Congress has spoken, and now the people have spoken: In polls released this week, Americans say they are not pleased with the healthcare reforms enacted by President Obama and congressional lawmakers.
Voters worry the new law will erode the quality of care and jack up costs, even while it helps reduce the number of people unable to get health insurance.
The new polls suggest that Democrats still have a big sales job ahead of them as November House and Senate elections draw closer, and as Americans try to learn more about what the law means for them (see "Healthcare Reform 101").
On Tuesday, Mr. Obama signed the second portion of the healthcare reform package, the so-called "reconciliation" that contains elements not in the original Senate legislation. As the president continues a public-relations campaign for the reforms, the polls taken since the House voted on March 21 don't all line up against him. But skepticism about the new law is sizable on several fronts:
Costs. Some 55 percent of Americans expect their own costs for healthcare to be higher because of the reforms, and 60 percent say the nation's overall health tab will rise, according to a Washington Post poll. Only 16 percent predict that medical spending in the US will be lower because of the law. Separately, a USA Today/Gallup poll found 64 percent saying the law "will cost the government too much."
Quality of care. Forty-four percent anticipate that the quality of their care will decline as a result of the reforms, while only 18 percent expect healthcare quality to rise, the Washington Post survey found. Similarly, 49 percent in a Rasmussen Reports survey said they think the quality of care will be adversely affected. In response to a more general question, 39 percent of respondents in a CNN/Opinion Research poll say they expect the law would make them and their family worse off, while 22 percent said "better off."
Size of government. Nearly half of Americans say the law "creates too much government involvement in the nation's health care system," according to the Washington Post poll, while 35 percent say the government role will be "about right." In the USA Today/Gallup poll, 65 percent said the law "will expand government's role in health care too much." Still, views on this subject are nuanced, with the same poll showing 51 percent saying the law doesn't go far enough in regulating health insurers, and 52 percent saying it should make a "public option" insurance plan available to all.
The political process. A 53 percent majority called Democratic methods used to pass the law "an abuse of power," according to the USA Today/Gallup survey. (The reconciliation process circumvented the potential for a Republican fililbuster and allowed passage with a simple majority of the Senate.) Forty percent had no problem with the methods.
If these results make health reform sound like a Pyrrhic victory for Obama, consider also that Americans are now well aware of the complexity of the medical-system challenge. Two mitigating themes have emerged in earlier polls: Americans don't see the status quo as a good option, and they support a number of specific ideas in Obama's plan.
In a February Newsweek poll, for instance, a strong majority supported requiring insurance companies to cover people regardless of any preexisting health condition, and setting up a government-regulated "exchange" on which individuals can buy coverage at more competitive rates. Americans are also open to a mandate on individuals to buy coverage (with government subsidies available) if they are currently uninsured. That idea garnered 59 percent support in the Newsweek poll and 45 percent support in a February CNN/Opinion Research poll.
Also, Americans generally have less confidence in Republicans than in Democrats on healthcare policy.
At the same time, the latest polls show some big campaign-trail challenges ahead for Obama and Democrats. In both the CNN and Washington Post surveys, a majority of Americans cite negative overall feelings about the reform, with 26 percent in each poll outright "angry" about it – reflecting a broader mood of anger in the electorate. When asked whether they would vote for a Democrat or a Republican to serve in Congress, Americans give a slight edge to the Republican, according to an average of such "generic ballot" questions tracked by the RealClearPolitics website.
A movement to repeal the law could even gain traction. The Rasmussen survey finds Americans favoring repeal by a 54-to-42 margin.
The law does addresses the risk that people will find themselves without health insurance, but does less to control costs. That's the view of many experts. And in effect, Obama himself acknowledged the hurdle in an NBC interview that aired Tuesday. The law "is a critical first step in making a healthcare system that works for all Americans," he said. But "we are still going to have adjustments that have to be made to further reduce costs."