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political cartoon on Obamacare
David Fitzsimmons via politicalcartoons.com
There's been a tremendous amount written about what we really don't know. How often has that happened (rhetorical question, you don't have to answer)? In this case, I'm referring to the public's ultimate reaction to the Affordable Care Act, aka Obamacare, after the dust has settled. There will be plenty of pundits breathlessly explaining to you What This All Means.

We certainly don't know as much as we need to, but here are some things we do know.

Before the SCOTUS ruling:

Poll: Americans split on Supreme Court health care ruling

A poll taken days before the high court’s ruling found that 43 percent of Americans said the court should not overturn the law, and 35 percent hoped it would.

The Public Religion Research Institute poll also found that one in five Americans (21 percent) had no opinion on what the court should do.

After the SCOTUS ruling:
Gallup: Americans are sharply divided over Thursday's Supreme Court decision on the 2010 healthcare law, with 46% agreeing and 46% disagreeing with the high court's ruling that the law is constitutional. Democrats widely hail the ruling, most Republicans pan it, and independents are closely divided.
See? I hope that settles things for everyone.

(Continue reading below the fold)

But there are some nuances to these numbers. Leadership is probably an easier thing to track than sentiment about a law that few understand and that hasn't been fully implemented yet. A note on public opinion from Gallup's Frank Newport:

First of all, most Americans will not understand all of the complex legal verbiage in the opinion. The public will mainly hear or see the simple message that the Affordable Care Act has been upheld. Many news reports also remind readers/viewers that this is a victory for President Obama (see this New York Times story for a good example).
And here's a note on leadership from Mike Allen at Politico:
PLAYBOOK FACTS OF LIFE: Obama looks like a winner, and you can’t underestimate the subtle impact that has on casual voters. The attack on Obama that has tested best with focus groups – incompetent, in over his head – is now in tatters.
For some outstanding details of what the public thinks, see this excellent summary from the Washington Post polling team, who summarized Kaiser Foundation, Pew and their own ABC/WaPo polling here: Six charts to explain health-care polling. And since much of their info comes from Kaiser Foundation polling, let's go to the source.

The most recent polling available is from May, and emphasizes just how partisan the discussion has been from day one:

Kaiser Foundation May 2012 poll
I asked Darrell West, VP and Director of Governance Studies at Brookings for perspective about this finding, and he noted that "everything associated with health care reform has been highly partisan and that is not likely to change any time soon.  Public opinion has been sharply divided from the very beginning and sentiments have not changed significantly over the past few years.  It is a sad commentary on our times that people cannot see beyond their own party views to evaluate how the legislation affects them personally."

Even though it's fair to say the bill is not widely popular, it's also fair to say individual provisions are. More importantly, look what people want to do about it:

Kaiser Foundation poll on whether to amend, repeal or replace

Two years, millions of dollars spent fighting it, and we're right where we started. Now how is that a winner for Republicans? It really doesn't matter how ticked off the tea party is. Most American voters are not tea party supporters, and a plurality do not want "repeal and replace"; they want the law to stand and they want it improved. Over time as we poll after the SCOTUS decision, and after the extremists in the GOP make fools of themselves, we need to keep an eye on the graph above to see how this does or does not change.

But let's make another point. Even if it changes somewhat in weeks to come, this graph won't change all that much:

So, calling it an unpopular law misses the point and exaggerates the public's opposition. And, as far as its effect on the November election, there is reason to be cautious and take all the hype from our Republican-dominated media about how galvanized Republicans are with a large grain of sea salt.

I'll let Nate Silver and Charlie Cook have the last words on that (I agree with both of them):

Nate Silver:

But particularly given the public’s confusion over the health care law, my view has been to keep it simple: Mr. Obama got the good headline here, and that is likely to be most of what the public reacts to...

And be wary of whatever the polls say for the next week or two — the short-term reaction to the news of the ruling may not match its long-term political effects. As before, the presidential election is mostly likely to be contested mainly on economic grounds. Next week’s jobs report is likely to have a larger effect on the election than what the Supreme Court ruled on Thursday.

Charlie Cook:
During this health care decision phase, just take a deep breath. That isn’t what the election will be about.
Still, don't lose sight of the fact that this was a huge win for Obama and the Democrats. Just imagine what the media would sound like had it gone the other way. Remember, wins represent leadership.

Follow Obama's approval ratings and his leadership score more closely than public opinion about the health law. Follow Romney's too: see opinions about Bain, especially in the swing states. Remember that Romney's other leadership claim, experience leading MA as governor, is off the table because he'd have to talk about Romneycare, the Godfather of Obamacare.

And never lose sight of the fact that Romney is unpopular. It flavors every outlandish charge he makes. More on leadership:

Obama’s re-election message is not expected to differ because of the ruling. But his presidency has changed.

Where others failed, he succeeded, pushing through a plan to get basic health coverage to millions of uninsured people in the richest nation on earth.

“Obamacare,” as critics derisively call it and supporters adoringly do, is his Medicare, his Social Security.

"Leadership" is something the public understands; "Obamacare," though they may have strong feelings about it, not so much, at least not yet. But in every case, all discussions of Obama and Obamacare lead to one place: compared to what?

The bottom line is that even though health care coverage expansion for millions of Americans is a tremendous win for Obama's leadership, the polls say Obama is just a few points ahead, running against a guy no one likes. Nothing that happened on health care last week is going to change that.

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