Health reform provisions poll well, even if bills do not

Washington -- Opponents of the Democrats' health reform legislation have been claiming for months that polls show most Americans are not in favor of the bills, but public opinion on reform is not that simple, polling experts said.

Sen. Lamar Alexander (R, Tenn.) was one of the Republicans pushing President Obama to start over on health reform during the Feb. 25 bipartisan White House health summit. Alexander said most of the country wants to scrap the legislation. "The American people ... have tried to say in every way they know how -- through town meetings, through surveys, through elections in Virginia and New Jersey and Massachusetts, that they oppose the health care bill that passed the Senate on Christmas Eve."

Reform plan supporters have been closing the gap since late last year, but they are still slightly outnumbered. On average, 49% of Americans opposed the Democrats' health reform plans in March, while 44% supported them, according to a compilation by Pollster.com of results from several national polls.

But polling experts said people should be skeptical of anyone who pushes a black-and-white analysis of Americans' opinions regarding health reform. "There isn't a simple answer about what people believe," said Mark Blumenthal, editor and publisher of Pollster.com.

A steady majority of the public has supported addressing health reform now rather than later, but their support shifts when asked about specific legislative ideas, said Claudia Deane, associate director for public opinion and survey research at the Kaiser Family Foundation.

The overall legislation is not as popular as some of its key provisions, Deane said. "So there's all these contradictions," she said. "Anybody who's going to try to sell you one clear line ... is not showing you all the data."

Some bill provisions enjoy significant bipartisan support. More than three-quarters of Americans are in favor of reforming health insurance, including ending lifetime benefit limits and exclusions based on preexisting conditions, according to the February Kaiser Health Tracking Poll. More than 70% of Americans support creating health insurance exchanges -- new marketplaces to compare and buy health coverage -- and tax credits for small businesses, according to the same poll.

Republicans also have asserted that public opposition to the bills are based on a good understanding of them. Senate Minority Leader Mitch McConnell (R, Ky.) said on Feb. 25 that the "American people have followed this issue like no other in the time I've been in Washington."

But the public is still learning about some of the provisions in the House- and Senate-adopted bills, according to the January Kaiser Health Tracking Poll. Just 52% recognized that the bills would provide tax credits to small businesses. Forty-four percent knew about provisions to narrow the coverage gap in Medicare's prescription drug benefit, and only 42% of respondents knew of language to end lifetime health plan benefit limits.

Blumenthal said that "most Americans aren't reading every story about this, aren't following every detail." Much of the health reform news coverage is about the legislative process, not the bills' content and potential impact, he said.

Americans know the reforms would cost a significant amount of money and that Congress is already spending a lot, Blumenthal said. They take cues from political leaders they respect. They've heard Republicans are uniformly opposed to the legislation, while Democrats have been arguing with each other. So people question whether the proposed reforms are any good, he said.

"The one question I wish was asked more often is about knowledge," Blumenthal said. "What do people know?"

Politicians are trying to use poll results to shape the health reform debate, said Karlyn Bowman, a senior fellow at the conservative American Enterprise Institute and an expert on public opinion. But she said the public is wary of the overall legislation because of its cost and complexity. "That's why the president has not been able to move the numbers in support of the plan."

Although the most recent Kaiser poll, for example, finds wide public support for specific reform provisions, Bowman isn't sure that support would survive follow-up queries about the provisions' cost. "I am very skeptical of hypothetical questions."