Healthy Skepticism

Wednesday, September 29, 2010

The Democrats made a strategic choice to pass health reform even though they knew it did not have majority support. They assumed its passage would generate a positive initial response from the media—which it did. They also hoped that with time voters would see reform in a more favorable light, and that health care would not pose an issue in the midterm elections. Were the Democrats right? If our polling is correct, they were not.

In January, we asked voters in eleven states that could have competitive Senate races in November—Arkansas, Colorado, Connecticut, Delaware, Florida, Louisiana, Missouri, Nevada, North Dakota, Ohio, and Pennsylvania—how they felt about health reform and how they were likely to vote. The polls were conducted by YouGov using a panel of Internet users selected to represent registered voters in each state. We found widespread opposition to reform—and to the Democratic senators who voted in favor of it.

In May, we went back to the same voters and asked the same questions. We found that public opinion about health reform was roughly stable, and opposition to reform appeared to be an important determinant of voting intention in the midterm elections—particularly for political independents.

In January, a majority in each of the eleven states opposed health reform. Not surprising, public opinion was more favorable in the more liberal states. Voters in Connecticut opposed reform by a ratio of 55 percent to 45 percent, whereas voters in Louisiana opposed reform 63 percent to 37 percent. In key battleground states like Colorado and Ohio, voters opposed reform 58 percent to 42 percent.

In January, voters who opposed health reform were 24 points more likely to vote Republican. By May, they were 44 points more likely.

By the end of May, opposition had generally declined, although the declines were small and not statistically significant. Notably, health reform’s biggest gains had come in the most liberal states, where election outcomes are less in doubt. Opinion about reform in Connecticut was now evenly split at 50/50; opinion in Louisiana had gone more negative, to 64 percent against and 36 percent for. In battleground states, opposition to reform had hardly budged. Voters in Colorado and Ohio still opposed reform 56 percent to 44 percent and 57 percent to 43 percent, respectively.

To determine how this is likely to affect the midterms, we used a statistical model to isolate the independent impact of people’s opinion about health reform, one factor among many of their candidate preferences. In our model, we controlled for people’s party identification; their self-reported ideology and 2008 presidential vote; their current opinion about President Obama; and an extensive set of demographic characteristics including age, gender, race, income, education, state of residence, and health insurance status.

In both January and May, opinion about reform had a statistically significant and electorally important impact on intention to vote against the Democratic candidate for Senate. Voters who opposed health reform were around 20 percentage points more likely to vote for the Republican candidate.

We also asked the standard generic ballot question, “If the 2010 elections for the House of Representatives were held today, would you vote Democrat or Republican?” If anything, the effect of health reform on House races is even larger than the 20-point effect on Senate races. In January, voters who opposed health reform were 24 points more likely to vote Republican. By May, they were 44 points more likely. This is consistent with Charles Franklin’s analysis in showing that, for the first time since 1994, Republicans lead in the generic ballot.

Opposition to reform appears to be an important determinant of voting intention in the midterm elections—particularly for political independents.

These estimates mask important differences among voters and among states. Back to Colorado and Ohio: even if Obama could persuade every self-identified Republican in these states to favor his health reform plan, our model predicts that he would not switch many votes. The same holds for Republicans. Even if they could persuade every self-identified Democrat to oppose health reform, very few Democrats would change their minds at the ballot box.

In contrast, independents’ views about health reform have a much greater effect on their vote intention. If, in either Colorado or Ohio, the president could swing independents’ opinion about health reform in his favor, our model predicts that the Democratic candidate for Senate could pick up as much as six additional percentage points of the independent vote.

In Colorado, this would mean that independents would split 56 percent to 44 percent for the Democrat rather than 50/50; in Ohio, it would mean that independents would split 52 percent to 48 percent rather than 57 percent to 43 percent for the Republican. In a close race, this could be enough to put the Democrat in the lead. Given the stability of public opinion in close states, our analysis suggests that the president faces an uphill battle.