Obamacare's Challenge: a Skeptical Public - Polling Shows the Administration Has Some Work to Do to Sell Health Law

Gerald Seib writes in The Wall Street Journal:

How big are the political problems facing the Affordable Care Act, aka Obamacare? Consider some numbers from summertime Wall Street Journal/NBC News polling.

Almost half of Americans—47%—now say the law overhauling the nation's health system is a bad idea, compared with 34% who call it a good idea.

More than half of working-class whites say it is a bad idea. Perhaps most stunningly, so do 48% of those currently without health insurance—the very people who stand to gain the most, in the form of help finding and paying for coverage.

Meanwhile, by a 30-point margin, political independents think they will be worse off under the law.

Let's just say the Obama administration has some marketing work to do.

That is the backdrop Democrats face heading into a fall in which the big health overhaul begins kicking in. Some provisions already are in place, but implementation will feel more real when health-care exchanges—the insurance marketplaces designed to help individuals and small businesses find coverage—open for enrollment in October.

Meanwhile, various taxes and tax breaks, designed to expand coverage and pay for it, also will begin taking effect, as a prelude to full implementation in 2014.

The administration is well aware of the risks it faces at this crucial juncture. Denis McDonough, the White House chief of staff, has been meeting with groups of jittery congressional Democrats to calm their nerves about the rollout. In a sign of concern, the administration has hired Washington veteran and Clinton White House alumnus Chris Jennings to help with the launch.

Even ardent defenders of the law acknowledge, though, that the administration is behind the curve in building support for President Barack Obama's most important domestic initiative. The biggest problem isn't the opposition from die-hard critics; it's the fact that the overhaul is being so badly received among key political swing groups, as well as among some who ought to be its biggest cheerleaders.

About six in 10 liberals and a similar share of Democrats said the law was a good idea, though support among even those core Obama constituencies has dropped slightly in the past month. That's the good news for the administration.

But just 30% of those making less than $30,000 a year, and 37% of young adults, call the law a good idea. That's a weak showing among two core Obama constituencies.

The other flashing red light comes from groups in the crucial political middle, which aren't convinced the law is good for them. Suburban women, a target constituency for both parties in recent elections, say, by 43% to 13%, that they will be worse off under the new law.

Political independents say the same by a similar count of 42% to 12%.

All told, Democratic pollster Peter Hart describes President Obama's health-law predicament this way: "He signed it, but he never sold it."

That hardly means the full story of this controversial law has been written, of course. Politically as well as substantively, the outcome hangs in the balance, and three questions are crucial going into the fall:

•Does the law have a marketing problem or a substantive problem? It seems pretty clear that the administration has failed to get its message about the law out effectively; if it had done a better job at that, at least those who stand to benefit more clearly would be more supportive. The administration is setting out to change that.

But the X-factor to watch in the fall is whether people like the law more as they learn more about it, or whether they decide they are scared as they learn of its specifics. Marketing problems can easily turn into substantive problems; if healthy young people aren't persuaded to sign up for coverage on the new exchanges, costs will go up for everybody else.

•Are people still going to give the law a chance, despite their skepticism? While just 34% of Americans now call the law a good idea, fully half say Republicans should stop trying to prevent the law from going into effect. That suggests some doubters still want to see the law implemented.

But Bill McInturff, a Republican pollster who helps conduct the Journal/NBC News poll, notes that substantial portions of key political groups still back Republican efforts to block implementation. "This law has a very fragile standing," he says.

•Will perceptions change when the law is in effect? Pollster Fred Yang, a Democrat who helps oversee the Journal/NBC News poll, thinks the best hope for turning around public perceptions will come after the law fully kicks in, at which point some beneficiaries will be convinced of its benefits, while others will be convinced its problems aren't as great as feared. At this point, that does seem the administration's best hope.