Politics Counts: Health Law’s Shades of Support

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The  intense media coverage around Thursday’s Supreme Court ruling on the Affordable Care Act would seem to indicate the 2012 campaign had seen a game-changing event.

Social media and blogs were buzzing before the opinions came down. And soon after both of the main presidential combatants sounded off on it. Presumptive Republican nominee Mitt Romney said the ruling didn’t change the fact that the act was “bad law” or that he would work hard to repeal it. President Barack Obama meanwhile hailed the ruling as a victory for “people all around this country.”

A hot issue. A new wrinkle. A clear divide in positions. Let the no-holds-barred campaign fight begin!

But, on second thought, maybe not. Look closer at the question of the uninsured, polling on the law and divisions within the country, and a few points jump out at you. First, the health-care debate is one of those issues where simple self-interest doesn’t seem to be the main driver of opinion – that makes it a harder matter to politicize. Second, the divide on the ACA shows challenges, for both candidates, at least in terms of broad campaign messaging.

Earlier this month the Pew Research Center conducted a poll asking people how they would feel if the ACA was upheld by the court. And looking at those responses using Patchwork Nation’s demographic/geographic county breakdown reveals sharper differences.

In the wealthy Monied Burb counties, the feelings were decidedly mixed, 45% said they’d be happy with the decision and 45% said they’d be unhappy. In the socially conservative Evangelical Epicenters, 61% said they’d be unhappy. In the more liberal Industrial Metropolis counties, 50% said they’d be happy and only 43% said they’d be unhappy.

Those numbers are interesting because they are not really tied to how much communities would benefit from the law – at least in terms of insurance coverage.

For instance, the socially conservative Evangelical Epicenter counties – mostly through western Arkansas, eastern Oklahoma and southern Missouri on the map – would seem to have the most to gain from the law. On the whole, more than 20% of the adults in the Epicenters don’t have insurance. Yet out of all the types in Patchwork Nation they are among its strongest opponents.

Meanwhile, the wealthier Monied Burb counties, where more people have health insurance – only 14% of adults are uninsured – are much more likely to support the health-care plan. Look at the map at the counties around major cities in the U.S., even in those same states, Arkansas, Oklahoma and Missouri – and you’ll see lower numbers of uninsured.

For the rest of this week's Politics Counts column, please visit the Wall Street Journal's Web site.