Shift to political left seen in health care poll

62 percent of Americans say coverage is government’s responsibility

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.