In 2010, the year the Affordable Care Act was signed into law, Republicans and their allies ran a bevy of ads promising to repeal the controversial law. Over the past four years, the House has voted to revise or repeal the law over 50 times. And when the federal government's rollout of HealthCare.gov proved disastrous, Republicans were certain they'd found their single most important rallying cry for the midterms. Though many of the major problems were fixed within a few months, calls for Obamacare's repeal haven't disappeared. They are, however, a little more muted than voters may have expected. This year the vast majority of ads that have mentioned the Affordable Care Act have bundled the issue in with a host of other topics that convey broader themes.
About 14 percent of all political ads that have aired this year through October 15 mention the Affordable Care Act or parts of the law, according to a new analysis from the Kaiser Family Foundation (KFF), based on data from Kantar Media. About three quarters of those ads, however, also mention issues like the economy or social issues.
"Mark Pryor has made things harder," charges one such ad from the conservative group Americans for Prosperity (AFP). The ad blames the vulnerable Democratic senator from Arkansas for "higher gas and grocery bills, higher health care costs from Obamacare, [and] driving up the debt we owe China."
Rather than providing a call to action against Obamacare or attempting to change voters' minds on the issue, the ads largely serve as a partisan signifier for voters.
Obamacare is "used as part of the fabric of any political discourse," Mollyann Brodie, a senior vice president at KFF, told CBS News. "It's the way a candidate distinguishes himself from another candidate, as they would with social issues."
The trend may not be that surprising, given the remarkably stable partisan divide over Obamacare. KFF has been tracking public opinion on the Affordable Care Act on a monthly basis for more than four years.
"Despite all of the big political controversies, the Supreme Court case, a presidential election, the rough launch of HealthCare.gov, the 40 or so repeal attempts in Congress, we've seen a remarkable stability in opinion," Brodie said. "That stability is also characterized by a remarkable partisan divide -- if you identify as a Democrat, you've liked this law from the beginning and still do." Republicans, meanwhile, have always disliked it.
At the same time, KFF's tracking poll has shown that for more than a year, views about the law have been consistently more unfavorable than favorable. That reality is reflected in this year's ads: Of the 849 unique political ads referencing Obamacare that have run this year, the vast majority -- 746 -- were affiliated with Republican candidates, and all were anti-Obamacare, according to the study. Of the 103 Democrat-aligned ads, 65 had a positive message about the health care law.
The candidates, parties and their allies spent $303 million to air those 849 ads more than 592,000 times, Kaiser found. Most of the candidates or groups sponsoring anti-Obamacare ads accounted for less than 1 percent of the ads, the study says. AFP stood out for sponsoring 7 percent of those 849 unique ads -- far more than any other group.
AFP has been campaigning against the Affordable Care Act consistently since its passage. It started airing anti-Obamacare ads for the 2014 election cycle in August of last year, starting with ads that focused solely on the health care law.
"The intent was to reach a level of saturation where people were thinking very clearly about the impact of the law, and seeing people's stories in front of them and recognizing how we got here in the first place -- which was Democratic senators voting for it," AFP spokesperson Levi Russell told CBS News.
Later in the cycle, AFP began to shift its focus, tying the issue of health care to issues that are bigger concerns to voters -- namely, the economy and good governance. The ads hit on themes like affordability. "Everywhere we turn, people are telling us life is getting less affordable," Russell said. "In our view, so much of that is caused by big government policies that are making life more expensive."