Pence’s Obamacare stance mirrors Hoosiers’ views

November 21, 2013
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More than a few readers of The Dose have accused Gov. Mike Pence of playing politics with his decisions not to embrace Obamacare in Indiana.

The theory is that Pence has his eye on the 2016 presidential contest and wants to spiff up his bona fides with the Tea Party and other hardline conservatives. What better way to fire up the conservative base than blowing off Obamacare—even if it hurts Hoosiers.

I don’t subscribe to this theory, because Pence’s objections to Obamacare seem to come from his honestly held conservative principles (like them or hate them, they’ve been quite consistent for a long time), not in cold political calculation.

But to the extent Pence is playing politics, it looks like his focus local, not national.

I say this because a new statewide survey by Ball State University’s Bowen Center for Public Affairs shows that Hoosiers are firmly behind Pence on his stance against Obamacare.

On the whole, the 605 Hoosiers interviewed don’t like the Affordable Care Act, a slight majority would like to see it repealed, and a large majority even support Pence’s handling of the question of expanding Medicaid.

Pence has said Indiana will not expand Medicaid coverage to more Hoosiers unless it can do so using a version of the Healthy Indiana Plan. The Ball State survey found that 47 percent of Hoosiers support an expansion via HIP and 15 percent favor no expansion at all.

That’s 62 percent who do not favor an expansion of traditional Medicaid—nearly twice as many as the 32 percent that do support the expansion of traditional Medicaid.

That has to be disheartening to groups like Cover Indiana, which brought 300 people to the Indiana Statehouse on Wednesday to urge Pence and state Legislators to expand coverage. They noted that as many as 350,000 Hoosiers could be eligible for Medicaid, if Indiana expanded it as the Affordable Care Act called for—although estimates of the number of Hoosiers that would actually sign up for Medicaid are running at about half that total.

“Hoosiers are demanding elected officials commit to addressing the coverage gap,” read a statement issued by the group.

Except they’re not, as the Ball State poll shows. In fact, Hoosiers have become much more opposed to the Affordable Care Act over the past year. Fifty-three percent view the law unfavorably, compared with 43 percent that view it favorably.

A year ago, Hoosiers held slightly more favorable views of the law than unfavorable, with 44 percent in favor and 42 percent against.

But since then, “very unfavorable” views shot up to 36 percent and another 17 percent view the law in a “mostly unfavorable” way. Just 13 percent of Hoosiers view Obamacare “very favorably.” And that even though the survey was conducted between Oct. 8 and Oct. 21--when much of the national news was still focused on the government shutdown, not the meltdown.

When asked whether Obamacare should be repealed or fully implemented, 51 percent of Hoosiers chose repeal, compared with 41 percent who want full implementation. Since the Ball State poll has a margin of error of 4.8 percent, it's possible that less than a majority of Hoosiers actually support repeal.

This local antipathy toward the law is being matched nationally. The Affordable Care Act has never been popular, but neither has it been terribly unpopular. Now, however, there is mounting evidence that Americans are turning against it.

The six polls averaged by RealClear Politics show 57 percent of Americans oppose the law, compared with 39 percent who support it. That 18-point gap was only half as wide a month ago--which is the time the Ball State survey concluded.

And, for what it’s worth, Pence enjoyed an overall approval rating in the Ball State poll of 55 percent. President Obama’s approval, meanwhile, has been hammered by the botched rollout of the Obamacare exchanges, tumbling to 40 percent in the latest RealClear Politics average.

Whether Pence’s health care stances remain popular, as the consequences of his decisions become tangible for thousands of Hoosiers, remains to be seen.

As I recently reported, Pence’s policies could end up costing Indiana $1.2 billion annually in federal subsidies for expanding both Medicaid and private health insurance coverage. Even conservative opponents of Obamacare question Pence’s support of a lawsuit that would end Obamacare’s tax subsidies to help Hoosiers by individual health insurance.

But for now, Pence and the Hoosier populace are in lock-step: neither one of them likes Obamacare. So don’t expect Pence to change his tune any time soon.

  • Results Are Only As Good As the Survey Methodology
    J.K. - Most of the people I talk with about the subject of health care do not understand the ACA--its goals, its implementation approach and milestones, the subsidies involved, and the role of the market place. Usually, they know some things but what they know is based on what they have read or heard, which often appears to have a political spin. For these reasons, I do not have much confidence in the results of the poll Ball State conducted. Perhaps, if I could see the questions and the context in which they were asked, I might find the poll results more reliable. I suspect that the survey did not lay out foundational information to the interviewee before asking for a question. Perhaps, you could provide us readers a better service if you first looked at the survey methodology before simply reporting the results as being on target.
    • Just proving the theory
      You just spent the whole article proving the theory you don't subscribe to. Pence's opposition is politically advantageous, even though it hurts Hoosiers. The failure to expand Medicaid, and the lawsuit to stop Federal subsidies for policies from the exchanges, are straight up damaging to Hoosiers. It's no surprise that people don't like the law, when the media has done a lackluster job at covering it. Most of the law's provisions have already been in place for 3 years, providing protections to consumers, but you wouldn't know that by reading IBJ, the Star, or any other the other news outlets in the State.
      • Jim F
        While I think that you're spot on about how well most people grasp all the facets of the ACA, I don't think that invalidates any of the study results. People will either be in favor or opposed based on their experiences/knowledge. Doubt any survey would have laid out a primer on healthcare in the U.S.
      • To Jim F.
        You make a good point. And you can read the full survey and results here: However, you seem to be saying that, if Hoosiers were better informed about how the ACA actually works and the various ways it could benefit them, then they would have different opinions. That could be 100 percent true, but it doesn't really matter does it? Unless someone changes people's minds about the law, their opinions are what they are--and we should expect politicians, to some degree at least, to react to polls such as these. President Obama has given speech after speech promoting the ACA, and there has been lots of explanatory media coverage, especially recently. But that does not appear to making Americans or Hoosiers like the law better. Do you have some other messaging strategy in mind?
      • Good article
        Sad, but good! I agree with JimF and MarkusR. But politics is politics. The enrollment snafus will be ironed out well before the 2016 elections and the public will have trouble recalling all the fuss. But in the meantime Pence is leaving big federal dollars on the table due to ideology, and many low income Indiana residents will suffer. Needlessly. Like I say, good article. Sad, but good.
      • To MarkusR
        The theory I don't subscribe to is that Pence is making his decisions because of how it will position him nationally. I see no evidence of that. But if Pence's decisions are damaging to Hoosiers, it appears that Hoosiers do not realize it--or at least don't realize it in large numbers. I am saying that Pence is acting out of his own beliefs and that Hoosiers have given him no compelling political reason, at this point in time, to do otherwise.
      • J.K. - Folllow Up On Methodology
        J.K. - As you suggested in your response to me, I did follow up and review the Ball State Survey results. Here are just a few observations regarding the survey. (1) The survey included no summary analyses/conclusions and covered a wide range of topics--not just health care; it was primarily statistical data; (2) the results were based on responses from 600 adults over the age of 18; (3) about 60% of the respondents listed "more affordable health care" as their top priority (job creation was the top priority); (4)survey questions about health care did not tie to "affordability;" (5) questions about the ACA did not provide any foundational information while the question about HIP did provide explanatory information; (6) nearly 5% of the respondents either did not know who Governor Daniels was or refused to comment on his role in government and about 78% of the respondents had not heard of Glenda Ritz, the Superintendent of Education. My overall point about using the survey results to make the headline you used for your article is that the survey results require more analyses before being used to make a definitive statement. I do not believe the 600 respondents accurately reflect the views of Hoosiers and I do not believe perceptions, while powerful, should be used as facts. I certainly agree with you and other commenters that the survey results show that more education is needed on the subject of health care.
        • Kentucky experience contrasted with Indiana
          Maybe more of those 600 uninformed people would have answered differently had they had facts like those in the opinion piece in the Fort Wayne Journal Gazette:
        • @ J K
          " I am saying that Pence is acting out of his own beliefs and that Hoosiers have given him no compelling political reason, at this point in time, to do otherwise." Governor Pence is being an obstructionist, plain and simple. Unfortunately most of my fellow Hoosiers lack the knowledge to know any better.
        • To Jim F.
          Those are all fair critiques of the survey, and there is always room for saying a headline is oversimplified. Headlines are oversimplified, unfortunately, by definition. But I would not be so quick to dismiss the survey's findings. The overall opposition is quite similar to national polls. Pence's approval rating suggests that, even if Hoosier sentiment toward the ACA is more positive than the poll indicated, that voters aren't ready to throw him out of office for it. The ACA is a complex law with so much in it that I think it is impossible not to find something to like and something to dislike. It's show-me time for the ACA, which has been complicated by woes. I think this thing is going to have to play out for real before we really get a good read on what will be the long-lasting opinions about it.
        • Benefits
          Many people are already benefitting from ACA. Do you think they really want that pulled out from under them? Also, some of us like the idea of retiring early and being able to obtain insurance without working until Medicare age. The local press has been overwhelmingly negative, and we have a posturing Governor that wants to make sure he is on record as opposing this measure on every level.
        • Pence was smart
          Pence made a brilliant move when he decided to let the federal government run our exchange. He knew that there was not enough time to get a exchange up and running properly and he wanted to blame to fall on Obama, not him. It was a very wise political move...because it is exactly what has happened.
        • A contrary view...
          It seems like Kentucky had enough time to get a state exchange up and running. I'd like to think that if KY did, Indiana could have. Also - let's add up the numbers the other way on Medicaid Expansion. 79% wanted either HIP or Medicaid to be expanded, and only 15% said we should not expand at all. I'd call that broad bipartisan support for expansion. If Mitch Daniels could negotiate and compromise, so can Mike Pence. So far, I do give him some credit for trying.
        • Anti-ACA
          The ACA would expand medical coverage to millions of people who, today, have no medical coverage. I've never understood why people would oppose this. Why would anyone not want fellow Americans to get health coverage? Do you know of any report that has addressed why people oppose the ACA? Maybe they oppose government run health care? But if they did, then they would also oppose Medicare. I think Medicare is wildly popular. Is it because most people who oppose the ACA already have health coverage (and don't care very much about those who don't)? I just don't know. Are there any reports that explain the reasons behind the opposition to the ACA?
        • Medicaid layoffs
          How do you reconcile your article with Bloomberg's article of the closing hospitals and layoff of employees where the state is not participating in Afordable Care Act Medicaid expansion

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