Today we release interesting results of a series of questions we asked about health care reform issues in our latest poll. We worked with The Brian Lehrer Show on WNYC radio to develop questions on support for the Supreme Court decision upholding the Affordable Care Act (Obamacare), a major proposed change to Medicare, the expansion of Medicaid under the ACA, and whether people trust government or insurance companies on health insurance matters.
Full text of the release follows. For a PDF of the text along with questions and tables, click here.
An Increasing Number of New Jerseyans Appear to Support Obamacare, WNYC/Rutgers-Eagleton Poll Finds
But voters also trust private insurance companies more than government
A clear majority of New Jersey voters support the recent U.S. Supreme Court decision upholding most of the Affordable Care Act (ACA), according to a new WNYC/Rutgers-Eagleton Poll. Nearly 6-in-10 registered voters in the Garden State say the Supreme Court was right to uphold the law, while 37 percent wanted it struck down. This represents a significant increase in support, compared to the 47 percent who supported the law in a March, 2010 Rutgers-Eagleton Poll. Other key findings of the poll include:
Given a choice between changing Medicare to a system providing fixed payments to seniors who would then buy their own insurance or maintaining the current system, more than two-thirds would stick with Medicare as it is. Only one-quarter supports changing the system to allow purchasing insurance on the market.
The ACA’s provision expanding Medicaid is popular in New Jersey, even though the state has not yet decided whether to participate in the expansion. Just over one-third opposes expanding Medicaid eligibility, while 57 percent support extending its coverage to more low income residents.
At the same time, voters are dubious about government decisions about health insurance: only 35 percent trust government on matters related to health insurance, while 44 percent trust private insurance companies more.
“New Jerseyans are for the most part supportive of the affordable health care act,” said Redlawsk. “While not all that supportive of government making health insurance decisions, they are still quite happy with the prospects of keeping children on parents’ policies and not being denied coverage for pre-existing conditions.”
“We learn again how incredibly conflicted people are when it comes to both health insurance and the role of government,” said Brian Lehrer. “Folks responding to this poll trust private insurance more than government in the abstract, but prefer Medicare to an insurance marketplace in their real lives. It’s also interesting that most New Jerseyans seem to want Governor Christie to opt into the Medicaid expansion, despite the refusal of some other Republican governors to do so.”
Results are from a poll of 790 registered voters conducted statewide among both landline and cell phone households from Sep 27-30. The sample has a margin of error of +/- 3.5 percentage points. Questions on health care issues were developed in consultation with The Brian Lehrer Show on WNYC radio, and were sponsored by WNYC.
Overall support for Affordable Care Act hides partisan differences
While 57 percent of New Jersey voters support the ACA court decision, support is driven by the nearly 80 percent of Democrats who are pleased that the law was upheld. Reflecting their party’s consistent position on “Obamacare,” only 23 percent of Republicans support the Court’s decision, while 74 percent wanted the law struck down. Independents are more supportive than not, at 56 percent to 35 percent.
Support for the law is clearly tied to support for President Barack Obama. Among those who say they will vote for Obama, 82 percent are happy with the decision. But 74 percent of Romney voters wish the ACA had been struck down. Reflecting this, there are also strong racial divisions, with only 52 percent of white voters in favor of the ACA, compared to 77 percent of black voters.
Parents of children under 18 are slightly more supportive of the Supreme Court decision on the health care act than are other voters, at 60 percent. Young people – many of whom may be direct beneficiaries of the law – are for the most part supportive: 61 percent are pleased the law was upheld. But senior citizens are much less so, with only 46 percent happy with the decision, with an equal number wishing the law had been overturned.
Voters who trust government more on health care insurance are overwhelmingly supportive of the Court’s decision, at 80 percent, with only 15 percent preferring the Court had ruled the other way. But those who trust private insurance companies more see things differently: 60 percent wanted the law struck down, while only 34 percent wanted it upheld.
“To a great extent, the results suggest that partisan voters stick with their parties on this one,” noted Redlawsk. “Democrats trust government, and also want the law, while Republicans do not. At the same time, those with a personal interest in getting coverage – parents of children, and the young voters themselves – are more supportive, while those who see less positive outcomes are much less so. Seniors generally don’t see much direct benefit, and may be worried about Medicare cuts, leading to less support for the law.”
Little stomach for major Medicare change
A large majority of New Jersey voters does not want Medicare to change from the basic government insurance program that it is today. One-quarter support changing to a type of voucher system, where seniors would buy their own insurance, but 69 percent of New Jerseyans reject that idea. Even a majority of voters who say they trust private insurance companies more on health insurance want to retain the current Medicare system, while 85 percent of those trusting government support the current system against a voucher proposal.
Predictable partisan differences arise, but even so, 54 percent of Republicans reject payments to seniors to buy their own coverage. Democrats, not surprisingly, are broadly in favor of the current system: 82 percent want to leave it alone while 64 percent of independents agree. Yet, 52 percent of Romney supporters would leave the system alone, and 81 percent of Obama voters are in the same camp.
Age matters, though not as much as might be expected. Voters over 65, most of whom are on Medicare, are widely in favor of the current system, but even 58 percent of voters under 30 reject a voucher-style alternative.
“Medicare remains a potential third rail in American politics,” said Redlawsk. “And our results in New Jersey reflect that. While Republican presidential candidate Mitt Romney has talked of a plan allowing seniors to buy their own insurance with a government-provided stipend, even voters in his own party are not so sure they like the idea. Whether they like the federal government or not, most voters like one of its signature programs just the way it is.”
Despite Medicare support, voters dubious about government and health insurance decisions
More New Jersey voters trust private insurance companies than the government when it comes to matters related to health insurance, reflecting a somewhat contradictory position compared to widespread support for the premier government insurance program, Medicare. Divisions over the role of government mostly reflect standard partisan divisions in American politics. Independents (44 percent) and especially Republicans (76 percent) are much more trusting of private insurance companies than are Democrats (25 percent). But significant shares of voters say they do not trust either – about 1 in 7 members of both parties — and 20 percent of independents take this position.
These divisions carry through in predictable ways: while 51 percent of white voters favor private insurance companies, 57 percent of black voters say they trust government more on matters related to health insurance. Voters who support the Supreme Court decision on the ACA are also more likely to trust government, 49 percent versus 26 percent trusting private companies. And voters who oppose the decision are trusting of private companies by a 71 to 14 percent margin.
“People can often hold contradictory opinions,” said Redlawsk. “We all remember the ‘keep your government hands off my Medicare’ comments supposedly made in the early days of the debate over health care. The fact is, while voters are dubious about government decision-making, they are also quite supportive of programs from which they see or expect a direct benefit.”
Redlawsk also pointed out that much of the contradiction comes from Republican voters, who are strongly anti-government, but more supportive than not of Medicare.
Proposed Medicaid Expansion has support
Among the provisions of the health care law is the expansion of Medicaid, the health insurance program for low income Americans. A federal program, Medicaid is administered by the states, and states have some leeway in establishing eligibility. The ACA would expand eligibility to cover many more Americans with the federal government paying at least 90 percent of the cost. In its ruling the Supreme Court allowed states to opt out of the expansion without penalty. New Jersey has not yet announced its decision.
Voters in New Jersey, however, express clear support for Medicaid expansion in the state, with 57 percent in favor and 35 percent opposed. When voters opposed to expansion are told it has little cost to the state, 65 percent of them continue to oppose it, while 23 percent become supporters.
Support for Medicaid expansion decreases as income increases: 65 percent of voters with household incomes under $50,000 are in favor, while only 48 percent of those making $150,000 or more agree. Sharp partisan differences emerge, driven in part by dramatic differences between black and white voters, and by age. Half of whites support expansion, while 86 percent of black voters do. Voters under 30 are also strong supporters, at 73 percent, while only 49 percent of those over 65 agree. As a result, 79 percent of Democrats are in favor of expanding Medicaid, while only 15 percent are opposed. But among Republicans, only 30 percent support expansion, while 60 percent are against it. Independents are much more split: 51 percent support and 41 percent oppose Medicaid expansion.
Three-quarters of those who support the decision to uphold the ACA also want to see Medicaid expanded, while 61 percent of voters who wanted the law struck down also oppose expanding Medicaid.
“Support for Medicaid expansion is driven by the same partisan and self-interest dynamic we see in the other health care questions,” said Redlawsk. “Those who might benefit – lower income voters in particular – are much more supportive than those who would not. Likewise, senior citizens, who already have Medicare accessibility, are also less interested in expanding Medicaid. And of course Republicans oppose it and Democrats support it.”
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It is beyond my why any one would want private insurance companies, whose bottom line is making a profit, making the medical decisions. At least the government has an overarching interest in the good of the people as a whole.
There have been too many times when we have had to argue with the insurance companies for medical decisions made by my doctors. I spent five years in Germany and would give anything to have a similar system hear. No co-pays, the doctor takes care of all the paperwork, and no arguing with insurance companies about decisions the doctor has made in my best interests.