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Affordable Care Act Continues to Outpoll Bush's Medicare Rx Launch

November 19, 2013

While Republicans and their media echo chamber have been quick to pronounce the Affordable Care Act "dead on arrival" and its troubled launch "Obama's Katrina," polling suggests the American people have reached no such conclusion. A Reuters/Ipsos survey conducted last weekend found that 41 percent of respondents approve of the ACA, little changed from a month before. Meanwhile, the latest United Technologies/National Journal Congressional Connection Poll found that less than two in five support the law's repeal, "virtually unchanged since last summer."
But lost in the flurry of polls is a helpful bit of context to another major health care program that cost Washington hundreds of billions of dollars and impacted over 40 million people. As it turns out, the numbers show that President Bush's Medicare Part D prescription drug plan, a program that now enjoys 90 percent approval from America's seniors, was far more unpopular during its launch than Obama's Affordable Care Act is now.

The charts from the Kaiser Family Foundation tell the tale. Since its passage in March 2010, support for and opposition to the Affordable Care Act has been largely unchanged. But KFF's polling of seniors' views of the Bush Medicare drug plan showed it consistently more unpopular than the ACA, with disapproval spiking during its launch in the fall of 2005. And that dismal performance was for a program for which enrollment was voluntary and the coverage fully paid by Uncle Sam.
The headlines in late 2005 and early 2006 explain why. The launch of the enrollment period for 43 million seniors to use their new drug benefit to purchase prescription coverage from private insurers was met with stories like "Medicare prescription drug plan stump seniors" (USA Today), "Officials' pitch for drug plan meets skeptics" (New York Times), "Medicare drug plan still not generating much enthusiasm" and "majority of Americans say drug plan is not working" (Gallup). As Sarah Kliff explained in June, "Part D was less popular than Obamacare when it launched":

Eight years ago, the federal government rolled out Medicare Part D, a prescription drug benefit. For the first time ever, Medicare was launching a benefit administered exclusively through private health insurance plans. The benefit was not popular: In the spring of 2005, when enrollment efforts ramped up, polls showed Medicare Part D to be less popular than the Affordable Care Act. Fewer Americans felt they understood how it worked, too...
Neither was especially popular in the months prior to their launch. Part D was even less liked: 21 percent of the public had a favorable opinion of the program in April 2005 compared to 35 percent in April 2013 for the Affordable Care Act.

Americans' disdain for the Medicare drug plan was understandable, giving its disastrous launch. As I explained previously:

The nonpartisan Government Accountability Office (GAO) ruled that some of the administration's ads promoting the new program were illegal while others were misleading. GAO investigators also found that the White House illegally withheld data from Congress on the cost of the new law. The Congressman who crafted the bill soon left Capitol Hill for K Street, where he made millions of dollars annually as a heath care lobbyist.
The new federal web site allowing people to compare plans and prices was delayed by weeks, while just 300 customer service reps manned the phones to help new enrollees. Yet over six million people immediately lost their coverage, while hundreds of thousands more would be refused treatment because of malfunctions in the computer systems linking providers and insurers. In response to the mushrooming crisis, governors in mostly Democratic states spent billions to continue coverage for their residents, while the President pleaded with insurance companies not to cut off their current policyholders. Nevertheless, the White House sided with insurers and rejected bipartisan calls to delay the enrollment deadline even as public approval plummeted to 25 percent. It's no wonder John Boehner called the rollout of the President's signature domestic policy achievement "horrendous."

But despite its catastrophic rollout, President Bush's Medicare prescription drug plan slowly but surely gained popularity over time. One key reason is that, despite their opposition to a program that was needlessly expensive and a giveaway to private insurers and pharmaceutical companies, Democrats on Capitol Hill and in the states helped make the program a success. Part D also had one other thing going for it. It was better than the alternative: nothing.
So Republicans now tap-dancing on Obamacare's grave would do well to put their celebration on hold. If Medicare's experience is any indication, a year--or two or three--from now the polling numbers will be looking much positive for the Affordable Care Act.


Jon Perr
Jon Perr is a technology marketing consultant and product strategist who writes about American politics and public policy.

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