Poll: Broad Support for Requiring Health Coverage

Country Keg & Pub Restaurant , Cedarburg, Wis.

Some Cedarburg, Wis., voters cast their presidential primary ballots at the Country Keg & Pub Restaurant earlier this month. Polls indicate health care is an important issue in this election for Americans. Joshua Lott/Getty Images hide caption

itoggle caption Joshua Lott/Getty Images
Chart of poll results i i

The NPR/Kaiser/Harvard poll shows that a majority of people believe the number of uninsured Americans is a very serious problem, regardless of political affiliation. NPR/Kaiser Family Foundation/Harvard School of Public Health hide caption

itoggle caption NPR/Kaiser Family Foundation/Harvard School of Public Health
Chart of poll results

The NPR/Kaiser/Harvard poll shows that a majority of people believe the number of uninsured Americans is a very serious problem, regardless of political affiliation.

NPR/Kaiser Family Foundation/Harvard School of Public Health

More Poll Results

In our poll, a majority supports a "shared responsibility" approach to health care. This plan is similar to one proposed by Sen. Hillary Clinton. A key feature is a requirement that all Americans have health coverage. See those results.

A different plan for dealing with the problem of the uninsured features a requirement that parents get health coverage for their children. This is similar to one of the elements in the plan put forward by Sen. Barack Obama. See those results.

Americans strongly favor rules requiring that insurance companies cover anyone who applies, regardless of pre-existing conditions. The NPR/Kaiser/Harvard poll also found that Americans are strongly opposed to requiring people to pay a fine if they don't get health insurance. See those results.

A new poll on health care from NPR, the Kaiser Family Foundation and the Harvard School of Public Health finds that a majority of Americans are backing key elements in the health reform proposals of Democratic presidential candidates Hillary Clinton and Barack Obama.

The poll also found very strong support for doing something about the problem of 50 million Americans being uninsured — 93 percent call it a serious problem, with 74 percent saying it's a very serious problem.

"One thing that the survey shows is that Americans are concerned about the problem of the uninsured," says Mollyann Brodie of the Kaiser Family Foundation, co-director of the NPR/Kaiser/Harvard polling project. "We see a universal sort of agreement that they'd like to see more people covered — that it's a good goal to go after."

One aim of the poll was to find out how people feel about the idea of requiring all individuals to buy health insurance. That's a centerpiece of Clinton's plan.

When asked whether they would support a broad proposal that would require everyone to get coverage, 59 percent said they would support it. Such a proposal would require employers to provide coverage or pay into a pool. The government would help low-income people get coverage, and insurance companies would be required to take anyone who applies. People who don't get coverage through one of these channels or purchase it themselves would pay a fine.

But when the question was asked a different way — without emphasizing government subsidies, employer mandates and requirements on insurance companies — support dropped to 47 percent in favor and 44 percent against. That's an even split, given the poll's margin of error of plus or minus 3 percentage points.

The finding suggests that support for requiring everyone to buy insurance may be iffy.

One of the people responding to the poll was Jeffreyna Harper of St. Clair Shores, Mich. She likes Clinton's plan better than Obama's, which would not require all adults to have coverage but would require that parents get their children covered.

"It's good that your children have insurance," Harper told NPR. "The parents need insurance too. Who's going to take care of the kids if the parents are sick?"

The poll finds most independents also support a requirement that everybody buy insurance. But many independents have trouble with that, including Lori Moyer of Roanoke, Va.

"That's a tough call for me because I don't know that the government should be requiring people to buy it," she says. "To me, that's too much involvement from the government by saying that you have to purchase health care."

Moyer favors Republican John McCain. But she also likes Obama's plan to require coverage for children.

"My main concern is children that are uninsured," she says. "I think it's important for the children to get the vaccines that they need and not be afraid to take them to the doctor because they can't afford a doctor visit to make them well."

Covering Children First

When asked whether they would favor a proposal that would not require all adults to get insurance, but one that would require parents to get health coverage for their children, support was higher: 65 percent support that proposal, including a majority (54 percent) of Republicans.

Robert Blendon of the Harvard School of Public Health, a co-director of the polling project, says support for covering children first may have something to do with last year's debate over the State Children's Health Insurance Plan. President Bush vetoed the proposal by Congress as too expansive. But the debate brought the problem of uninsured children to the public's attention.

"There was extraordinary support in this poll among all groups — Democrats, Republicans and independents — for the idea of requiring that every child has a health insurance policy and then provid[ing] help to parents that can't afford it," he says. "And we don't have as wide a consensus for what to do about adults. So it's the childrens' side of this which offers the possibility of a very quick breakthrough in the next Congress."

On the issue of employers' responsibilities, there's sharp difference between the parties. Three-quarters of Americans say employers should offer health insurance or pay into a government pool to provide coverage. But about twice as many Democrats as Republicans are strongly in favor of this approach.

"The employer issue is, I think, going to be a very important issue because that's going to be quite popular from the Democratic side — that the employers be asked to contribute," Blendon says. "And Sen. McCain is going to say absolutely no requirement for individuals and absolutely no requirements for business."

The poll also showed that there is a fairly low level of understanding about what the presidential candidates have proposed regarding health care. Only 48 percent could correctly answer the question, "Have any of the current candidates for president proposed a health plan requiring all Americans to have health insurance, or not?"

Some 42 percent correctly identified Clinton as having proposed such a plan, but only 11 percent knew correctly that Obama had not.

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