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Feb. Tracking Poll Examines Public’s Views on Medicare, Contraceptives, Health Reform

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March 1, 2012

Poll Finds Most Americans Oppose Medicare Premium Support Proposal Even With Newly Offered Traditional Medicare Option, Though Arguments In Favor Can Lessen Opposition

Among Women, Democrats Are Twice As Likely As Republicans To Support Federal Requirement That Health Insurance Plans Cover Contraceptives

In the midst of continuing debate on the future of the Medicare program, the February Kaiser Family Foundation Tracking Poll finds most Americans and most seniors favor the status quo, though arguments about the program’s solvency have the potential to sway opinion toward new proposals. The survey also gauges public opinion about the ongoing contraceptive coverage debate, views of the Affordable Care Act, and trust in the presidential candidates on health care issues.  The poll is available at http://www.kff.org/kaiserpolls/8281.cfm.

The poll measures the public’s view of recent "premium support" plans put forward separately by Republican presidential candidate Gov. Mitt Romney and by Republican Rep. Paul Ryan and Democratic Sen. Ron Wyden.  Each of these proposals would have the Medicare program provide seniors with a fixed payment, or premium support, that they would use to buy health insurance, but in a twist on past premium support proposals, seniors could apply that fixed payment toward the purchase of either a private plan or traditional Medicare.

When initially asked about such a change, 25 percent of Americans say they would support it, while 70 percent say they favor Medicare’s current structure.  Seniors and younger adults have similar initial reactions, with at least two-thirds in each age group supporting the status quo.  Even among Republicans, a narrow majority initially say they would prefer to keep Medicare as currently structured.

However, public opinion on this issue is malleable, and strong arguments on both sides have the potential to sway Americans. For example, when those who back the status quo hear the argument that "without this change, Medicare’s costs will be unsustainable and the program will go bankrupt," a notable one-third of Americans say they feel "more interested" in the proposal. Arguments against the change, including that it could shift costs onto seniors, lead about one in ten Americans to become "less interested" in the change.

The poll also finds most Americans do not favor major reductions to Medicare spending to rein in the federal budget deficit, with 13 percent supporting sizeable cuts, another third (36 percent) favoring minor reductions, and half opposed to any cuts.  Not surprisingly, the strongest opposition comes from seniors.

The poll also assesses public opinion on other potential changes to Medicare, including raising Medicare’s age of eligibility, an idea raised last week by Gov. Romney.  The public is split on the concept, with 47 percent supporting an increase in Medicare’s eligibility age and 50 percent opposing it. The majority of seniors, a group that already qualifies for Medicare, support the plan, while a majority of those under age 65 oppose it.

Nearly a quarter of Americans -- and a similar share of registered voters -- say they would only vote for a presidential candidate who shares their views on Medicare.  A third of seniors fall into this category of "Medicare voters," compared with just under a quarter of pre-retirees and one in five adults under age 50.  Democrats are also somewhat more likely than Republicans and independents to consider Medicare a make-or-break issue.

Views on Contraceptive Coverage

Amid a public debate about contraceptive coverage in insurance plans, about six in ten Americans say they support a new federal requirement that insurance plans include no-cost birth control, while a third oppose it. Catholics split along similar lines, but there’s a big partisan divide, including among women: 85 percent of women who are Democrats support the requirement, compared with 42 percent of women who are Republicans; 67 percent of women who are independents support the requirement.

The public is also divided over what the root issue is in the debate about requiring religiously affiliated employers to cover contraceptives in their plans, with a quarter saying it is religious freedom, a quarter saying women’s rights, another quarter thinking it is a mix of both, and the rest not having heard anything on the subject.   There is a partisan divide, with women who are Republican more likely to say the debate is about religious freedom (43 percent) and women who are Democrats more likely to say it is about women’s rights (43 percent).

The poll -- a snapshot look at this still-evolving issue -- suggests that at this point, contraceptive coverage falls far short of issues like the economy and jobs in this year’s election, though it does surface among health issues as a priority.  Asked to name the issues they most want to hear the presidential candidates address, less than 1 percent of women volunteered contraceptive coverage, compared to 58 percent who named the economy.  At the same time, when women were presented with a list of specific health issues that could impact their presidential choice, three in ten said women’s reproductive health care services, including birth control, would be ‘extremely important’ in determining their vote for president this fall, compared to 39 percent who say the same about health care costs and 22 percent about abortion.

Other survey findings

Nearly two years after its passage, Americans remain divided on the Affordable Care Act, with 42 percent holding favorable views of the law and 43 percent unfavorable.  This reflects a five percentage point increase in support for the law since January, driven mostly by an improvement in views among political independents. The proportion of Americans that think their family will be worse off under health reform dropped to 25 percent from 33 percent in January, though there was virtually no change in the share who expect their family to benefit (27 percent).

At this point in the 2012 campaign, President Barack Obama is trusted by a larger share of the public than any of his Republican challengers in dealing with the future of both Medicare and the Affordable Care Act. Roughly six in ten say they have at least some trust in the President on those issues, compared to roughly four in ten who say the same about Gov. Romney, Sen. Rick Santorum or Rep. Ron Paul, and three in ten who say so about former House Speaker Newt Gingrich.

The full findings, question wording and methodology for the poll are available online athttp://www.kff.org/kaiserpolls/8281.cfm.

Contact Craig Palosky 202-347-5270 or Rakesh Singh 650-234-9232 for further information.

The Kaiser Family Foundation, a leader in health policy analysis, health journalism and communication, is dedicated to filling the need for trusted, independent information on the major health issues facing our nation and its people.  The Foundation is a non-profit private operating foundation, based in Menlo Park, California.

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