A slim majority of Americans continues to favor moving forward on health care reform now despite an intensifying ad war and a political climate of contentious town hall meetings that coincide with rising concerns about the reform effort, according to the August Kaiser Health Tracking Poll.
Fifty-three percent of the public believes that tackling health reform is more important than ever, compared to 42 percent who say we cannot afford to take on health care reform right now. The gap between those points of view has narrowed in recent months as criticisms and doubts about reform plans seem to be registering. Sixty three percent of the public say they are "hopeful" about reform, 41 percent are "afraid" and 46 percent are simply "confused".
The August poll was conducted during a period in which politically active members of the public vented their fears and hopes about reform plans in fiery and widely-publicized town hall meetings with elected officials, and at a time when an increasing number of Americans (45% compared to 31% in July) reported seeing advertisements having to do with proposed changes in the health care system.
"The August health reform wars about hot button issues have definitely made the public more anxious but they have not caused public support to unravel," said Kaiser President and CEO Drew Altman. "When the Congress returns the debate will refocus on core issues such as how to pay for health reform and meet the public's expectations for help with their health insurance problems."
Better Off/Worse Off for Me and the Country
The intensifying debate appears to have impacted some key tracking poll indicators over the last month. One key indicator in the debate is the percentage of Americans who think that they or their families would be better off if the president and Congress enacted major health reform legislation. The largest group (36%) continues to say their family will be better off if health reform passes -- a proportion that has held relatively steady all year. However, the share who believes their family will be worse off has jumped 10 percentage points since July and now stands at 31 percent.
Similarly, while a larger proportion of Americans continues to believe the country as a whole would be better off if Congress passed health care reform than think it would be harmed (45% vs. 34%), the gap between those viewpoints has shrunk over the course of the summer. The share of Americans who see negative consequences for the country has climbed and the share anticipating benefits has fallen. Just one month ago, for instance, 51 percent thought the country would be better off if the president and Congress pass health reform, while 23 percent thought it would be worse off.
The uptick in fears of negative outcomes is driven in large part by a big jump in concerns among Republicans. This month, 61 percent of Republicans say they would be personally worse off if health reform passes, up 22 percentage points from July. Similarly, 68 percent of Republicans said the country would be worse off if reform passes, up 25 percentage points from July.
In addition, for the first time this year, more independents say they personally will be worse off rather than better off if health reform passes (36% vs. 30%). And independents now are roughly divided on whether or not health care reform will benefit the country, in contrast to previous months where optimists outnumbered pessimists in this group. Democrats have remained fairly steady in their perception of how health reform might affect them personally; a majority (53%) say they and their family would be better off if health reform passed.
Support for Individual Reform Proposals Remains High, and Expanding and Subsidizing Coverage and Insurance Reform Top the List of Most Important Goals
Despite the increasingly passionate debate this summer, public backing for key individual elements of health reform remains steady. Substantial majorities continue to say they support individual reform components designed to expand coverage, including a public plan option (59%), an expansion of state programs such as Medicaid (80%), an individual mandate (68%) and an employer mandate (68%).
Asked which elements of health reform are the "most important" to them, members of the public cited expanding and subsidizing health coverage to Americans who have been unable to afford it as their top choice (32%), followed by insurance reform (24%), and strengthening prevention programs (19%). Reining in the amount of money the country spends on health care came in fourth (9%).
Attention to the Debate
There is heightened attention to health reform, with 33 percent of Americans saying they are following the debate "very closely", up from 27 percent in July. Those who think they personally will be worse off if health reform is enacted are more likely to say they are following the debate "very closely" than those who think they personally will be better off (55% to 30%).
Moreover, with the ad wars becoming more intense, there has been a big spike in the share of Americans who say they have seen a health care reform-related ad over the course of the past week. Nearly half (45%) say they have seen, heard or read some sort of message on health reform, pro or con, over the past seven days, up from 31 percent last month and 21 percent in June. So far the pro-reform ads have a slight edge. Of those who saw an ad, 40 percent say the ad they saw was pro-reform, compared to 32 percent who said the ad they saw was anti-reform. Twenty-one percent said they had seen both kinds of ads.
Feelings About Reform Range Widely, and Seniors Are Most Likely to Feel Confused