The difference between the number of supporters and opponents of Obamacare in Alaska is well within the margin of error of a poll released by the American Medical Association today, but the general sentiment on the replacement that passed the House is not.
Only 18 percent of surveyed Alaskans said the health care bill passed by the House and endorsed by Trump (before he called it “mean”) is a good idea. A majority of Alaskans felt otherwise with 51 percent of respondents who said it’s a bad idea.
By comparison, Obamacare eked out a slight edge with 44 percent of Alaskans who felt it was a good idea to 43 percent who felt it was a bad idea. The reported margin of error on the poll is +/- 4.38 percent.
The poll doesn’t reflect Alaskans’ feelings on the Senate’s draft health care bill because it was gathered between June 15 and 20. The contents of the bill were a closely held GOP secret before its unveiling on June 22.
Alaskans aren’t likely to feel much better about the new bill.
[PDF: Key findings of American Medical Association survey of Alaskans]
Initial analysis of the Senate bill largely mirrors that of the House bill, showing Alaska stands to be the hardest hit under a repeal of Obamacare. Key Republican positions like per capita funding of Medicaid and cuts to individual insurance subsidies a have an enormous impact when applied to Alaska’s high cost of health care and small population.
Alaskans buying insurance through the individual marketplace almost universally stand to see their annual premiums spike, in some cases by more than $30,000 due to changes in subsidies. Changes to Medicaid, particularly around Medicaid expansion could also bring real pain to Alaska’s budget.
Alaskans opposed repealing Medicaid expansion by 56 percent to 33 percent, according to the poll.
A tough sell
Republicans haven’t been able to sell the bill to the public. Jarring losses in coverage have dominated the headlines throughout the bill’s movement through Congress. The Congressional Budget Office released its numbers on the Senate bill on Monday, finding that 22 million people would be without coverage by 2026. In the next year alone, some 15 million people are expected to drop from coverage largely due to the repeal of the individual insurance mandate.
The Center for American Progress, a progressive think tank that’s been one of the foremost critics of the bill, estimates about 64,500 in Alaska will lose coverage under the Senate bill.
The Senate GOP hopes that the few bright spots in the CBO report, such as falling premiums in 2020 and beyond, could win over the public. Those gains, though, are minor when staring down the broad losses of coverage and potential loss in services covered. The pitfalls in the bill are deeper and more numerous the longer people have chance to look through them and, in the words of U.S. Sen. Lisa Murkowski, “crunch the numbers.”
Direction for Congress
Murkowski and Sen. Dan Sullivan have been pretty quiet on the Senate bill since last Thursday. Murkowski said in an interview with CNN that she is still evaluating the bill.
“Today I don’t have enough information, I don’t have enough data, in terms of the impact to my state, to be able to vote in the affirmative,” she said.
A plurality of respondents said the best approach, right now, is to not pass any part of the House bill and leave Obamacare in place. On the question of what to do 36 percent said to leave Obamacare in place, 24 said to pass it with major changes, 22 percent said to pass it with minor changes and just 7 percent said to pass the House bill as is.
Though the calculation is a little different if you’re looking only at registered Republicans, who mostly favored making minor changes to the bill. That voting base is still set on repealing Obamacare, while independents and Democrats would rather see big changes or keep Obamacare.
Murkowski, for her part, said the Senate should at least have some more time to consider the bill.
“I don’t think it’s asking too much to say give us the time to fairly and critically analyze these numbers,” she told CNN. “And if you say, well, CBO numbers don’t matter, let’s look at the numbers that you don’t think matter. But it really does make a difference. And these numbers that we’re talking about, these are men and women, these are our families that are being impacted. So let’s please get it right.”
The poll did find broad support for allowing people to buy insurance across state lines.
The Senate bill has been pitched as a draft that’s open to changes. The Senate on Monday added a provision that would penalize people with gaps in insurance coverage by making them wait six months before getting on a new plan. The House would allow insurance companies to charge people 30 percent more for a year for coverage gaps.
More about the poll and its funding
The poll included 500 Alaskans with a political breakdown of 48 percent independent, 29 percent Republican and 17 percent Democrat. Overall registration in those groups is 52 percent non-partisan or undeclared, 27 percent Republican and 14 percent Democrat.
The American Medical Association paid for the poll, which was done by Public Opinion Strategies. The American Medical Association has made no secret its feelings about the bill. The doctors group said the Senate draft violates the medical principal of Primum non nocere, or “first, do no harm.”
“The draft legislation violates that standard on many levels,” the group told Congress.
“The poll did find broad support for allowing people to buy insurance across state lines.”
Most people aren’t aware that nothing’s keeping people from buying insurance across state lines — nothing except every state’s insurance commissioner, who’s tasked with allowing real insurance companies with real coverage and a reputable history of serving policyholders honestly to do business with his state’s residents.