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In the midst of a government shutdown stemming from Republican opposition to the Affordable Care Act, we’ve heard many times that the controversial law has a consistently low approval rating.
President Barack Obama’s response to that criticism is that his signature health care law isn’t the only one that had a rocky start in the polls.
He says Medicare Part D, the subsidized prescription drug program for seniors, faced the same struggle at first.
"At the time that (Medicare Part D) was passed (it) was actually less popular than the Affordable Care Act, according to the polls," he told NPR in an interview that aired Oct. 1, 2013.
We decided to check into the poll results.
The prescription drug benefit was signed into law by President George W. Bush in December 2003 as part of the Medicare Modernization Act. The program passed by a close margin after Republican leadership whipped votes for several hours.
February 2004 poll results from the nonpartisan Kaiser Family Foundation, which experts told us did the most thorough work on the issue, show that 25 percent of adults favored Part D, while 38 percent had an unfavorable view. The rest were either neutral or didn’t know.
Those numbers didn’t change much until November 2006, after the enrollment period had been open nearly a year, said Jack Hoadley, a health policy analyst at Georgetown University.
By contrast, in September 2013 the Affordable Care Act registered a 39 percent favorable rating and a 43 percent unfavorable rating, according to Kaiser. That hasn’t changed all that much since the law was drafted in 2009.
So if Obama was measuring how many people liked Medicare Part D (25 percent) compared with the health care law (39 percent), he’s right that Obamacare is more popular.
But the health care law also has higher unfavorable ratings. Polling shows that 43 percent have an unfavorable view of Obamacare, while fewer, 38 percent, had an unfavorable view of Medicare Part D.
We’ll note that those who didn’t want to express an opinion about Medicare Part D was much higher than the health care law, at 37 percent versus 17 percent.
Both polls have a margin of error of 3 percentage points. Factoring these in leaves unfavorability ratings a wash, while Obamacare still sees a significantly higher favorability rating.
As for the point Obama intended to make by noting the statistics, that Medicare Part D became more popular as people became familiar with it, we found that also holds water. Today, 9 out of every 10 seniors are satisfied with Medicare Part D, though we should note that’s according to the Healthcare Leadership Council, which is made up of health care executives.
"When you think of the popularity of Part D today, it’s easy to forget how divided people were," Hoadley said. "People felt like they didn’t have enough information to understand the program."
Of course, it’s too soon to say if Obamacare will have the same long-term success in the public eye. Robert Blendon, a Harvard University health policy professor, said that poll results could start to shift as early as May, after enough people have had personal experiences with the law.
"It’s going to be a consumer issue rather than a policy issue," Blendon said.
Obamacare’s popularity will also be affected in the next few years by the rhetoric of elections in 2014 and 2016, Hoadley said. So while people could look back years from now and not remember the act being a sharply divided policy issue, that shift won’t likely happen overnight.
Now, the comparison Obama sets up isn’t the most straightforward, Blendon said. The prescription drug program for seniors is just one part of Medicare, which began in 1965. For students of politics, comparing Medicare itself with Obamacare would be more apples-to-apples. The former was favored by a majority of Americans at the time it was passed.
To illustrate that the Affordable Care Act can overcome its low popularity ratings, Obama claimed that Medicare Part D was even less popular when it first passed. Polling data shows that a lower percentage of people favored Part D in 2004 than favor Obamacare in 2013. However, depending on the margin of error, a slightly higher percentage of people may view the president’s reform unfavorably compared with Part D. We rate Obama’s statement Mostly True.
The Center on Health Insurance Reforms, "Launching the Medicare Part D Program: Lessons for the New Health Insurance Marketplaces," June 2013
Email interview with Eric Schultz, White House spokesman, Oct. 2, 2013
Kaiser Family Foundation, "March/April 2005 Health Poll Report Survey," April 2005
Kaiser Family Foundation, "January/February 2004 Health Poll Report Survey," February 2004
Kaiser Family Foundation, "Kaiser Health Tracking Poll: September 2013," Aug. 28, 2013
KRC Research, "Seniors’ Opinions About Medicare Prescription Drug Coverage," Sept. 2013
NPR, "Transcript and Audio: NPR Interview with President Obama," Oct. 1, 2013
Phone interview with Jack Hoadley, Georgetown University health policy professor, Oct. 2, 2013
Phone interview with Robert Blendon, Harvard University health policy professor, Oct. 2, 2013
PolitiFact, "Obamacare ‘Has Never Been Favored By a Majority of Americans,’ Gingrich Says," Sept. 26, 2013
Voicemail from Michael Traugott, political communication professor at University of Michigan, Oct. 3, 2013
Washington Post, "Lessons from the Medicare Prescription Drug Benefit Vote," March 8, 2010
Washington Post, "Part D Was Less Popular Than Obamacare When It Launched," June 21, 2013
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