Voter polls portend conflict between Obama administration and Republican leaders over ACA

An analysis of newly released polls shows that most of those who voted for President Obama in the 2012 election favor implementing the Affordable Care Act (ACA) and want the federal government to continue efforts to make sure most Americans have health insurance coverage. However, at the same time the President was re-elected, Republicans maintained a majority in the U.S. House of Representatives, and 30 of the nation's 50 states will have Republican governors. The polls suggest that those who voted for these Republican officeholders, and therefore many of the Republican governors and House Republican leaders, are likely to oppose parts of the implementation of the ACA.

This analysis will be published as a Special Report on November 28, 2012 in the .

A large majority (78%) of Obama voters favor implementing or expanding the ACA, while 84% of those who voted for Republican candidate Mitt Romney want all or part of the law repealed. More than nine in ten Obama voters (92%) want the federal government to continue efforts to make sure most Americans have , while 62% of Romney voters oppose continuing such efforts.

"While President Obama has support to implement the ACA overall, he is likely to face opposition from Republican governors and state legislators in expanding Medicaid and implementing statewide exchanges," said Robert J. Blendon, professor of health policy and political analysis at Harvard School of Public Health and co-author of the analysis. "In the House, he is likely to face Republican opposition to efforts to fix or improve upon the ACA and on budget matters."

Note: To request a copy of charts showing some of the highlights, email Marge Dwyer at mhdwyer@hsph.harvard.edu.

Starting with the post-election interim session of Congress, a debate will take place between President Obama, the Democratic-led Senate, and the -led House about reducing the . Many proposals to cut the deficit depend on large cuts in future Medicare expenditures. The poll results show that majorities of both Obama (78%) and Romney voters (68%) oppose making large Medicare cuts as a way of reducing the budget deficit.

"This gap between many political leaders in both parties and their voters is likely to make finding a permanent agreement on the fiscal issues facing the country harder than most people believe," said Blendon.

The results also show that viewed President Obama as better than Gov. Romney at handling health care issues. However, the President's advantage on handling health care was not as large as those held by the Democratic presidential candidates in the previous three elections.

More information: "Implications of the 2012 Election for Health Care: The Voters' Perspective," New England Journal of Medicine, Robert J. Blendon, John M. Benson, Amanda Brulé, online November 28, 2012

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