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The GOP Health Care Bill Is Unpopular Even In Republican Districts

With a vote tentatively scheduled for Thursday, the health care bill put forth by Republican Congressional leaders and endorsed by President Trump is still taking heat from all sides in the House of Representatives. Some of the opposition comes from moderate Republicans such as Florida’s Ileana Ros-Lehtinen who represent districts that voted for Hillary Clinton. But most of it has come from the Freedom Caucus and other highly conservative members who say the bill does not go far enough in repealing the Affordable Care Act and scaling back government involvement in health insurance markets.

This puts Trump and Republican leaders in a potentially unwinnable position: Further efforts to mollify conservatives in the House could jeopardize the bill’s already endangered chances of ever passing the Senate. Here’s the thing, though: Trump and Republicans would have a lot more leverage if their bill weren’t so darned unpopular.

I estimate that there are only about 80 congressional districts — out of 435 — where support for the bill exceeds opposition. About two-thirds of Republican members of the House, in fact, likely come from districts where the plurality of voters oppose the bill. And because even Trump supporters have lukewarm opinions on the bill, there may not be any districts where vigorous support for the health care bill exceeds vigorous opposition.

These estimates are derived from a YouGov poll, released on Wednesday, that showed 33 percent of registered voters supporting the GOP’s bill and 48 percent opposed to it. Those numbers are right in line with the polling average for the bill. But YouGov did something interesting and broke down support and opposition based on who respondents said they voted for last November. Among Clinton voters, only 7 percent support the bill while 84 percent oppose it. By comparison, 61 percent of Trump voters support the bill while 16 percent oppose it.

Some of the opposition among Trump supporters probably comes from conservatives; a quarter of conservatives in the YouGov poll said they oppose the bill. In any event, Clinton voters are a lot more uniform in their opposition to the bill than Trump voters are in support of it. And they also have much stronger feelings about it. Among Clinton voters, 71 percent said they strongly oppose the bill, while only 21 percent of Trump supporters strongly support it.

Those numbers are lopsided enough that they come out looking pretty bad for Republicans even in Trump-friendly districts. Take, for instance, Rep. Mike Simpson of Idaho’s 2nd Congressional district, encompassing Boise and the Eastern part of the state, which Trump won 55-30 last November, according to Daily Kos Elections.1 That’s a really red district. But if you infer these voters’ views of the health care bill based on the YouGov poll and the number of Trump, Clinton and third-party voters in the district,2 you wind up with only 39 percent in favor in the bill and 43 percent opposed. Meanwhile, strong opposition to the bill exceeds strong support 29-13 in Simpson’s district, according to this estimate. Even in Idaho, therefore, the politics of the bill are dubious for Republicans.

And the numbers are much worse, of course, in districts like Ros-Lehtinen’s. By this calculation, opposition to the bill exceeds support 57-28 in Florida’s 27th Congressional district, where she serves. And strong opposition to the bill exceeds strong support 44-9.

Perhaps there are regional variations in GOP support for the bill, or certain states and districts where support is unusually high, but at least based on this simple estimate, there are about 80 districts, as I mentioned, where supporters of the bill are in the plurality. But I estimate that there are only three of them — Alabama’s 4th, Kentucky’s 5th and Texas’s 13th — where supporters of the bill constitute an outright majority. And even in those three districts, strong opposition to the bill matches strong support for it.

To repeat, Republicans in Congress don’t have a lot of good options on their hands. There are consequences for defying Trump, just as there are consequences for voting for an unpopular bill. But this is not the typical case where Republican members can necessarily count on their base to save them. As polarized as the country has become, the bill has strikingly few supporters, and the average Republican member of the House represents a district where the health care bill is somewhat unpopular.

You can find our estimates of support for the bill in all 435 congressional districts3 in the table below.

CORRECTION (March 22, 7:22 p.m.): An earlier version of this article misstated how Clinton voters said they feel about the Republican health care bill in a recent poll. Seventy-one percent of those voters oppose it, not support it.


  1. There were also a significant number of third-party voters in Idaho, mostly for Evan McMullin.

  2. The process for this was simple: I allocated the Trump, Clinton and other voters in each district based on their overall levels of support or opposition to the bill in the YouGov poll. Although you could also account for other factors, such as partisan identification in each district, the 2016 presidential vote was the strongest predictor of support or opposition to the bill in the YouGov poll, so adopting a more complicated methodology probably wouldn’t have changed things much.

  3. And the District of Columbia.

Nate Silver founded and was the editor in chief of FiveThirtyEight.