2008). (AAPOR RR1) 1992 (72 percent; re-interview 89 percent); 1994 (Overall 74.1 percent, X-Section 72.1 percent, Panel 77.0 percent); 1996 (71 percent; re-interview 90 percent); 2000 (61.2 percent; re-interview 86.0 percent); 2002 (55.8 percent; re-interview 89.1 percent); 2004 (66.1 percent; re-interview 88.0 percent); 2008 (Not yet calculated); 2012 (face to face 38 percent/online 2 percent; re-interview face to face 94 percent/online 93 percent).

PEW: National sample. Modes are landline and cellular telephone. Languages are English and Spanish for most surveys during the past decade. (AAPOR RR3) 7/09, 14.5% (L), 10.5% (C); 8/09, 15.5% (L), 15.2% (C); 9/10/09, 14.8% (L), 10.1% (C); 9/30/09, 18.8% (L), 14.7% (C); 10/09, 18.5% (L), 13.7% (C); 11/09, 18.5% (L), 14.4% (C); 12/09, 15.2% (L), 10.0% (C); 1/10, 14.7% (L), 9.9% (C); 2/10, 17.7% (L), 7.4% (C); 3/10/10, 18.4% (L), 13.3% (C); 3/11/10, 16.4% (L), 11.9% (C); 4/10, 13.8% (L), 10.6% (C); 7/10, 13.3% (L), 17.6% (C); 8/10, 16.5% (L), 11.0% (C); 9/10, 15.2% (L), 18.9% (C); 11/10, 12.6% (L), 10.2% (C); 1/11, 15.4% (L), 8.8% (C); 3/12, 10.9% (L), 6.5% (C); 4/12, 11.4% (L), 7.0% (C); 6/07/12, 11.3% (L), 5.6% (C); 6/28/12, 6 segments (11.7% (L-RDD), 5.7% (C-RDD), 1.3% (L-screen unaffiliated), 1.3% (C-screen unaffiliated), 20.7% (L-callback unaffiliated), 21.3% (C-callback unaffiliated)); 9/13, 8.5% (L), 5.7% (C); 10/13, 12.0% (L), 8.2% (C); 12/13, 9.4% (L), 6.1% (C); 2/14, 11.2% (L), 10.0% (C); 4/03/14, 6.6% (L), 10.2% (C); 4/23/14, 8.4% (L), 8.5% (C); 9/14, 8.1% (L), 8.2% (C). L = landline and C = cellular.