Four years later, the jury is still out on whether the Affordable Care Act works. The Pew Research Center released a study on Thursday tracking the popularity of the healthcare law among different demographics, and how closely people have been following Obamacare in the news. Given those numbers, and recent headlines, this much is clear: Obamacare is still unpopular, but for different reasons for different demographics. It's succeeding in states that didn't support it and struggling in states that did (and vice versa). It's also still boring — despite low support and continued legal challenge, the public's interest peaked when the Supreme Court upheld it in 2012. Basically, it's complicated.
Obamacare is still unpopular
The one clear fact about Obamacare is that the majority of Americans disapprove of the law, especially Republicans and Tea Partiers. But since September there has been a small shift among those who disapprove — more people want the government to fix the law (30 percent) than make it fail (19 percent).
Exactly 50 percent of 18 to 29 year olds approve of the law, which is good news if you've been appearing on a series of talk shows and viral videos to attract younger enrollees. The question is whether that slightly higher support — only 41 percent of the general population approves — will translate into enrollments.
And while it's no surprise that white people, old people and high earners don't support the law as much (they have the least to gain, support among Hispanics has fallen sharply, from 61 percent in September to 47 percent this month. The Kaiser Family Foundation found that 31 percent of Hispanics are uninsured, but they haven't been signing up. Part of that is the administration's fault — Spanish-language tools were delayed, and CuidadodeSalud.gov linked to English-language plans. There is also a high level of distrust of the government among Hispanics. This week the president assured people that immigration officials would not deport the relatives of people who enroll, but Hispanics are skeptical given the administration's record on deportations. Those enrollment hurdles, and the need to overcome them, will continue to factor in to the administration's strategies.
Obamacare's success is hard to gauge, or predict
When the exchanges first launched, the narrative was that 1) Healthcare.gov sucks and 2) the state exchanges are working great because their Democratic leaders were invested in the success of Obamacare. Both narratives ended up being overly simplistic. As Hawaii, Minnesota, Oregon and Maryland proved, some state exchanges were more deeply flawed than the federal exchange. The Washington Post argued that Oregon is the worst exchange in the country, though The Wire nominated Maryland, which is being investigated by the federal inspector general. Those states all enthusiastically embraced the law, but have busted websites.
Jaime Fuller points out in The Post that several red states, like North Carolina and Florida, have managed to exceed enrollment expectations despite lacking the financial resources of state-run exchanges. Michigan, run by Republican Gov. Rick Snyder, agreed to expand Medicaid, and right-leaning states like Arkansas have pioneered market-based Medicaid options that insure low income consumers without making Republicans nervous.
Obamacare is boring
Four years in, the public's interest in Obamacare is near an all-time low. As seen in the chart to the right, the number of people who said they were closely following news developments on the health law tended to peak after key events: when the House passed the bill, when the Supreme Court upheld it, and when the website launched. In Pew's March 2014 survey, Democrats and Republicans were equally like to be following Obamacare closely. Just 23 percent really care.
This suggests a few things. First, recent legal battles over Obamacare's legality —specifically whether subsidies are legal in federal exchange states (they are) — aren't a big deal. Still, next week the Supreme Court will hear arguments on whether the law's birth control mandate is legal. USA Today called it "a case about God, money, power, sex — and Obamacare," which makes it sound like a docu-drama, but we'll see if anyone's interested.
Jason Millman at The Washington Post argued the numbers imply that people don't think the law is going anywhere, since no one is interested. That's bad news for the left and the right. "There's still a whole lot of noise around the health care law - and that includes last-minute messaging to sign up for coverage by March 31," he wrote. "Polls like this one make you wonder how much people are even listening." And yet, here we are.