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53% of Republicans don’t know repealing Obamacare repeals the Medicaid expansion

What happens when they find out?

Constituents Rally Outside Senator Pat Toomey's Office, Demanding 'Don't Take Away My Health Care' To GOP Photo by Lisa Lake/Getty Images for Moveon.org

Over at the Upshot, Kyle Dropp and Brendan Nyhan look at a new Morning Consult poll exploring Americans’ confusion regarding the terms “Affordable Care Act” and “Obamacare.” Thirty-five percent either think Obamacare and the Affordable Care Act are different policies or aren’t sure whether they’re different policies. The confusion is worst among young people and those making less than $50,000, and it’s magnified when you begin asking about the consequences of repeal:

When respondents were asked what would happen if Obamacare were repealed, even more people were stumped. Approximately 45 percent did not know that the A.C.A. would be repealed — 12 percent of Americans said the A.C.A. would not be repealed, and 32 percent said they didn’t know.

The pollsters dug into more specific consequences of repeal, too. Among Republicans, only 47 percent knew that the Medicaid expansion and insurance subsidies would be rolled back — 29 percent said Medicaid and the subsidies would be unaffected, and another 24 percent weren’t sure. So fully 53 percent don’t know or don’t believe that repealing Obamacare would repeal its coverage expansion, too.

Polls like this are sensitive to changes in wording and can’t tell us how respondents really interpret the question, so it’s worth being cautious when reading the results. Perhaps the Republicans who assumed the Medicaid and insurance subsidies would survive under repeal were assuming repeal would include a full replacement, too. That’s certainly an impression Republicans have encouraged, even if it’s not one they have backed up through policy.

But the basic message of this poll — that there’s a lot of confusion around what the Affordable Care Act actually is and does — is consistent with past surveys. The Kaiser Family Foundation, for instance, polled Trump voters on the Affordable Care Act, and found the Medicaid expansion, Medicare taxes, and out-of-pocket limits are popular even among Trump supporters:

Kaiser Family Foundation

Dropp and Nyhan end their piece with a question. “Despite this widespread confusion, Republicans in Congress have recently started to edge away from A.C.A. repeal as the politics of the issue have become more difficult,” they write. “What would happen if people understood the law better?”

Republicans know they’ve benefited from voter confusion on this issue. It’s why Donald Trump’s health care policy could literally be to repeal Obamacare and replace it with “something terrific.” They also know that begins to end as soon as they release a real plan, and it really ends if they pass something into law. Which is why congressional Republicans are in disarray over their replacement strategy, Trump has begun making impossible promises about what will come next, and even Medicaid’s most committed opponents are admitting that slashing it is harder than they thought.

But there is one way out for Republicans, as Topher Spiro, a health policy expert at the liberal Center for American Progress, notes:

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