Saturday, March 27, 2010


Washington Post poll finds split on health-care law remains deep

By Jon Cohen and Dan Balz
Washington Post Staff Writer
Sunday, March 28, 2010; A01

Americans overwhelmingly see the new health-care law as a major shift in the direction of the country, but they remain as deeply divided today over the changes as they were throughout the long congressional debate, according to a Washington Post poll.

In the days since President Obama signed the farthest-reaching piece of social welfare legislation in four decades, overall public opinion has changed little, with continuing broad public skepticism about the effects of the new law and more than a quarter of Americans seeing neither side as making a good-faith effort to cooperate on the issue.

Overall, 46 percent of those polled said they support the changes in the new law; 50 percent oppose them. That is virtually identical to the pre-vote split on the proposals and similar to the divide that has existed since last summer, when the country became sharply polarized over the president's most ambitious domestic initiative.

The health-care debate galvanized the country to a remarkable extent. About a quarter of all adults say they tried to contact their elected representatives in Congress about health care in recent months, including nearly half of those who say they are "angry" about the changes. In general, opponents of the measure were more than twice as likely as supporters to say they had made the effort.

But there are signs that Democrats have started to rally, with the party's base firming up after intense internal battles over a public insurance option and provisions covering abortion funding. Fifty-six percent of Democrats now "strongly support" the recently enacted health-care changes; last month, 41 percent were solidly behind the proposals. Eight in 10 Democrats now approve of the way Obama is handling health care, the most since last summer.

Obama's overall approval rating is at 53 percent in the poll, about the same as it has been in Post-ABC polls in the past several months; 43 percent disapprove.

Obama has renewed his effort to sell the legislation to the public ahead of the November midterm elections, with more rallies planned this week. His success could be crucial to Democratic fortunes in this fall's midterm elections, with about six in 10 saying the congressional votes on health care will be a factor in their choice at the ballot box.

At this point, Democrats hold a razor-slim edge (47 to 43 percent) on the "generic ballot," the question about which party's candidate people support in their local districts. Independents, who swung solidly for Democratic candidates in 2006 and 2008, now divide 42 percent for the GOP candidate and 39 percent for the Democrat.

Democratic officials have long argued that once the debate ended and health-care legislation was enacted, the public would begin to see the changes in a far-more-favorable light. The new poll suggests that the president and his party still face significant obstacles in this new phase of the debate.

Passions remain strongest among the plan's detractors, as 26 percent of all adults said they are angry about the changes enacted by Congress, up from 18 percent in August. That includes 54 percent of all Republicans. Fewer Americans, 15 percent, said they are enthusiastic about the new measure, including 40 percent of liberal Democrats.

Among opponents, there is near-universal support (86 percent) for efforts to cancel the changes either through a new vote in Congress or through the courts. Since passage, Republican leaders have called for repeal of the new law and replacement with more modest changes.

Many key provisions of the new law have been highly popular in recent polling, particularly insurance changes such as extending coverage to young adults and eliminating exclusions based on preexisting conditions. But the intensity of the overall opposition adds to the Democrats' challenge in pitching those benefits to voters, with just over seven months until the midterm elections.

More people see the changes as making things worse, rather than better, for the country's health-care system, for the quality of their care and, among the insured, for their coverage. Majorities in the new poll also see the changes as resulting in higher costs for themselves and for the country.

Most respondents said reform will require everyone to make changes, whether they want to or not; only about a third said they believe the Democrats' contention that people who have coverage will be able to keep it without alterations. And nearly two-thirds see the changes as increasing the federal budget deficit, with few thinking the deficit will shrink as a result. The Congressional Budget Office said the measure will reduce the deficit.

About half of all poll respondents said the plan creates "too much government involvement" in the health-care system, a concern that is especially pronounced among Republicans.

Senior citizens, who typically make up about one in five midterm voters, represent a particularly valuable but tough audience on this issue. More than six in 10 of those 65 or older see a weaker Medicare system as a result of the changes to the health-care system. Overall, seniors tilt heavily against the changes, with 58 percent opposed and strong opponents outnumbering strong supporters by a 2-to-1 ratio.

At the same time, seniors who say they understand the upcoming changes are much more apt to back the new law than those who say the plan is too complicated.

Support for the changes is significantly higher among Democrats and independents who say they understand the legislation than it is among those who do not. Republicans are solidly opposed, regardless of whether they think they understand the changes.

The overall political landscape continues to look favorable for Republicans to make gains in November, with six in 10 Americans seeing the country as pretty seriously off on the wrong track and that broad dissatisfaction likely to fall hardest on incumbents.

At this point, more poll respondents said they are likely to oppose a lawmaker who backed the president's health-care initiative than said they would support such a candidate (32 percent to 26 percent), with more passion again on the negative side. Forty percent said the health-care vote will make no difference in their decision this fall.

The Democrats hold a 13-point advantage over the GOP when it comes to dealing with health care in general. That's a significant, but far slimmer, lead than they carried into the 2006 elections, which returned them to the majority. Similarly, Democratic advantages on the economy, taxes, immigration and the deficit are all severely attenuated.

Republicans now have a six-point edge when it comes to handling terrorism, a historical GOP strong point that Democrats had neutralized. Democrats are favored on Afghanistan policy, an area that remains a strong point for the president.

The largest Democratic lead in the new poll is on energy policy, where the party holds a 49 to 32 percent advantage.

A big concern for both parties may be that significant numbers in the poll -- 10 percent or more -- see neither as more trustworthy on each of those major issues.

Public approval of Obama's handling of health care has rebounded somewhat, but a slim majority continues to disapprove of the way he is dealing with issue No. 1: the economy. About half of respondents (49 percent) said Obama won't be a factor in their vote in November. The rest split about equally between saying they would vote in part to express support for the president and saying it would be to show opposition.

The poll was conducted March 23 to 26 among a random national sample of 1,000 adults; the results have a margin of sampling error of plus or minus three percentage points.

Republicans were for President Barack Obama's requirement that Americans get health insurance

Obama health insurance requirement taken from GOP
Associated Press Writer
Republicans were for President Barack Obama's requirement that Americans get health insurance before they were against it.

The obligation in the new health care law is a Republican idea that's been around at least two decades. It was once trumpeted as an alternative to Bill and Hillary Clinton's failed health care overhaul in the 1990s. These days, Republicans call it government overreach.

Mitt Romney, weighing another run for the GOP presidential nomination, signed such a requirement into law at the state level as Massachusetts governor in 2006. At the time, Romney defended it as "a personal responsibility principle" and Massachusetts' newest GOP senator, Scott Brown, backed it. Romney now says Obama's plan is a federal takeover that bears little resemblance to what he did as governor and should be repealed.

Republicans say Obama and the Democrats co-opted their original concept, minus a mechanism they proposed for controlling costs. More than a dozen GOP attorneys general are determined to challenge the requirement in federal court as unconstitutional.

Starting in 2014, the new law will require nearly all Americans to have health insurance through an employer, a government program or by buying it directly. That year, new insurance markets will open for business, health plans will be required to accept all applicants and tax credits will start flowing to millions of people, helping them pay the premiums.

Those who continue to go without coverage will have to pay a penalty to the IRS, except in cases of financial hardship. Fines vary by income and family size. For example, a single person making $45,000 would pay an extra $1,125 in taxes when the penalty is fully phased in, in 2016.

Conservatives today say that's unacceptable. Not long ago, many of them saw a national mandate as a free-market route to guarantee coverage for all Americans — the answer to liberal ambitions for a government-run entitlement like Medicare. Most experts agree some kind of requirement is needed in a reformed system because health insurance doesn't work if people can put off joining the risk pool until they get sick.

In the early 1970s, President Richard Nixon favored a mandate that employers provide insurance. In the 1990s, the Heritage Foundation, a conservative think tank, embraced an individual requirement. Not anymore.

"The idea of an individual mandate as an alternative to single-payer was a Republican idea," said health economist Mark Pauly of the University of Pennsylvania's Wharton School. In 1991, he published a paper that explained how a mandate could be combined with tax credits — two ideas that are now part of Obama's law. Pauly's paper was well-received — by the George H.W. Bush administration.

"It could have been the basis for a bipartisan compromise, but it wasn't," said Pauly. "Because the Democrats were in favor, the Republicans more or less had to be against it."

Obama rejected a key part of Pauly's proposal: doing away with the tax-free status of employer-sponsored health care and replacing it with a standard tax credit for all Americans. Labor strongly opposes that approach because union members usually have better-than-average coverage and suddenly would have to pay taxes on it. But many economists believe it's a rational solution to America's health care dilemma since it would raise enough money to cover the uninsured and nudge people with coverage into cost-conscious plans.

Romney's success in Massachusetts with a bipartisan health plan that featured a mandate put the idea on the table for the 2008 presidential candidates.

Democrat Hillary Rodham Clinton, who failed in the 1990s to require employers to offer coverage, embraced the individual requirement, an idea advocated by her Republican opponents in the earlier health care debate.

"Hillary Clinton believed strongly in universal coverage," said Neera Tanden, her top health care adviser in the 2008 Democratic campaign. "I said to her, 'You are not going to be able to say it's universal coverage unless you have a mandate.' She said, 'I don't want to run unless it's universal coverage.'"

Obama was not prepared to go that far. His health care proposal in the campaign required coverage for children, not adults. Clinton hammered him because his plan didn't guarantee coverage for all. He shot back that health insurance is too expensive to force people to buy it.

Obama remained cool to an individual requirement even once in office. But Tanden, who went on to serve in the Obama administration, said the first sign of a shift came in a letter to congressional leaders last summer in which Obama said he'd be open to the idea if it included a hardship waiver. Obama openly endorsed a mandate in his speech to a joint session of Congress in September.

It remains one of the most unpopular parts of his plan. Even the insurance industry is unhappy. Although the federal government will be requiring Americans to buy their products — and providing subsidies worth billions — insurers don't think the penalties are high enough.

Tanden, now at the Center for American Progress, a liberal think tank, says she's confident the mandate will work. In Massachusetts, coverage has gone up and only a tiny fraction of residents have been hit with fines.

Brown, whose election to replace the late Democratic Sen. Edward M. Kennedy almost led to the collapse of Obama's plan, said his opposition to the new law is over tax increases, Medicare cuts and federal overreach on a matter that should be left up to states. Not so much the requirement, which he voted for as a state lawmaker.

"In Massachusetts, it helped us deal with the very real problem of uncompensated care," Brown said.


Police Say Stray Bullet Hit Office of Lawmaker
On Thursday, Representative Eric Cantor of Virginia, the second-ranking Republican leader in the House, said that Democratic members of Congress were not the only ones who had been the targets of threats and vandalism in recent days. He said that he had been threatened, too, and that a bullet had been fired through the window of his campaign office in Richmond.

But a preliminary investigation indicated that the bullet was probably not aimed at his office, the Richmond police said Friday.

“We believe it was a stray bullet as a result of random gunfire,” said Gene Lepley, a spokesman for the Richmond Police Department.

Mr. Cantor drew attention to the incident at a news conference he held Thursday to criticize Democrats for publicizing the threats and vandalism several Democratic lawmakers have faced since they voted for the health care bill. Then he made a dramatic announcement.

“Just recently, I have been directly threatened,” he said. “A bullet was shot through the window of my campaign office in Richmond this week, and I have received threatening e-mails. But I will not release them because I believe such actions will only encourage more to be sent.”

A preliminary investigation indicated that the incident in question took place around 1 a.m. Tuesday, when a bullet was apparently fired into the air, striking the office window as it traveled back downward, the Richmond police said in a statement.

The bullet struck the window with enough force to break a pane, the police said, but did not penetrate the blinds inside the window. The bullet landed about one foot inside the office, which Mr. Cantor had occasionally used for meetings, the police said.

At his news conference, where he declined to take questions from reporters, Mr. Cantor had urged that threats be left to law enforcement officials, and not used for publicity purposes.

“Legitimate threats should be treated as security issues, and they should be dealt with by the appropriate law enforcement officials,” he said. “It is reckless to use these incidents as media vehicles for political gain.”

A spokesman for Mr. Cantor did not return two calls or respond to an e-mail message seeking comment on Friday.