According to the latest Reason-Rupe poll, 58 percent of Americans are satisfied with their health care and 87 percent say they are covered by health insurance. Nevertheless, Americans are still keenly aware of extant problems in the health care system, yet are unconvinced the new health care law passed by Congress in 2010 is necessarily the solution (with 32 percent favorability). Opposition to the law is likely driven by the 62 percent of Americans who believe the individual mandate is unconstitutional. Nevertheless, other provisions in the law, such as Community Rating, maintain majority support. However, Community Rating loses majority support when potential unintended costs, such as lowered health care quality, higher taxes, higher premiums, or longer wait times, are considered.
The Health Care Market
Whereas 65 percent of Americans say they have shopped around for less expensive and better auto insurance, 69 percent would like to have similar ability to shop around for less expensive or better health insurance. Instead a sizeable portion, 42 percent, of Americans say they do not have a choice in health insurance providers. When asked how respondents would improve health care, 32 percent specifically mentioned lower costs. Interestingly, 43 percent of Americans believe health insurance premiums would decrease if health insurance companies were allowed to compete across state lines, and 24 percent believe premiums would increase.
There is also substantial support to move away from the employer-based health insurance system with half of Americans reporting they would prefer to receive an equivalent amount of funds from their employers to shop for and purchase their own health insurance plans. Thus, instead of employers allocating a part of employee compensation toward an employer-selected health insurance policy, employees would receive that money to select health insurance independently of their employers. 41 percent would prefer to buy insurance through their employer.
The New Health Care Law
It is not clear that Americans perceive the new health care law as the solution to problems in the health care market. Half of Americans have an unfavorable opinion compared to 32 percent who have a favorable opinion of it. When given the choices to let the new law stand or repeal it, 36 percent want the new health care law to stand and half want to repeal it.
A likely driver behind opposition to the law is the unpopular individual mandate. Fifty-one percent of Americans do not think Americans should be required to have health insurance. Fully 62 percent of Americans believe it is unconstitutional for Congress to require Americans to have health insurance.
Besides the individual mandate, other provisions in the law enjoy majority support, such as Community Rating and requiring employers with more than 50 employees to provide health insurance.
Concurring with other polls, 52 percent favor the Community Rating provision in the law which prohibits health insurance companies from charging some customers higher premiums based on medical history or pre-existing conditions. Unlike other polls, however, Reason-Rupe delved deeper regarding the potential unintended costs associated with Community Rating. If longer wait times to see a physician or specialist were to result from the Community Rating Provision, support drops to 41 percent. If higher premiums were to result, support drops to 38 percent, and if higher taxes were to result, support drops to 37 percent. The most significant shift in opinion occurs if the Community Rating provision were to result in lowered health care quality with 76 percent in opposition.
54 percent of Americans believe the new law will lead to government rationing of health care services, meaning that some forms of medical care would no longer be covered because it is too costly, not essential, or has too little chance of success.
Congruent with other poll findings, a majority (56 percent) favor the new law's requiring employers with more than 50 employee to provide health insurance or else pay a fine. Interestingly, when following up regarding the expected impact of this provision, 58 percent of Americans believe this will lead companies to pay their employees less and 47 percent believe this will lead companies to lay off workers.
These expectations create a problem for policymakers because polls continue to reiterate the public's top concerns being the economy and jobs. If an unintended consequence of this provision in the law were to actually cut jobs and reduce pay, it is unclear how policymakers prioritize.
Nationwide telephone poll conducted March 10th-20th of both mobile and landline phones, 1200 adults, margin of error +/- 3%. Columns may not add up to 100% due to rounding. Full methodology can be found here.
Full poll results found here.
Emily Ekins is the director of polling for Reason Foundation where she leads the Reason-Rupe public opinion research project, launched in 2011. Follow her on Twitter @emilyekins.