Path to Health Care Reform Becoming a Steeper Climb

Public support for health care reform in the United States has weakened following an August congressional recess marked by contentious town-hall meetings around the country during which critics voiced concerns about the cost and the large government role that such legislation is expected to bring.

Growing opposition is borne out in numerous public-opinion polls, including an August tracking poll by the Kaiser Family Foundation. Among the findings of the nationally representative monthly phone survey of more than 1,200 adults was that support for major health reform declined from 62 percent in February to 53 percent in August, while opposition rose from 34 percent to 42 percent.

The public's cold feet could stem from growing concern about health care reform's costs and impact on them and their families. For instance, the Kaiser poll found in February that only 12 percent thought they would be worse off after reform, but in August, 31 percent thought that would be the case.

Thus, shortly before Congress resumed deliberations over health care reform, a substantial portion of the population appeared unwilling to pay the cost they believe it will entail. While 55 percent of respondents to the Kaiser survey said they would be unwilling to pay more in either insurance premiums or taxes to cover health care reform, 42 percent were willing to accept additional costs as the tradeoff for a more comprehensive health care system.

The public resistance to paying for more widely available health insurance coverage predates the current legislative fight to enact health care reform. An August Health Affairs article by researchers who examined public opinion in January found that while most people supported expanding access to health coverage, only a minority was willing to pay for coverage expansions. The Internet-based survey of 3,344 U.S. adults found that the only specific revenue-raising proposal that drew a bare majority of support was an increase in federal income taxes to expand Medicaid to cover half of the uninsured population, estimated to be about 47 million.

Meanwhile, the decline in public support for major health care reform has led reform advocates to plan campaigns to convince the public about the value they see in overhauling the health system (see MH Groups Intensify Efforts to Pass Health Care Reform). Those efforts could be critical to spurring Congress toward enacting health care reform legislation this fall, a target set by President Obama.

Organizing for America, the reconstituted campaign organization of Obama, launched a nationwide bus tour earlier this month to spur passage of health reform legislation with stops in 11 cities—the last stop was in Washington, D.C., as Congress returned from its summer recess. Health Care for America Now, an umbrella organization of groups pushing for comprehensive health care reform, coordinated with the national Democratic Party to hold about 2,000 pro-reform events from late August to mid-September.

Also, mental health advocacy groups are urging their members to continue to contact their congressional representatives and speak out in support of a comprehensive overhaul that includes mental health provisions.

“If we want to be taken seriously, we need to be part of the process where members of Congress hear from their constituents,” said Andrew Sperling, J.D., director of legislative affairs for the National Alliance on Mental Illness (NAMI), in an interview with Psychiatric News.

Sperling said September is a “critical stage of the process” to enact reform legislation. Members of Congress returned from recess after hearing what voters in their districts thought about the various reform proposals.

The Kaiser poll results are posted at<www.kff.org/kaiserpolls/posr082209pkg.cfm>. TheHealth Affairspoll is posted at<http://content.healthaffairs.org/cgi/content/full/hlthaff.28.5.w909/DC2>.▪