03/23/2010 03:05 pm ET Updated May 25, 2011

Health Reform and the Will of the People

Both sides of the epic health care reform battle continued to invoke the view of "the people" over the last few days. A few hours after the bill passed, President Barack Obama described it as "a victory for the American people."    A few hours earlier, House Minority Leader John Boehner described the bill as something that would "defy the will of our fellow citizens, and the day before he said that Americans "want no part of this bill" and "haven't been shy about saying so."   

Unfortunately, poll questions do not easily resolve the argument about where the American people stand. Yes, most surveys asking about the reform bill in general terms show more opposition than support, but the variance is considerable. In the last week or so, we have seen surveys of Americans showing everything from a four-point plurality (46% to 42%) favoring the "the health care proposals being discussed in Congress" on the Kaiser Family Foundation survey, to a twenty-point majority (59% to 39%) opposing the "final legislation that would make major changes in the country's health care system" that the "U.S. House of Representatives and the U.S. Senate are trying to pass" on the CNN/ORC poll.**

Of course, a follow-up question on that same CNN poll found finds nearly a quarter of the opponents (and 13% of all adults) say they oppose the legislation because it is "not liberal enough." Thus, even though 59% express opposition, just 43% oppose the legislation because it is "too liberal." They have obtained comparable results on two prior surveys since November (more here).

The CNN follow-up is important because it demonstrates that the "will" of the American people takes more than a single question to discern. That said, I would be careful about interpreting the 13% statistic too literally. A big chunk of that number likely includes Americans who prefer a single-payer system or a government run "public option." But it may also include others who, as our friend Brenden Nyhan points out, may not know what "liberal" means. But either way, the results show that attitudes on health reform are difficult to force into a simple favor-or-oppose categories.

Much of the variation from survey-to-survey owes to subtle differences in questions language, format and order, showing that despite nearly a year of news coverage, many Americans remain unaware of the details of the actual legislation. Chicago Tribune columnist Eric Zorn notices that even in Barack Obama's Chicago, today's front pages "suggest a truth I've long maintained -- that most people haven't really been following the fine points of the debate over health-care reform and have been waiting for the bickering in Washington to subside before taking a close look and reaching a verdict" (h/t Smith).


Taking a look at the various differences in polling results in a must-read blog post today, ABC News polling director Gary Langer reaches a conclusion that's consistent with Zorn's observation:

Each side likes to lay claim to the high ground in public opinion, and may be able to pull out individual data points supporting its case. Clearly, as has been covered in detail, views on the plan are highly partisan. Nonetheless in sum, evaluating the data below and the many other results we've seen over the past months, it seems best to describe public attitudes on health care reform as divided.

That means there's opportunity ahead for each side to make its case - and while the future's unknown, we do have one recent experience to consider: In our polling in April 2006, just 41 percent of adults overall, and 50 percent of seniors, supported the expansion of prescription drug coverage in Medicare that had just passed the Congress. By 2008, in an AARP poll of seniors who were enrolled in the program, 67 percent described themselves as very or extremely satisfied with it.

I think that's right, if not over the next six months, then certainly over the longer haul (see my column from September for more).   

**And just as I was posting this entry, we get word of a new USA Today/Gallup poll, conducted since the House vote on which 49% of Americans say "it is a good thing" that "the U.S. House of Representatives passed a bill that restructures the nation's healthcare system" and only 40% say it is a "bad thing."