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Health Reform Opposition From The Left

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As you probably know, we run a chart on that aggregates the various questions asked on national surveys about general support or opposition to (variously) "President Obama's health care plan," "the health care reform proposals being discussed," and so on. Although these questions show a lot of variation from pollster-to-pollster, the overall patterns and trends have been reasonably consistent: Most surveys have shown more opposition than support, and support has declined modestly over the last month.

Support has fallen in recent weeks from the 43% and 45% range where our trend estimate had been from Labor Day through early November to 39% as of this writing. Meanwhile, opposition has risen from a range of 47% to 49% over much of the fall to 53% today. That trend is reasonably robust across pollsters, showing up on Rasmussen surveys, other polls that sample registered or likely voters, and traditional live interviewer telephone polls that sample adults. Again, the current level of opposition is slightly lower (47%) in the all adult samples than the likely/registered voter samples (53%), but that gap is roughly consistent with what we see for presidential approval.

A few weeks ago, New Republic columnist Jonathan Chait wrote that despite the apparent opposition, "health care reform actually remains quite popular." The problem with the general favor-or-oppose question about health care reform, he argued, "is that it lumps together Obama's critics from the right with those from the left." Other questions he cited appear to show that "majorities of the public either support Obama's approach or wish it went further."

At about the same time, the pollsters at CNN and the Ipsos-McClatchy poll were testing follow-up questions that provided an effective test of Chait's theory. I wrote about the CNN results in my own column, Ipsos pollsters Cliff Young and Aaron Amic wrote up their results in a guest post, and Nate Silver chimed in as well. The gist of both results was that a big chunk of opposition appeared to come from the left: 10% of the total CNN sample who said they oppose the reform bill because it is "not liberal enough," and 12% of the Ipsos sample who say they oppose reform because it "does not go far enough."


This week, the Democratic leaning pollster PPP released results of an automated survey showing more overall opposition and asking a different follow-up question showing only 3% opposing reform because "it doesn't involve government enough." So at the very least we have some inconsistency: The CNN and Ipsos surveys imply that a majority of Americans "favor either the House-passed version of health care reform or something further to the left," as Alan Reifman puts it, while in the PPP survey the combination of those who support or something further left (42%) is still less than the number who oppose reform because "it gets government too involved in health care" (47%).

Why the inconsistency? As usual, there are many possibilities: three different though similarly structured questions, two different populations (registered voters and all adults), two different modes (automated and live interviewer), different timing and ordinary random sampling error. Choose your own theory, I'm not going to begin to speculate about which is best.

I can shed some light on one issue raised earlier today by my Atlantic colleague Megan McArdle. As she points out, "going too far," the follow-up phrase from the Ipsos survey, has many potential interpretations:

I could go down to [the] Cato [Institute] right now and poll 65% support for the proposition that the health care reform doesn't go far enough--in the direction of taking away the employer health care tax exemption, means testing Medicare, and other ideas that no one would call "left". Republicans who want liability caps and bigger HSAs might have similar complaints.

As it happens, I asked the folks at IPSOS for some tabulations this week that help shed a little light on that question. The results are what we might expect in some ways and surprising in others. On the one hand, the 136 respondents who said they oppose the current proposals because they "don't go far enough to reform health care" lean Republican (54% to 38%) -- not surprising, given that most of the opposition is Republican or independent. Like those who think reform goes too far, they overwhelmingly oppose "a single payer system in which the government controls the entire healthcare insurance system" (85% to 15%).

On the other hand, the same group, those who opposes reform because "it does not go far enough", supports the public option concept (59% to 35% - described as "creation of a public entity to directly compete with existing health insurance companies"). In contrast, those who oppose reform because it "goes too far" also oppose the public option by a nearly two-to-one margin (62% to 32%).

The picture you should get from all of this is a lot of fuzziness of opinion, and I think that's the most important point.

Yes, the gradual increase in opposition to health care reform over the last month should concern reform supporters, and yes, it's important to take into account that some of the expressed "opposition" on these questions is coming from the left rather than the right. But my main advice in interpreting these results echoes something that Young and Amic argued here last week: We mislead ourselves by treating the general favor-or-oppose-reform question as analogous to a measure of candidate preference before an election

[P]olling on healthcare reform is quite different than polling on presidential elections because our "true value" is not fixed. This makes the construction of singlequestions impossible and misleading. Such issues are, well, fuzzy and, therefore, only a multiple indicators approach will tell the entire story-some generic, some specific questions.

I'll have more to say on that question in my next column on Monday.