Indiana University


Americans May Disagree About The New Health Care Reform Law, But There May Be More Common Ground Than Many Think.

Repeal or Leave It?

CHPPR’s most recent national survey of Americans has found that less than a quarter of Americans (mostly Democrats) are completely satisfied with the health care reform legislation signed into law by the president last month.  However, that doesn’t mean that Americans necessarily want to see the law repealed.  Twenty-eight percent of Americans would like to see the legislation left in place, but with changes made to it.  Of the 51 percent of Americans favoring repeal of the legislation, the overwhelming majority still are interested in seeing reforms made to the health care system


What are they thinking?

Of the almost four in ten Americans who want the law repealed and new health care legislation enacted, 40 percent say they are most unhappy about what the current legislation proposes to do, while another 39 percent say they can not decide what they are most unhappy about – the process by which the legislation was passed or the legislation itself.

When asked what reforms they would like to see contained in a new piece of legislation, this group of Americans still favored many of the same reforms that are already contained in the law signed by the President last month such as coverage of pre-existing medical conditions, and filling the donut hole in Medicare prescription drug benefits.  The one glaring exception to this trend is the requirement that all Americans purchase health insurance.  Eighty percent of those who want repeal are opposed to the inclusion of this mandate in new health care reform legislation. 


The allure of additional health care reforms

This survey also explored the interest of the American public in seeing additional health care system reforms passed.  Of those Americans who are in favor of some type of reforms to the health care system, 83 percent were supportive of adding provisions on medical malpractice reform, 85 percent endorsed the sale of insurance across state lines, and 73 percent wanted to see increased pharmaceutical regulation.  However further health care reforms fell low on the list of priorities for the upcoming legislative session with reduction of the federal deficit and reforming financial system regulation being seen as the most important issues to be addressed.


The enigma of the “public option”

One of the most unexpected findings of this survey may be what people had to say about creation of a public option -- a government run insurance plan that had previously been proposed, but dropped from the final version of the law. The survey found the public option to be more popular than expected, with 59 percent of those asked supporting it.

Even more surprising, is how much the phrasing of the public option question clearly mattered to those surveyed.  When the public option was framed as a government administered option that that would “compete” with private health insurance only 48 percent supported it; when framed instead as a “choice” between government provided health insurance or private health insurance the percentage who supported it increased to almost three quarters of those surveyed.  

Also striking is the change of support observed when the data is broken out along party lines.   Support for the public option among Independents shifts from 41 percent to 72 percent when the framing is changed from “compete” to “choice.”  A similar, although smaller scale shift is also seen among Republicans (33% “compete” vs. 49% “choice”).   


Bottom Line

Many continue to focus on Americans' being divided on whether they want to repeal The Affordable Care Act.  Lost in this is the fact that for the most part, Americans agree on what they want the Act to do – such as cover those with pre-existing conditions, increase insurance company regulation, and close the Medicare donut hole.  The one exception seems to be the requirement for individuals to purchase health insurance, which is overwhelmingly opposed by those who want repeal. 

Ironically, another issue on which many Americans agree seems to be the public option.  A significant majority supports its addition, and this can be significantly impacted based on whether the public option is framed as being a “choice” or as “competition” for private insurance.


Survey Methodology and Full Report

Market Strategies International conducted the survey on behalf of CHPPR and the CBE during the period between April 15 and 19, 2010.  A total of 600 adults, ages 18 and older, living in the 48 contiguous states and the District of Columbia responded to this survey.   The margin of sampling error for results based on the total sample is plus or minus 4 percentage points. 

Download a full report of survey results.