The Supreme Court Upholds Health Reform. What Will it Mean to Voters?
This post is part of a series in which Robert Wood Johnson Foundation (RWJF) leaders, scholars, grantees and alumni offer perspectives on the U.S. Supreme Court rulings on the Affordable Care Act. Hahrie Han, PhD, is an associate professor of political science at Wellesley College. She was an RWJF Scholar in Health Policy Research from 2009-2011.
The Supreme Court’s decision to uphold the Affordable Care Act is unlikely to change anyone’s mind, but its political legacy may lie in its ability to energize the base of each party.
From a policy standpoint, there is no doubt that the Supreme Court’s decision to uphold the health reform law has vast implications for millions of Americans. The political impact of the decision, however, remains unclear. Will it help Obama in 2012 by affirming the centerpiece of his legislative record? Will it hurt him by firing up the Tea Partiers in opposition? Or, will it have little to no impact on the 2012 election?
Initial polling results from the Kaiser Family Foundation show that people’s views on the law have not changed as a result of the Supreme Court’s decision. People who opposed the law in the past are still opposed to it and people who supported it still support it.
What has changed, according to Kaiser, is the intensity of partisan support for the law. In May, only 31 percent of Democrats reported having “very favorable” views of the ACA. In the days after the Supreme Court’s ruling, that number had jumped 16 percentage points to 47 percent. (Republicans remained consistent in their dislike for the law, with 64 percent reporting “very unfavorable” views.)
This surge in Democratic enthusiasm could make an electoral difference in our polarized political climate. Elections in polarized times are often about turnout more than persuasion. An election that is about persuasion is won or lost on a candidate’s ability to persuade the undecided voter to support his or her side. An election that is about turnout hinges not on the undecided voter but instead on the candidate’s ability to turn out the partisan base. When elections are very polarized, as this year’s presidential election is, the undecided voter is an ever-narrowing slice of the population. Turning out the partisan base thus becomes that much more important.
The question is how stable rising Democratic enthusiasm for the law is. Republican opposition to the law has been very stable and research shows that people are more likely to take political action to fight against laws they do not like (threats) as opposed to supporting laws they do (opportunities). The Supreme Court’s decision seems only to have reinforced Republican opposition to Obama. Will it also solidify Democratic support for Obama?
The Obama campaign’s ability to capitalize on this surge in enthusiasm may depend on its ability to organize its supporters using the venerated organizing machine it built in 2008. As I have argued in my work, people are motivated to take political action when they are personally invested. To connect people’s personal lives to the Supreme Court decision, the Obama campaign would need to rebuild the personal relationships and neighborhood teams that were the secret to its success in 2008.
Political scientist Gerald Rosenberg has argued that the major legacy of the Supreme Court’s decision in Roe v. Wade was not to make legal abortions more widely available to women, but instead to spur a political backlash that polarized the debate over reproductive rights and is still felt today.
Time will tell if the legacy of this decision by the high Court lies in its impact on improving the health of millions of Americans, spurring political backlash, or both.