Shift to po­lit­i­cal left seen in health care poll

62 per­cent of Amer­i­cans say cov­er­age is govern­ment’s re­spon­si­bil­ity

The Denver Post - - NEWS - By Ri­cardo Alonso-Zaldivar and Lau­rie Kellman

WASHINGTON» Amer­i­cans were never too thrilled with the Af­ford­able Care Act, and they def­i­nitely dis­ap­prove of Repub­li­can al­ter­na­tives in Congress. So what does the pub­lic want to do on health care?

A new poll sug­gests the coun­try may be shift­ing left on this core is­sue, with 62 per­cent say­ing it’s the fed­eral govern­ment’s re­spon­si­bil­ity to make sure that all Amer­i­cans have health care cov­er­age, while 37 per­cent say it is not.

The sur­vey find­ings from the As­so­ci­ated Press-NORC Cen­ter for Pub­lic Af­fairs Re­search in­di­cate a change in pub­lic at­ti­tudes over the past few months, as concerns mounted about GOP leg­is­la­tion es­ti­mated to leave tens of mil­lions with­out cov­er­age.

“No­body should be with­out in­surance,” said Louise Pri­eto of Fort Lee, N.J., a re­tiree cov­ered by Medi­care. She said she’s most con­cerned about se­niors, chil­dren and people with pre-ex­ist­ing med­i­cal con­di­tions.

As re­cently as March, the AP-NORC poll had found Amer­i­cans more am­biva­lent about the fed­eral govern­ment’s role, with a slim 52 per­cent ma­jor­ity say­ing health cov­er­age is a fed­eral re­spon­si­bil­ity, and 47 per­cent say­ing it is not.

The sur­vey didn’t spec­ify how the govern­ment might make sure that people have cov­er­age, but a true guar­an­tee en­tails some­thing like the “Medi­care for all” plan that was a ral­ly­ing cry for Ver­mont Sen. Bernie San­ders’ pres­i­den­tial campaign last year. And that would in­volve hard-to-swal­low tax in­creases.

“There is a sig­nif­i­cant in­crease in people

who sup­port uni­ver­sal cov­er­age,” said Robert Blen­don of the Har­vard T.H. Chan School of Pub­lic Health, who tracks opin­ion trends on health care. “The im­pact of the de­bate over drop­ping cov­er­age looks like it has moved (more) people to feel that the govern­ment is re­spon­si­ble for mak­ing sure that people have cov­er­age.”

Cur­rently the U.S. has a hy­brid sys­tem of pay­ing for med­i­cal care, with em­ploy­ers, fed­eral and state gov­ern­ments, and in­di­vid­u­als shar­ing re­spon­si­bil­ity. Govern­ment at all lev­els pays close to half the an­nual $3 tril­lion cost, and fed­eral tax breaks sup­port em­ployer-pro­vided cov­er­age.

Em­ploy­ers cover more than 170 mil­lion work­ers, de­pen­dents and re­tirees. Medi­care, the fed­eral govern­ment’s flag­ship health care pro­gram, cov­ers about 56 mil­lion re­tirees and dis­abled people. Med­i­caid, a fed­eral-state Med­i­caid part­ner­ship, cov­ers more than 70 mil­lion low-in­come people, from new­borns, to se­verely dis­abled people, to many el­derly nurs­ing home res­i­dents. About 28 mil­lion people re­main with­out cov­er­age, al­though for­mer Pres­i­dent Barack Obama’s health care law has brought the unin­sured rate to a his­toric low of about 9 per­cent.

The lat­est AP-NORC poll found a fa­mil­iar par­ti­san split: more than eight in 10 Democrats said health care is a fed­eral re­spon­si­bil­ity, com­pared with three in 10 Repub­li­cans. Po­lit­i­cal in­de­pen­dents were more closely di­vided, with 54 per­cent say­ing cov­er­age is a fed­eral re­spon­si­bil­ity and 44 per­cent say­ing it is not.

In the poll, Amer­i­cans didn’t find much to like about the Repub­li­can leg­is­la­tion of­fered in Congress. Over­all, only 17 per­cent thought they and their fam­i­lies would be better off; 37 per­cent thought they would be worse off.

On specifics, 73 per­cent op­posed giv­ing states the op­tion to let in­sur­ers charge some people higher pre­mi­ums be­cause of their med­i­cal his­tory. And 57 per­cent op­posed al­low­ing states to re­duce the types of ben­e­fits that fed­eral law now re­quires in­sur­ers to cover. Sim­i­larly, 64 per­cent op­posed al­low­ing states to per­mit some health plans to omit cov­er­age for men­tal health and drug ad­dic­tion treat­ment. There was also solid op­po­si­tion to Med­i­caid cuts (62 per­cent) and over­whelm­ing dis­ap­proval (78 per­cent) for al­low­ing in­sur­ers to raise pre­mi­ums for older adults be­yond what is per­mit­ted cur­rently.

Repub­li­cans have ar­gued that al­low­ing states to loosen such in­surance rules, par­tic­u­larly for people who let their cov­er­age lapse, would re­sult in lower pre­mi­ums all around. The poll also found that Amer­i­cans dis­ap­prove of var­i­ous strate­gies that the Obama law and the GOP bills rely on to nudge healthy people to buy cov­er­age, from the cur­rent tax penal­ties for those who don’t have in­surance, to wait­ing pe­ri­ods and pre­mium penal­ties pro­posed by Repub­li­cans.

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