Telling people the truth

The Kaiser Family Foundation released their health care tracking poll for the month of December this week. Again, this emphasizes the worst week ever for releasing interesting stuff. Moving on, probably the most interesting data to come out of this poll is the role of messaging on the Affordable Care Act’s least popular feature – the individual mandate.

The pertanent slide:

I’m sure strategists of both parties would be interested in this information, though, I have to imagine that their minds are already churning for the ‘spring spin’ when oral arguments begin in the Supreme Court case in March.
Sarah Kliff wonders if there’s more to lose than gain for advocates of the law:

[…] On the flip side, there’s also a lot of space to turn public opinion even more negative on the individual mandate than it is right now. Only about a third of Americans are inclined to support the mandate. And the vast majority turn negative if they hear that health reform means some people will have to buy insurance they don’t want, or if the Supreme Court challenge comes up[…]

And Kevin Drum likens this question to the Prospect Theory:

Most people, it turns out, aren’t so much risk averse as they are loss averse: they prefer a sure gain over a gamble for a bigger gain, but they prefer a gamble when the alternative is a sure loss. Bottom line, people really, really hate to lose things that they already have.

Basically when people are asked about the individual mandate, Prospect Theory would tell us that most people would rather take the gamble – not needing health care in the foreseeable future – than the guaranteed cost (loss) of paying for health insurance now. Yet whether the advocates have more to lose or the fact that behavior teaches us that people can make irrational decisions, is largely besides the point to me if you don’t tell people the whole truth.

Slide 12 of the KFF poll asks respondants whether or not they view the mandate favorable and includes the word ‘fine.’ But then when they ask those who have a positive view of the mandate whether they still support it knowing that some may have to purchase insurance they may not want, the favorability rating drops. It seems that by the first followup question KFF has fallen prey to the same misleading anti-ACA messaging as the people they poll. Because after 2014 you will not have to purchase health insurance if you do not want to purchase health insurance. The consequences of not doing so are essentially the same as not buying a house. Or not having children. Or not buying a Prius. After 2014, if you decide not to purchase insurance – assuming you don’t already have it – your federal income tax liability will go up. That’s it.


The question I have for the pollsters at Kaiser is why they felt the need to exclude “fine” or “will face a higher federal tax liability” in the followup question. Leaving out that crucial part tells me less about “messaging” than it otherwise would have. Usually Kaiser is very good at asking questions that contain context, but in this regard they’re clearly lacking.

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