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Americans Still Split Over New Health Reform Law

A majority supports expanding insurance, but most say the measure makes the wrong changes, poll finds

FRIDAY, April 30 (HealthDay News) -- One month after President Barack Obama signed the historic health-reform bill into law, Americans remain divided on the measure, with many people still unsure how it will affect them, a new Harris Interactive/HealthDay poll finds.

Supporters and opponents of the reform package are roughly equally divided, 42 percent to 44 percent respectively, and most of those who oppose the new law (81 percent) say it makes the "wrong changes."

"They are shoveling it down our throats without explaining it to the American people, and no one knows what it entails," said a 64-year-old female Democrat who participated in the poll.

Thirty-nine percent said the new law will be "bad" for people like them, and 26 percent aren't sure.

About the only thing that people agreed on -- by a 58 percent to 24 percent majority -- is that the legislation will provide many more Americans with adequate health insurance.

"The public is divided partly because of ideological reasons, partly because of partisanship and partly because most people don't see this as benefiting them. They see it as benefiting the uninsured," said Humphrey Taylor, chairman of The Harris Poll, a service of Harris Interactive.

Some 15.4 percent of the population, or 46.3 million Americans, lack health insurance coverage, according to the U.S. Census Bureau. Those 2008 figures, however, do not count people who recently lost health insurance coverage amid widespread job losses.

The centerpiece of the voluminous health reform package is an expansion of health insurance. By 2019, an additional 32 million uninsured people will gain coverage, according to the Congressional Budget Office.

The measure also allows young adults to stay on their parents' health insurance plan until age 26, and that change takes effect this year.

"I think that people are optimistic about stuff that they know about for sure, which is the under-26 provision, and then just the fuzzy nature of just what's been promised to them," said Stephen T. Parente, director of the Medical Industry Leadership Institute at the Carlson School of Management at the University of Minnesota in Minneapolis, and a former adviser to Republican Presidential candidate Sen. John McCain.

Expanding coverage to children under 26 "promises to be a relatively cheap and easy way to cover a group that was clearly disadvantaged under the old system," noted Pamela Farley Short, professor of health policy and administration and director of the Center for Health Care and Policy Research at Pennsylvania State University.

"It will give parents peace of mind and save them money if they were paying for COBRA extensions or individual policies so their kids would not be uninsured," she explained. "So I think that change will be popular and may help to build support for the exchanges and the big expansion of coverage in 2014."

However, on other measures of the legislation's impact, public opinion is mixed, the Harris Interactive/HealthDay poll found. More people think the plan will be bad for the quality of care in America (40 percent to 34 percent), for containing the cost of health care (41 percent to 35 percent) and for strengthening the economy (42 percent to 29 percent).

People often define quality in terms of access to the doctors they like, but "it's not clear any of this really changes or affects that," Parente said.

And he added, "No one is unequivocally saying this is going to solve the cost problem."

While President Obama said his plan would "bring down the cost of health care for millions of families, businesses, and the federal government," many have questioned the legislation's cost-containment provisions.

In a report issued last week, Chief Medicare Actuary Richard S. Foster said overall national health expenditures under the health-reform package would increase by an estimated $311 billion, or 0.9 percent, compared with the amounts that would otherwise be spent from 2010 to 2019.

Meanwhile, some health insurers have proposed steep premium rate increases in anticipation of health reform.

Anthem Blue Cross of California, a unit of Indianapolis-based Wellpoint Inc., the nation's largest insurer, in February proposed raising insurance rates as much as 39 percent on some policyholders in California. The company twice delayed the rate hikes in the wake of negative publicity and, on Thursday, the California Department of Insurance announced that Anthem had withdrawn the rate-hike request. Prompted by Anthem's proposed rate increases, Sen. Dianne Feinstein (D-Calif.) proposed legislation that would grant authority to the federal government to review "potentially unreasonable" rate increases and has vowed to press ahead with the measure.

So how would opponents change the new health-reform package?

A 41-year-old Independent male poll participant would like to see "an actual way to pay for this bill without mortgaging our great grandchildren." A Republican male, age 77, said it should have included malpractice limits. Creating a national insurance exchange would be more efficient than the state-based exchanges in the law, said an Independent female, age 30.

Neither the President nor the Democrats in Congress get much political credit for their legislative victory, with 48 percent of those polled saying Obama did a bad job (versus 40 percent who support his efforts). The public is even more critical of House Speaker Nancy Pelosi (58 percent negative versus 23 percent positive) and Congressional Democrats (59 percent versus 25 percent).

But Republicans in Congress fared even worse, with a 68 percent to 18 percent majority saying they did a bad job.

Harris Interactive's Taylor suspects that, if Obama and the Democrats are successful in passing popular bills, like financial market regulation, or if the economy improves faster than economists predict, that could boost public sentiment and "possibly have a halo effect on the health-care bill."

And if those things don't happen? "I have no doubt that many Republicans will campaign against this in the fall and it will be one of the sticks they use to beat the Democrats," he said.

The Harris Interactive/HealthDay poll, conducted online April 14-16, involved a national cross section of 2,285 adults 18 and older.

More information

Read more about the poll at Harris Interactive.

SOURCES: Humphrey Taylor, chairman, The Harris Poll, Harris Interactive, New York City; Stephen T. Parente, Ph.D., associate professor, and director, Medical Industry Leadership Institute, Carlson School of Management, University of Minnesota, Minneapolis; Pamela Farley Short, Ph.D., professor of health policy and administration, and director, Center for Health Care and Policy Research, Pennsylvania State University, University Park, Penn.; March 3, 2010, news release, The White House; April 22, 2010, memorandum, Centers for Medicare and Medicaid Services; Sept. 10, 2009, news release, U.S. Census Bureau; March 4, 2010, news release, Sen. Dianne Feinstein, D-Calif.; Harris Interactive/HealthDay poll, April 14-16, 2010

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