The Affordable Care Act made a remarkable recovery in 2014, starting the year with a barely functioning federal exchange website and ending it with millions of Americans reenrolling in subsidized health insurance plans that did not include sky-rocketing prices in the second year of operation. But American voters weren’t won over by last year’s turnaround or Congress’ efforts to repeal or protect the healthcare law. According to Morning Consult polling, both the legislative and executive branch received a D average from registered voters on how they handled healthcare issues in 2014.
The poor performance isn’t a shock when you consider the low approval ratings of Congress and the president. In the Morning Consult poll, 64 percent of voters said the country was on the “wrong track.” But there is a glimmer of hope for lawmakers and the Obama administration. While many voters gave Congress and the White House failing grades, a plurality or near-plurality of voters often gave both branches a more-than-passing grade. This was especially true for younger voters, age 18-29, who were regularly 10 percentage points higher than their older peers in giving the White House and Congress an A, B or C grade.
The poll surveyed 1,776 registered voters online from Dec. 16 through Dec. 19. Respondents had the option of giving Congress and the White House a grade ranging from A to F, or to say they did not know or had no opinion on the issue. Average grades were calculated using a 4-point GPA scale. The margin of error is plus or minus 2.3 percentage points.
Health Care Costs
“What grade would you give them when it comes to how they handled each of the following issues…the cost of healthcare?”
When it comes to the cost of healthcare, Congress has been on the sidelines since the passage of the Affordable Care Act in 2010. And it’s not just because health policy has become politically toxic – the jury is still out on exactly how Washington could write legislation that reins in health spending. But as the focus moved off of the national debt and federal deficit, Capitol Hill held far fewer conversations on how to bring down health costs than in years prior.
White House: D+
The Obama administration had a good year when it came to healthcare costs, as national health expenditures continued their historic slow rate of growth. But whether the administration’s policies, via the Affordable Care Act, were the reason behind slowing health cost growth is still up for debate among economists.
A plurality of voters gave Congress a failing grade on healthcare costs. But the second-biggest group of respondents gave Congress a grade of A, B or C. The White House fared better overall. While 36 percent of voters said the Obama administration failed on health costs, 39 percent gave the White House an A, B or C. Younger voters were the most forgiving. Forty-three percent gave Congress a grade of C or higher and 46 percent gave the White House similar marks.
The Affordable Care Act
“What grade would you give them when it comes to how they handled each of the following issues…the health reform law?”
Congress’ involvement with the Affordable Care Act in 2014 was largely limited to votes to repeal the entire law or hack away at specific provisions. Few efforts were successful beyond pure political messaging. In September, the House passed legislation that would allow insurers to continue offering any insurance plan that existed in 2013, even if they did not meet the standards set under Obamacare. Like most healthcare reform legislation, it didn’t get consideration in the Democratic-controlled Senate.
White House: D+
The Obama administration started off the year mounting a recovery from the total failure of Obamacare’s federal exchange website launch at the end of 2013. By the close of the open enrollment period, the Department of Health and Human Services reported that 8 million people had chosen plans through the hastily fixed federal exchange. The second enrollment period, which opened in November, launched without any major problems. Still, it wasn’t enough to bump up the White House GPA.
A plurality of voters, 42 percent, gave the White House an A, B or C grade. Congress received the same grades from 32 percent of voters, while 39 percent gave the legislative branch a failing grade. Younger voters gave both Congress and the White House higher grades than their older respondents. Congress got an A, B or C from 50 percent of voters age 18-29, a figure 18 percentage points higher than the overall registered voter response.
“What grade would you give them when it comes to how they handled each of the following issues…Medicare, the federal health insurance program for Americans age 65 and up?”
The legislative branch in 2014 tended to the annual ritual of preventing a double-digit pay cut for Medicare physicians but didn’t do much else to tweak the massive federal program. The exception was a bill that became law in October: post-acute care providers must submit data on whether or not the healthcare they provide actually makes patients healthier.
White House: D+
With the focus off of the national debt and federal deficit in 2014, the White House felt less pressure to offer proposals to slow Medicare costs such as making wealthier seniors pay higher premiums. But it wasn’t all smooth sailing for the administration. Proposals from the Centers for Medicare and Medicaid Services to overhaul parts of a Medicare prescription drug program were summarily rejected by Democrats and Republicans in Congress, and fights continued between the administration and industry over Medicare Advantage rates.
Congress and the White House both earned more-than-passing grades from a plurality of voters. Younger voters once again gave both branches of government far better marks on this health measure. More than half of voters age 18-29 gave Congress an A, B or C, compared to 39 percent of all registered voters.
Access to Healthcare
“What grade would you give them when it comes to how they handled each of the following issues…access to doctors and hospitals?”
The continued critiques of the Affordable Care Act made Congress a politically unfriendly environment for health legislation, particularly when it comes to the private market. The exception was a program that provides federal funds for medical residents at children’s hospitals which was reauthorized after nearly expiring.
White House: D+
The Obama administration’s greatest role in providing access to healthcare in 2014 came indirectly through the implementation of the Affordable Care Act. Enrollment is still ongoing, but approximately 8 million Americans have signed up for health insurance through the federal government’s insurance exchanges in 2014.
The White House and Congress both earned an A, B or C from a plurality of voters, at 44 percent and 49 percent, respectively. Like every other health measure in the poll, a larger group of voters age 18-29, approximately 10 percentage points higher, gave both branches a more-than-passing grade.