Tony Leys

tleys@dmreg.com

© COPYRIGHT 2017, DES MOINES REGISTER AND TRIBUNE COMPANY

Iowans have grown fonder of Obamacare as its potential demise looms larger, a new Des Moines Register/Mediacom Iowa Poll shows.

Iowa adults are evenly split over whether the law, also known as the Affordable Care Act, has been mostly a success or mostly a failure. Forty-five percent believe it has been mostly a success, and 46 percent say it has been mostly a failure, the new poll shows. In an Iowa Poll in October, 32 percent of Iowans saw it as mostly a success, and 59 percent said the law was mostly a failure.

Last October’s poll came as Americans were gearing up to elect Republicans who vowed to repeal and replace Obamacare. The new poll comes as President Donald Trump and his fellow Republicans seek ways to fulfill the pledge.

The new poll shows most of Obamacare’s main elements remain popular with Iowans. For example, 87 percent of Iowans want to retain a ban on insurance companies denying coverage to people with pre-existing health problems. Seventy-nine percent want to keep the law’s requirement that insurance companies allow parents to keep their children on their policies until age 26. Seventy-one percent want to retain an expanded Medicaid program to cover more poor adults, and 59 percent want to maintain subsidies to help moderate-income Americans pay insurance premiums.

The only major portion of the law that most Iowans want to see repealed is a requirement that all Americans have insurance coverage or pay a penalty. Fifty-nine percent of Iowans want to see the requirement repealed, the poll shows. (The poll question did not note that consumers unable to find affordable coverage can seek an exemption to the requirement.)

The poll’s results reflect continuing sharp partisan differences on the law. Among Iowa Republicans, 89 percent see Obamacare as mostly a failure. Among Iowa Democrats, 83 percent see it as mostly a success. Political independents are evenly split, with 46 percent seeing Obamacare as mostly a success and 45 percent seeing it as mostly a failure.

But even among Republicans, most people like some sections of the law. For example, 64 percent of Iowa Republicans want to retain the rule allowing parents to keep their sons and daughters on their insurance until age 26. And 80 percent of Iowa Republicans would retain the Obamacare rule barring insurers from denying coverage to people with pre-existing health problems. But 59 percent of Iowa Republicans want to end the premium subsidies for moderate-income Americans, and 77 percent of Iowa Republicans want to end the requirement that most Americans have health insurance.

The Iowa Poll, conducted Feb. 6-9 by Selzer & Co. of Des Moines, is based on telephone interviews with 802 Iowans ages 18 or older. The poll has a margin of error of plus or minus 3.5 percentage points.

Poll participant Corey Baldwin of Cresco is among those who see the Affordable Care Act as mostly a failure, even though he has gained benefits from it. Baldwin, 44, is a self-employed truck driver who buys his own insurance. He bought a subsidized policy three years ago for about $50 per month. Since then, he’s seen his share of the monthly premium rise to $130 per month. “It just keeps going up and up and up,” he said.

Baldwin, who is a political independent, doesn’t think the entire law should be scrapped. For example, he’s a big believer in the ban on insurers denying people coverage due to pre-existing health problems. However, he wants Congress to spike the rule requiring most people to have coverage or pay a penalty. “I think nobody should be forced to buy anything — and if they have to go to the doctor, then that’s on them. We can’t babysit everyone,” he said.

Insurance companies contend they couldn’t afford to offer coverage to people with pre-existing health problems unless consumers are required to buy policies before they become ill. Otherwise, the companies say, healthy people might wait to buy insurance until they need it. That would be like letting people delay buying homeowners’ insurance until their houses catch fire, the insurers say.

Baldwin said he understands that argument, but he said leaders need to figure out a fair way to solve the problem without requiring Americans to buy health insurance.

Poll participant Wendy Rodriguez of Coralville thinks Obamacare has been mostly a success. Rodriguez, 23, is a Democrat and a nursing assistant at University of Iowa Hospitals and Clinics. She sees firsthand how many Iowans have benefited from gaining coverage under the Affordable Care Act.

“It should be a right for Americans to have insurance. It should be a benefit of being part of this country,” she said.

Rodriguez said it stands to reason that more Iowans have come to appreciate the law as they hear about how it helps many of their fellow citizens. “People are like, ‘Hey, it wasn’t that bad,’” she said.

The new Iowa Poll’s findings are similar to national polls’. For example, a Wall Street Journal/NBC News poll published in January found that 45 percent of Americans believed the Affordable Care Act was “a good idea.” That was the highest mark it had ever scored in the poll. Just 41 percent saw the law as “a bad idea,” down from 50 percent in late 2013. A national Fox News poll published last month found only 23 percent of Americans wanted the law repealed entirely. That was down from 39 percent in June 2013.

A Kaiser Family Foundation poll taken shortly after the election found that just 26 percent of Americans wanted the entire law repealed. Seventeen percent said they wanted the law “scaled back,” 19 percent wanted it implemented as is, and 30 percent wanted it expanded.

Liz Hamel, who oversees polling for the Kaiser Family Foundation, said more Americans are expressing reservations about abruptly repealing the Affordable Care Act. “They’re starting to focus on what people might lose if it’s taken away,” she said.

Hamel noted polls show the issue remains highly partisan, with Republicans being much more critical of the law than Democrats or independents are. After Obamacare was enacted, proponents had hoped for a response similar to what the nation saw after Medicare became law in 1965, Hamel said. Medicare faced initial Republican skepticism, which eased over time as many older Americans benefited from the program, she said. “But we haven’t seen that with the ACA,” she said.

Brian Kaskie, an associate professor of health policy at the University of Iowa, said much of the animosity toward Obamacare appears to stem from conservatives’ general distaste for the Democratic Party and for former President Barack Obama. But many polls show popularity for most of the law's major components, such as the ban on insurers denying coverage to people with pre-existing health problems.

“When you take away the window dressing — the Obamacare title — people say, ‘Oh, that’s what it is?’ It’s hard to be against many of these things,” Kaskie said.

The professor said the latest poll findings suggest critics’ general disapproval for Obamacare is being tempered by concerns about Congress moving too quickly to pull it down without concern for how the repeal could harm many Americans.

About the poll

The Iowa Poll, conducted Feb. 6-9 for The Des Moines Register and Mediacom by Selzer & Co. of Des Moines, is based on telephone interviews with 802 Iowans ages 18 or older. Interviewers with Quantel Research contacted households with randomly selected landline and cellphone numbers supplied by Survey Sampling International. Interviews were administered in English. Responses were adjusted by age and sex to reflect the general population based on recent census data.

Questions based on the sample of 802 Iowa adults have a maximum margin of error of plus or minus 3.5 percentage points. This means that if this survey were repeated using the same questions and the same methodology, 19 times out of 20, the findings would not vary from the percentages shown here by more than plus or minus 3.5 percentage points. Results based on smaller samples of respondents — such as by gender or age — have a larger margin of error.

Republishing the copyright Iowa Poll without credit to The Des Moines Register and Mediacom is prohibited.

Poll methodology is available here.