Credit: Tom Page

June 14, 2017; New York Times, “The Upshot”

As a small group of the Republican senators confer in secret to craft their version of the American Health Care Act (AHCA), they seem oblivious to the opinions and concerns of their constituents and of anyone outside of their meeting rooms in D.C. Inside the beltway, in Washington, D.C, where its voters have no representation in the Senate, 70 percent of that electorate oppose the AHCA. Massachusetts, Hawaii, and the state of Washington follow D.C. as the states with the next highest levels of opposition at 59 percent. The other 47 states fall into place, all with levels of opposition for the AHCA ranging from 57 to 40 percent. The poll shows that actual support for the AHCA is limited to a high of 38 percent in Oklahoma to a low of 22 percent in Massachusetts. There is no state that supports the secret plan that the GOP senators are currently writing to replace Obamacare.

The authors of this polling information, Christopher Warshaw and David Brookman, utilized multiple polls to get to this data.

To get a sense of support by state, we combined recent polls to estimate support for the AHCA in every senator’s home state. Our estimates indicate that not one state favors it. Even though very few state polls have been conducted on views of the AHCA, we are able to estimate views on the bill in each state using a statistical method called MRP (multilevel regress and post-stratification) and eight national polls that the Kaiser Family Foundation, YouGov, and Public Policy Polling shared with us on people’s views of the AHCA.

Warshaw and Brookman, both political science professors (at MIT and Stanford), cited those findings as a surprising show of unity among red states and blue states. But they also indicated that elected officials (in this case, senators) are not totally oblivious to the opposition to this legislation back home.

With AHCA support in the subbasement, Republican senators have indicated they hope to make changes to the law. Although we can’t be sure exactly what they will change or how it might influence public support, the YouGov data indicate that Republicans in the House had little success softening the public’s opposition with their own modifications. In fact, support for the AHCA was even lower in the three YouGov polls after the House made its changes than in the two YouGov polls conducted before it.

What is, perhaps, most surprising in all of this opposition is the limited amount of information known about the Senate version of the AHCA. “The bill’s secrecy is garnering more and more attention, and more and more outrage,” Paul Waldman writes in an opinion piece for the Washington Post. “It has become one of the leading complaints Democrats make about it. And as any marketer knows, suspense is a terrific tool to increase public interest in your product. Tell people that your new movie or album is coming out soon, but give them only a taste of what it contains, and you’ll heighten the anticipation.”

“By the time we actually get a look at the Senate’s bill,” Waldman writes, “all that waiting may have primed the media to give it a great deal of attention, primed Democratic officeholders to run to the cameras to denounce it, and primed liberal activists to mount an all-out assault on the bill, pressuring potentially wavering senators to oppose it.”

How damaging will reelection prospects be for senators who support the AHCA in spite of the lack of support in their home states? A study from March 2012 found that “Democrats who supported Obamacare lost about six percentage points in the vote in 2010, a dangerous omen for the 15 sitting Republican senators who won their most recent elections by less than that number.”

The verdict is out as to whether senators will actually pay attention to the objections of their constituents. But sometimes public opinion can be persuasive. As the Times says, the evidence shows that “when politicians learn that a majority of their constituents oppose a bill, many change their votes as a result. In one study, academics randomly assigned some legislators to receive information on public opinion in their districts, and found that legislators were much more likely to vote along with constituency opinion when they were informed of it. Research shows that politicians are surprisingly poor at estimating public opinion in their districts and states, Republicans in particular. GOP politicians tend to overestimate support for conservative healthcare views by about 20 percentage points—meaning Senate Republicans might see their states as just barely supporting the AHCA.”

As the Republican leadership continues to huddle behind closed doors, with even members of their own party not privy to any information about the AHCA, they all might do well to pay closer attention to the views and concerns of voters in their home states before they embrace this unknown plan.—Carole Levine