NEWSWEEK Poll: Mixed Signals on Health Care

As Democrats struggle to salvage health-care-reform legislation, a new NEWSWEEK Poll shows that while a majority of Americans say they oppose Obama's plan, a majority actually support the key features of the legislation. The findings support the notion that Democrats have not done a good job of selling the package and that opponents have been successful in framing the debate. The more people know about the legislation, the more likely they are to support major components of it.

When asked about Obama's plan (without being given any details about what the legislation includes), 49 percent opposed it and 40 percent were in favor. But after hearing key features of the legislation described, 48 percent supported the plan and 43 percent remained opposed.

The NEWSWEEK Poll asked respondents about eight health-care-reform provisions that Obama and many Democrats in Congress have generally supported. It found that the majority of Americans supported five of those provisions, three by particularly large margins. Eighty-one percent agreed with the creation of a new insurance marketplace, the exchange, for individual subscribers to compare plans and buy insurance at a competitive rate. Seventy-six percent thought health insurers should be required to cover anyone who applies, including those with preexisting conditions; and 75 percent agreed with requiring most businesses to offer health insurance to their employees, with incentives for small-business owners to do so.

Not all Democrat positions received such high marks. Imposing a fine on individuals who do not buy health insurance was the least popular provision, supported by only 28 percent and opposed by 62 percent. Fifty-five percent opposed the so-called Cadillac tax on the most expensive health-insurance plans.

The shift in support for health-care reform, after learning specific information about it, was most noticeable among women. Their support went from 42 to 52 percent supportive after hearing the main provisions. Democrats and liberals saw similar shifts. Republicans were much less likely to be swayed by hearing the details; they moved from 15 percent supportive to 18 percent after learning more. There was also little movement among self-described independent voters; after hearing details of the plan, 57 percent were still opposed—down slightly from 62 percent before they knew any specifics.

While the poll indicates high support for key health-care-reform provisions, Americans are, by and large, dissatisfied with Washington's handling of the issue. Only 39 percent approve of how Obama has managed the push for reforming the medical system. But the public is even less supportive of how Congress has handled the debate: only 27 percent approve of the performance by Democrats in Congress and 21 percent for their Republican counterparts.

Approval ratings on other major issues are similarly low, with Americans generally saying Obama is doing a better job than the Republicans in Congress. Forty-six percent of Americans prefer Obama's handling of the economy, compared to 30 percent who say the Republicans have a better approach. Similar gaps persist on job creation, tax policy, the federal budget deficit, and the handling of the wars in Iraq and Afghanistan. The only issue where Americans say Republicans in Congress are doing better than the president is on the use of military courts vs. civilian trials for terrorism suspects. Thirty-eight percent prefer the GOP approach while 34 percent prefer Obama's.

While Obama tends to score higher than the Republicans on major issues, he does not enjoy a particularly high level of support. His approval rating dips down to 48 percent, from 57 percent in July and 61 percent in April. The number of Americans satisfied with where the country is going has also dropped, from 22 percent back in April to 19 percent today. Nearly three quarters of Americans (73 percent) are dissatisfied with the direction of the country.

How this will play out in the 2010 midterm elections is difficult to know; after all, November is eons away—in political terms. If the congressional elections were held today, 45 percent say they would vote for or lean toward a Democratic candidate, 43 percent would vote or lean Republican, and 12 percent are undecided. Leading up to the 2006 midterms, things looked much better for the Democrats: 50 percent supported or leaned toward the party, compared with 39 percent for the Republicans, when polled in March 2006.