Obamacare’s Last Stand?

What social media data can tell us about the recent surge of support for the Affordable Care Act

On March 6, Donald Trump announced his new bill to repeal and replace Obamacare via Twitter. “Time to end this nightmare,” he wrote.
Signed into law by President Obama in March 2010 and launched in October 2013, Obamacare, also known as the Affordable Care Act, currently covers millions of Americans. These Americans include the low-income voters residing in rural areas, many who voted for Trump. But now the law is the next item on the chopping block under the new Trump administration.

Are Americans putting up a fight to save Obamacare, or are they ready for Trump’s replacement?
The answer appears to be a bit of both, but with a growing contingent of pro-Obamacare supporters. Obamacare has always been a divisive issue, but with its existence in jeopardy, the nation appears to be vocally responding to the threat of losing healthcare coverage. We analyzed the social media conversation about Obamacare between 2010 and today to understand how its reception has evolved over the years, and where, exactly, it stands now in the eyes of the public.

A Lackluster Launch

aca_generalsupport_discussiontrend chart
Obamacare’s launch in October 2013 didn’t go entirely smoothly — the website was ridden with glitches that prevented users from creating accounts. Outside of website discussion, however, opposition to Obamacare had over double the conversation volume than support for the program when it launched in October 2013. Despite its intentions to improve healthcare access, people rejected Obamacare for the following reasons according to our data: weakening the economy, costing taxpayer dollars, and helping immigrants secure coverage.
Post-launch, Obamacare conversation trailed off, but resurged in the final months of the 2016 election season.

Back in the spotlight

Obamacare conversation experienced a major uptick in September 2016 during the heated presidential race between Hillary Clinton and Trump and another spike in January 2017 as repealing Obamacare morphed from campaign promise to reality. In terms of conversation volume, Obamacare discussion in January 2017 had nearly half a million more posts than October 2013. In January 2017, support for Obamacare was more than double opposition to Obamacare — the complete reverse of what happened back in October 2013. Now that the threat of losing healthcare coverage is more imminent, people seem to be more vocal in supporting it.

According to Social, Repeal and Replace Lacks Appeal

SOV repeal replace
Since Trump’s election win on November 8, specific terminology for Obamacare’s future became the major discussion topics. Several options emerged:

  • Oppose repeal and replace
  • Support repair or improvement of Obamacare but oppose replace
  • Support repeal and replace
  • Support repeal but oppose replace

Repealing Obamacare without replacing it has become an increasingly unpopular option on social. In November, repealing Obamacare without replacing had 26 percent of the conversation, compared to a paltry 1 percent in March. Supporting Obamacare repair without replacing edged its way into the conversation in January 2017, but the main debate is between oppose repeal and replace versus support repeal and replace. And so far, those opposing repeal and replace are much more vocal.

Understanding the Topics Driving Support and Opposition for Obamacare

The conversation surrounding Obamacare cannot simply be whittled down to supporting or opposing the program. We looked at how people talk about the above topics within the Obamacare discussion, and how that influences their support or opposition for the program. Those talking about seniors, millennials, or healthcare costs favor Obamacare while those talking about taxpayers, immigrants, or the economy oppose the program.
Under Obamacare, seniors pay less for Medicare. Repealing Obamacare would mean higher premiums for the 55 million people enrolled in the program. As one of the groups most negatively affected by the repeal of Obamacare, 82 percent of people discussing seniors favors Obamacare.




On the other end of the age spectrum, millennials benefit from staying under their parents’ coverage until the age of 26. According to the conversation on social, this gives them more career flexibility— they do not have to worry about securing a job that offered a healthcare insurance plan, freeing them up to pursue freelance or small business careers.
When it comes to healthcare costs, the general consensus is that Obamacare provided subsidies to those who were not able to afford healthcare insurance and decreased the costs of screenings, treatments and drugs.
Over the years, Obamacare has resulted in mainly positive social conversation in regards to how it has helped Americans handle and cope with severe illnesses, regardless of their financial situation. Given that this was one of the main goals of the Affordable Care Act, this is not surprising. But not everyone agrees with Obamacare’s benefits.

The Obamacare opposition conversation is driven largely by economic concerns. Some view Obamacare as a foray into socialism, a system that only 13 percent of Republicans and 58 percent of Democrats view favorably according to a 2016 Gallup poll. Others feel it will burden the economy by expanding government and subsidizing costs. In 2016, the federal government was slated to spend more on Obamacare than projected.
The topic with the largest Obamacare opposition is taxpayers, with a staggering 98 percent against the program. According to people, the tax hikes needed for Obamacare will decrease employment and suppress wages.
Aside from economic concerns, people are particularly worried about illegal immigrants benefiting from Obamacare. With anti-immigrant sentiment on the rise, many people voice their opinions that immigrants do not deserve healthcare coverage.


The American Health Care Act or American Wealth Care Act?

Despite mounting support to keep Obamacare, Trump has moved forward with AHCA. Under AHCA, premiums are lowered for the wealthy and Congressional Budget Office estimates that for people over 50, the uninsured rate will increase by 17 percent in nine years.
The GOP health plan was only recently discussed at significant volume levels a week ago. Conversation jumped from less than 4,000 posts on March 5 to over 400,000 posts in a period of 48 hours. Since March 6, 41 percent of people on social talk about opposing the plan whereas only 13 percent talk about supporting it. Opposition to the GOP health plan continues to be the dominant discussion.

What’s Next?

With mounting support for Obamacare and opposition to the GOP health plan, the rising opposition to Obamacare’s repeal on social networks suggests that the current administration faces an uphill battle in terms of gathering support for their proposed Obamacare alternative. Social conversation provides insight into the Obamacare sentiment changes over time and the topics that drive sentiment.

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