CONGRESS

Public Still Opposes Health Care Mandate

Linda Door, of Laguna Beach, Calif., protests against the Affordable Care Act. 
National Journal
Ronald Brownstein
March 26, 2012, 5:30 p.m.

Amer­ic­ans re­main over­whelm­ingly against re­quir­ing in­di­vidu­als to pur­chase health in­sur­ance, but they di­vide in half about the health care law that Pres­id­ent Obama signed in 2010, ac­cord­ing to the latest United Tech­no­lo­gies/Na­tion­al Journ­al Con­gres­sion­al Con­nec­tion Poll.

The poll found sweep­ing op­pos­i­tion to the so-called in­di­vidu­al man­date, whose con­sti­tu­tion­al­ity the Su­preme Court is con­sid­er­ing. But it also found the na­tion split along over­lap­ping lines of par­tis­an­ship and race when re­spond­ents were asked about the im­pact of Obama’s health re­form law and its ef­fort to ex­pand cov­er­age to the un­in­sured. At the same time, the Re­pub­lic­an pro­pos­al to re­struc­ture Medi­care in­to a premi­um-sup­port or vouch­er sys­tem faces res­ist­ance as wide­spread as the in­di­vidu­al man­date.

The man­date on in­di­vidu­als to pur­chase in­sur­ance or pay a pen­alty, as in earli­er na­tion­al polls, re­mains an idea without any sig­ni­fic­ant con­stitu­ency. Over­all, when asked if “the fed­er­al gov­ern­ment should or should not be able to re­quire all Amer­ic­ans to ob­tain health in­sur­ance or else pay a fine,” just 28 per­cent of those sur­veyed said they sup­por­ted the man­date, while 66 per­cent op­posed it.

The man­date faced op­pos­i­tion even from a nar­row ma­jor­ity of non­white adults; al­most three-fifths of young people; and two-thirds of col­lege-edu­cated white wo­men””all pil­lars of the mod­ern Demo­crat­ic co­ali­tion. Even Demo­crats, by a 48 per­cent to 44 per­cent plur­al­ity, said they op­posed a man­date. Two-thirds of in­de­pend­ents re­jec­ted the idea, and op­pos­i­tion soared to nearly three-fourths among whites without a col­lege edu­ca­tion. Re­pub­lic­ans op­posed the idea by more than 15-to-1.

The United Tech­no­lo­gies/Na­tion­al Journ­al Con­gres­sion­al Con­nec­tion Poll, con­duc­ted by Prin­ceton Sur­vey Re­search As­so­ci­ates In­ter­na­tion­al, sur­veyed 1,003 adults on March 22-25. It has a mar­gin of er­ror of plus or minus 3.6 per­cent­age points.

Ques­tions about the re­form law’s over­all im­pact split the coun­try more closely. Asked for their over­all as­sess­ment of the 2010 law, 43 per­cent of adults said they favored it, while 46 per­cent op­posed it.

Re­ac­tion di­verged along par­tis­an lines: While Demo­crats backed the law by 75 per­cent to 17 per­cent, Re­pub­lic­ans op­posed it by an even more lop­sided 86 per­cent to 6 per­cent. In­de­pend­ents split, with 45 per­cent op­pos­ing and 43 per­cent sup­port­ing.

The ra­cial di­vi­sion was equally vivid. Sixty-eight per­cent of non­white adults said they sup­por­ted the law, with only 18 per­cent op­posed. Among whites, just 33 per­cent ap­proved of the law, while 58 per­cent op­posed it.

White voters’ at­ti­tudes fis­sured fur­ther along edu­ca­tion­al lines. Al­though whites without a col­lege de­gree are un­in­sured at high­er rates than whites with ad­vanced edu­ca­tion, just 28 per­cent of non­col­lege whites said they favored the law, while 61 per­cent op­posed it. Work­ing-class white men and wo­men were equally du­bi­ous.

Col­lege-edu­cated whites were more sup­port­ive over­all, but with a sig­ni­fic­ant gender gap. Just 37 per­cent of col­lege-plus white men sup­por­ted the law, while 56 per­cent op­posed it. Col­lege-edu­cated white wo­men, usu­ally the white demo­graph­ic group most re­cept­ive to Demo­crats, were again more en­thu­si­ast­ic: 51 per­cent of them favored the law, while 46 per­cent op­posed it.

The coun­try di­vided sim­il­arly closely on an­oth­er ques­tion that asked about the law’s at­tempt to ex­pand cov­er­age to the un­in­sured. The ques­tion noted that fed­er­al es­tim­ates pro­ject the law would provide health in­sur­ance to 33 mil­lion of the 50 mil­lion Amer­ic­ans now without it at a cost of about $150 bil­lion. The ques­tion then asked re­spond­ents wheth­er Con­gress should re­peal the pro­gram be­cause it is un­af­ford­able “at a time of large budget de­fi­cits,” or keep it “be­cause it’s im­port­ant to re­duce the num­ber of Amer­ic­ans without health in­sur­ance.”

By 45 per­cent to 42 per­cent, re­spond­ents said that Con­gress should keep the pro­gram. Nearly four-fifths of Re­pub­lic­ans backed re­peal, while al­most three-fourths of Demo­crats wanted to main­tain the law. In­de­pend­ents, by 45 per­cent to 40 per­cent, sup­por­ted main­tain­ing the cov­er­age ex­pan­sion.

Once again, the ra­cial di­vide may be even more telling. Al­most two-thirds of minor­it­ies said that Con­gress should main­tain the law’s pro­vi­sions to ex­pand cov­er­age; by 49 per­cent to 38 per­cent, though, whites backed re­peal. Still, that’s a slightly bet­ter show­ing than the 33 per­cent of whites who favored the law over­all. Among whites, those without col­lege de­grees ac­coun­ted for all of the dif­fer­ence between the two ques­tions.

In a meas­ure of how dif­fi­cult it is to gen­er­ate sup­port for big change in al­most any dir­ec­tion on health care, the Medi­care re­struc­tur­ing at the cen­ter of the House GOP’s long-term budget plan fared as badly in the sur­vey as Obama’s in­di­vidu­al man­date. Asked what Medi­care should look like in the fu­ture, just 26 per­cent said it “should be changed to a sys­tem where the gov­ern­ment provides seni­ors with a fixed sum of money they could use either to pur­chase private health in­sur­ance or to pay the cost of re­main­ing in the cur­rent Medi­care pro­gram.” Fully 64 per­cent said “Medi­care should con­tin­ue as it is today, with the gov­ern­ment “¦ pay­ing doc­tors and hos­pit­als dir­ectly for the ser­vices they provide to seni­ors.”

Even a sol­id 56 per­cent to 30 per­cent ma­jor­ity of Re­pub­lic­ans pre­ferred the cur­rent sys­tem.

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