NCPA - National Center for Policy Analysis

Americans Want More Control Over Their Own Health Care

April 10, 2012

The Supreme Court will spend several months making a final decision on the constitutionality of the Patient Protection and Affordable Care Act (ACA), but public opinion is currently making waves of its own.  A Kaiser Family Foundation tracking poll earlier this month found that six out of 10 Americans want lawmakers to keep searching for workable reforms even if the Supreme Court eventually kills the president's reform law, says Shikha Dalmia, a senior analyst with the Reason Foundation.

To this end, a Reason-Rupe poll released recently is instrumental.  Accepting the Obama administration's argument that individual components of the ACA remain popular, the poll sought to understand how people's opinions on certain reforms changed given explicit consequences.

With regard to Americans' feelings about providing care for all, the poll undermines the Obama administration's argument that there continues real support.

  • Fifty-two percent approved of the ban on insurance companies from charging higher premiums based on medical history -- an approval rating that President Obama would tout.
  • However, this support falls precipitously when respondents are forced to face practical consequences of such a provision.
  • Fifty-two percent drops a great deal if the provision's side effects include longer wait times for doctors (41 percent) or higher premiums (38 percent) or lower-quality care (15 percent).
  • This suggests that much of the approval for the ACA exists in a vacuum, isolated from practical consequences of policy decisions.

The poll also offers insight into how to better reform the health care sector if the ACA is in fact found unconstitutional.  The larger trend among respondents is that Americans want greater control over their medical consumption.

  • Forty-eight percent said they'd prefer it if their employers gave them the money to purchase their own coverage, compared to 41 percent who would not.
  • Sixty-five percent of Americans want Medicare payouts in the form of a credit for use toward a private health plan, compared to 24 percent who don't.
  • Almost 70 percent said they want the same ability to shop around for "a less expensive or better [health] insurance policy" as they have for their auto insurance.
  • In their trust in various entities to make health care decisions, 61 percent trust themselves, compared to 5 percent for the government.

Source: Shikha Dalmia, "Americans Want More Control Over Their Own Health Care," Reason Magazine, April 3, 2012.

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