For All Its Intensity, Americans Are Not Swayed by the Healthcare Debate

Public Remains Split on Reform Proposals

Wednesday, September 02, 2009

Washington, DC – Americans remain divided in their views of healthcare reform, as roughly as many feel that a public health insurance plan is necessary in order for all Americans to have access to quality healthcare (49%) as say that this can be achieved without creating a public plan (46%), according to a new telephone poll conducted by Ipsos Public Affairs. This mirrors attitudes from a poll held in early July, when 52% said a public option was needed and 44% said it was not.

  • African-Americans (78%), Hispanics (70%), those with a household income of less than $25,000 (65%), unmarried adults (55%), and those under age 55 (53%) are most likely to say that a public health insurance plan is needed. In contrast, majorities of Americans with a household income of $50,000 or more (55%), are married (52%), are college graduates (51%), and are aged 55 and older (50%) disagree.
  • Across partisan lines, Democrats are three times as likely as Republicans to say that they favor a public option (68% vs. 23%). Independents are more likely to align with the Democrats in this instance, with 54% saying that a public plan is needed.

Americans also remain split when it comes to the objectives of healthcare reform. While nearly half (49%) feel that the primary goal of a national healthcare overhaul should be to extend health insurance to the millions of Americans who now lack it, four in ten (39%) say that it should be to rein in the rising costs of healthcare. Attitudes were relatively similar in early July, when 46% prioritized extending coverage over cutting costs and 44% focused on costs rather than coverage.

  • Again, younger adults and less affluent adults are more likely to choose expanding coverage while older, more affluent adults are more concerned about reigning in rising costs. Majorities of African-Americans (79%), Hispanics (70%), those with a household income of less than $25,000 (61%), adults under 55 (55%), those with a high school education or less (57%), and unmarried adults (57%) believe that the main objective of the reform should be extending coverage to the uninsured. Conversely, college graduates (48%) and those with a household income of at least $50,000 (47%) are more likely to think the primary goal should be reducing costs.

Similarly, nearly equal proportions of the public say that they favor as say that they oppose the “healthcare reform proposals presently being discussed;” 40% favor them while 45% oppose them. The remaining 15% volunteer that they either do not have an opinion on the matter or that they are unsure.

  • Similar trends emerge across demographic groups: adults over 55 (52%) and with a household income of at least $25,000 (51%) are most likely to oppose the proposed plan, while African-Americans (76%), Hispanics (56%), and those with a household income of less than $25,000 (51%) are most likely to favor it.
  • Partisanship is also closely linked to support for the reforms being discussed. Over six in ten Democrats (62%) are proponents of the reform proposals while 81% of Republicans are opposed. Independents are much more uncertain, with 39% in favor, 37% opposed, and 22% saying that they do not have an opinion.

These are some of the findings of an Ipsos poll conducted August 27-31, 2009. For the survey, a nationally representative, randomly selected sample of 1,057 adults aged 18 and older across the United States was interviewed by Ipsos. With a sample of this size, the results are considered accurate within 3.1 percentage points, 19 times out of 20, of what they would have been had the entire adult population in the U.S. been polled. All sample surveys and polls may be subject to other sources of error, including, but not limited to coverage error, and measurement error. These data were weighted to ensure that the sample's composition reflects that of the actual U.S. population according to U.S. Census figures. Respondents had the option to be interviewed in English or Spanish.

Trust Levels Remain Stable Despite Mudslinging

When it comes to healthcare reform, Americans still tend to place their trust in the same people and organizations as they did in early July in spite of the heated debate. While they are somewhat more likely to trust doctors (28% now vs. 20% then), President Obama remains one of the most trusted players in the debate (27% currently vs. 26% in early July).

  • Among those most likely to say they place the most trust in the President are African-Americans (52%), Hispanics (36%) and Midwesterners (33%). Americans are nearly as likely to say that they most trust Democrats in Congress (12%) as to say they most trust Republicans in Congress (14%). Less trusted parties include health insurance companies (4%) and pharmaceutical companies (1%). More than one in ten (11%) says that they do not trust any of these and 4% are unsure.
  • Again, notable differences emerge depending on party affiliation. Democrats tend to primarily place their trust in President Obama (41%) or Democrats in Congress (24%), while Republicans first put their faith in doctors (39%) and Republicans in Congress (31%). Independents seem to be the most jaded; while 36% say they trust doctors most and 24% say they trust Obama most, nearly a quarter (22%) say that they do not trust any of the players involved in the reform debate.

When asked which one they trust least, those most frequently cited are health insurance companies (20%), Republicans in Congress (18%) and Democrats in Congress (17%).

Americans Prefer Gradual Reform to Sweeping Change

Though Americans are fairly evenly divided when it comes to healthcare reform, they do tend to agree on one thing: that the focus of health care reform should be on “making gradual but continuous improvements” (75%) rather than “fixing everything at once” (22%).

  • With few exceptions, at least seven in ten adults across demographic groups say that they would prefer incremental change to improve the healthcare system – including Democrats (70%). However, Hispanics (38%) and African Americans (35%) are among those most likely to favor fixing everything at once.

There is also some consensus that the reform should include specific regulations to ensure basic patients' rights, such as portability of coverage. Nearly three quarters of adults (74%) say that they favor this measure while just 15% oppose. One in ten either has no opinion (8%) or is unsure (2%).

  • Parents of younger children (82%), Democrats (81%), 35 to 54 year olds (80%), and those who are not currently employed (79%) are particularly likely to support regulations to promote patients’ rights.

Other measures, however, are more controversial. Americans are more likely to favor “legislation that would permit the creation of insurance co-operatives not run by the government” (54%) than they are to favor the “creation of a public entity to directly compete with existing health insurance companies” (49%). However, there is significant opposition to both of these proposals (36% and 41%, respectively).

  • When it comes to the creation of a public entity to directly compete with existing health insurance companies, African Americans (69%), Hispanics (62%), those with a household income of less than $25,000 (58%), and adults under 55 (54%) tend to be proponents. In contrast, those most likely to oppose this public option include those aged 55 and older (49%), men (48%), married adults (47%) and those with a household income of at least $25,000 (46%).
    • Democrats are as likely to support this initiative as Republicans are to oppose it (64% of Democrats favor; 63% of Republicans oppose). While Independents are more likely to favor than oppose this measure (49% vs. 34%), 16% say that they have no opinion.
  • Midwesterners (60%), those with a household income of at least $50,000 (60%), parents (61%), college graduates (59%), and those who are not currently employed (59%) are most likely to be proponents of legislation that would allow for the creation of insurance co-operatives while African-Americans (50%) and Southerners (42%) are most likely to be opposed
    • Majorities across partisan lines favor this legislation, including 50% of Democrats, 58% of Republicans, and 54% of Independents.

For more information on this news release, please contact:
Clifford Young
Senior Vice President
Ipsos Public Affairs
(312) 777-3911

About Ipsos Public Affairs

Ipsos Public Affairs is a non-partisan, objective, survey-based research practice made up of seasoned professionals. We conduct strategic research initiatives for a diverse number of American and international organizations, based not only on public opinion research, but elite stakeholder, corporate, and media opinion research.

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For All Its Intensity, Americans Are Not Swayed 
by the Healthcare Debate


Clifford Young
President, US
Ipsos Public Affairs