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Will Affordable Care Act Gain Popularity As It Ages?

MELISSA BLOCK, HOST:

Yesterday, when the House of Representatives voted to repeal the health care law, the vote was almost entirely along party lines. Recently, opinion polls show the public nearly evenly divided about that law and again it's a partisan split.

Well, we thought we'd go back to history to see what Americans thought of other major social programs at their inception - back, say, to 1935.

PRESIDENT FRANKLIN DELANO ROOSEVELT: Today, a hope of many years' standing is in large part fulfilled.

BLOCK: That's FDR signing the Social Security Act which promised benefits to retirees and the unemployed through a federal tax. So how was that program received at the time?

We'll put that question to Lawrence Jacobs, who studies public opinion toward government programs. He directs the Center for the Study of Politics and Governance at the University of Minnesota. Professor Jacobs, welcome to the program.

LAWRENCE JACOBS: Good to be with you.

BLOCK: Let's go back to April of 1935. Social Security was part of FDR's New Deal. How much support did it have?

JACOBS: There was support. It ranged from in the 60s into the 70 percent range. And of course, times were very dreary and dark, and folks were looking forward to some kind of government action.

BLOCK: Was there any strain of anti-tax rhetoric opposing this, because this was going to be funded through a federal tax?

JACOBS: Yes, there was quite a bit of acrimony on themes that we would find familiar about government overreach, threats to individual liberty, even the specter of communism and socialism was raised as a way to put into stark relief the threat that some saw in Social Security's passage.

BLOCK: You mentioned that those threat of socialism and I was reading about when the labor secretary, Frances Perkins, went before Congress, a senator asked her: isn't this socialism? And she said, no. And then he said: Isn't this a teeny-weeny bit of socialism?

JACOBS: And I think that captures this very emotional, ideological battle that we've had in our country sometimes across party lines, but often between the Democrats and Republicans over what is the proper role of government. Today, most people take Social Security for granted. They don't even think of it, in some cases, as a government program. But when it started, the sparks were flying because people saw America at its core as at risk.

BLOCK: Let's jump ahead and talk about another major social program that dates back to 1965.

PRESIDENT LYNDON BAINES JOHNSON: No longer will older Americans be denied the healing miracle of modern medicine.

BLOCK: And that's President Lyndon Johnson signing Medicare into law. Interesting, Professor Jacobs, that this was a fight that had gone on for a long time as is seen by the fact that when President Johnson signs the bill, he goes to Independence, Missouri and is there with former President Harry S. Truman.

JACOBS: Yeah, Harry Truman had fought for a national health insurance. And it took, you know, some number of years - during the '50s and early '60s - to make that argument, to build support. But once again, very ideological, very emotional and some real sparks flew.

BLOCK: And again, the warning talk at the time was of socialism and socialized medicine. There was a campaign in 1961, organized by the American Medical Association, called Operation Coffee Cup. And it had as its spokesman, a well-known actor, Ronald Reagan. And we're going to hear him here urging people to write their congressmen, opposing a law guaranteeing health insurance for the elderly.

RONALD REAGAN: And if you don't do this and if I don't do it, one of these days you and I are going to spend our sunset years telling our children and our children's children what it once was like in America when men were free.

BLOCK: Professor Jacobs, was that a successful campaign?

JACOBS: Well, it was very successful in mobilizing conservatives against Medicare. In fact, when you look at polls done around that time, there was support for Medicare, with 46 percent supporting Medicare and high 30s percent support for the alternative private plan that was being promoted by the insurance companies.

BLOCK: Well, ultimately, when Medicare was passed in 1965, what do the numbers show? How much support they have?

JACOBS: Soon after President Johnson signed Medicare to law, support for the program quickly expanded. It rose from the low 60 percent range to above 80 percent by the end of 1965. And we've seen support for Medicare stabilize in the 80 percent, even above 80 percent range in subsequent decades.

BLOCK: Are there lessons from history here, do you think, when we talk about public opinion and the new health care law?

JACOBS: Yes. The acrimony at the moment - the emotional feverish pitch that we're seeing today will fade with time. And, as it does, the public support for the program will adjust to their experience with it.

If the program's successful, as Medicare and Social Security have been, in bringing peace of mind to seniors, then support will grow. If there are significant problems, then the public will remain split or might continue to be opposed to the program.

BLOCK: Well, Professor Jacobs, it's good to talk to you. Thanks so much.

JACOBS: Great to be with you.

BLOCK: That's Lawrence Jacobs of the University of Minnesota. He's co-author of the book, "Health Reform and American Politics." Transcript provided by NPR, Copyright NPR.