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Public Opinion on Health Reform Stable and Supportive as Debate Heats Up, But Moveable Too
Date:6/15/2009

MENLO PARK, Calif., June 16 /PRNewswire-USNewswire/ -- As Congressional committees begin to hone in on the details of their health reform bills and debate intensifies, the latest Kaiser health tracking poll finds remarkable stability in public opinion on health reform.

A solid majority of the American people (61%) continue to believe that health reform is more important than ever given the country's economic problems); sizeable majorities support key elements of reform currently being debated such as employer mandates (69%), individual mandates (71%), and a public plan option (65-67% depending on wording). However, as we have seen in previous polls less than half of the public (41%) say they are willing to pay more for health reform, with a similar number supporting changing the tax treatment of employer based health insurance (40%), one of the major revenue raisers being discussed. Overall opinion remains highly moveable, with support for many elements of reform susceptible to arguments pro and con and often moving by as much as 40 percentage points when arguments are tested.

"It will be important for policymakers to move quickly once there is legislation on the table to get it on the president's desk so that a protracted debate and a Harry and Louise style ad war do not undermine the high level of public support we see today," said Kaiser President and CEO Drew Altman.

The underlying problems that have motivated the public to care about health reform, such as skipping or delaying care due to costs, remain high and largely unchanged from previous surveys, with a majority (55%) of Americans reporting that they or another member of their household have put off some needed medical care because of cost in the past 12 months, such as skipping a recommended test or treatment or not filling a prescription for medication.

Some new findings emerged in the tracking poll as well.

  • Only about two in ten people reported seeing an ad related to health reform and most who did thought the ad was pro-reform.
  • Perhaps reflecting the public's general perceptions of these groups on health reform from past debates -- and despite the fact that they have been very publicly at the table so far on health reform -- substantial majorities said that big business groups (64%), health insurers (62%), drug companies (58%), and doctors groups (54%) are NOT supporting the president's and Congress' effort to reform health care this year.
  • A narrow majority of the public (53%) supported limiting future increases in how much doctors and hospitals are paid under Medicare to help pay for health reform (37% opposed). A majority (56%) of those under 65 supported this while only four in ten (40%) of those age 65 or older did. Reductions in future increases in Medicare payments are thought to be an important potential part of a health reform financing package.
  • A large majority (70%) liked the idea of insurance exchanges -- tested with different descriptions -- as a way to help people purchase insurance on their own. Exchanges are a key part of the legislation being debated.

Disagreement Remains on Willingness to Pay for Health Reform

With financing health reform looming as a key challenge, the survey focused several questions on this issue.

  • The public remains divided in their willingness to pay more to expand coverage to the uninsured, with a slight majority (54%) saying they are not personally willing to pay more to expand coverage.
  • Six in ten Americans (60%) continue to say that if policymakers made the right changes the health care system could be reformed without spending more money to do it.
  • Slightly more than half (54%) of Americans oppose taxing the employer sponsored health benefits of those with the most generous plans (compared to 63% among those insured by an employer).
  • Roughly two-thirds (67%) oppose across-the-board increases on income taxes.

On a few financing options there is some agreement. A narrow majority supports taxing soda (53%) and unhealthy snack foods (55%). Clear majorities support increased taxes on the wealthy (68%), cigarettes (68%) and alcoholic beverages (67%) as a way to pay for health reform.

"With all the talk of inefficiencies in the system and achieving future savings, the public may confuse the potential for long-term savings with the need for short-term outlays and think that health care can be reformed for free. This could make policymakers' jobs tougher when the price tag for the legislation comes out," Altman said.

Forging Bipartisan Agreement

Another challenge will be forging bipartisan support. The poll found areas of large partisan disagreement. For example, three-quarters (74%) of Democrats and six in ten (59%) independents said given the country's serious economic problems health reform is more important than ever, while a majority (56%) of Republicans said we can't afford health reform right now. A slim majority of Democrats (53%) are willing to pay more for providing coverage, while smaller numbers of independents (38%) and Republicans (29%) say the same.

There are some key areas of agreement across party identification lines. For example, a majority of Democrats (68%), Republicans (69%) and independents (75%) agreed insurance exchanges that guaranteed that "participating plans would not deny coverage to those with pre-existing conditions or charge higher premiums to those who are in poorer health" would be helpful if one had to purchase health insurance on one's own. Previous tracking polls also found strong bipartisan agreement on measures to reform the private health insurance marketplace, such as eliminating medical underwriting.

Methodology

The survey was designed and analyzed by public opinion researchers at the Kaiser Family Foundation and was conducted June 1 through June 8, 2009, among a nationally representative random sample of 1,205 adults ages 18 and older. Telephone interviews conducted by landline (804) and cell phone (401, including 157 who had no landline telephone) were carried out in English and Spanish. The margin of sampling error for the total sample is plus or minus 3 percentage points. For results based on subgroups, the margin of sampling error is higher.

The full question wording, results, charts and a brief on the poll can be viewed online at http://www.kff.org/kaiserpolls/posr061609pkg.cfm.

The Kaiser Family Foundation is a non-profit private operating foundation, based in Menlo Park, California, dedicated to producing and communicating the best possible analysis and information on health issues.


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SOURCE Kaiser Family Foundation
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