Attitude Check

How Americans feel about health care reform

Frank Newport Mar 29, 2012

Jeremy Hobson: The Supreme Court has heard the arguments for and against President Obama’s healthcare reform law, and must now decide if that law is constitutional. Yesterday, the question was whether most of the law could stand if the part of it that requires Americans to purchase health insurance were to be struck down.

Here’s one of the more liberal justices, Elena Kagan:

Elena Kagan: The question is always, does Congress want half a loaf — is half a loaf better than no loaf? And on something like the exchanges, it seems to me a perfect example where half a loaf is better than no loaf.

And here is one of the court’s more conservative justices, Antonin Scalia:

Antonin Scalia: You know, sometimes Congress says all the provisions of this act will be severable. And we ignore that when the act really won’t work.

Now we could spend all day trying to figure out what these justices are going to decide. But why bother, when we already know what the American people think? According to Gallup, more than 7 in 10 Americans think the individual mandate is unconstitutional — which brings us to a segment we call Attitude Check.

Frank Newport is editor-in-chief at the polling firm Gallup and he joins us now. Good morning, Frank.

Frank Newport: Hi, good morning.

Hobson: Well, is it just the individual mandate part of the law that Americans don’t seem to like, or is it something more fundamental?

Newport: You know, looking over the research, in terms of the specifics of the law, it is the individual mandate which is the most negative of anything that gets tested. In fact, some of the other aspects of the law individually — like allowing 18-25 year olds to ride on their parents policies and to make sure that you’re not denied coverage because of pre-existing conditions — those are fairly wildly popular in a lot of polling.

But most polling shows that in addition to saying it’s unconstitutional, Americans just don’t like the idea of the individual mandate. So when you look at it specifically, that is the Big Kahuna; that’s the thing that Americans really are most negative about. And I think that’s in part because that represents bigness — big government requiring everybody to have insurance — and that’s in the bigger sense what Americans are really sensitive to.

Hobson: So they don’t like “bigness,” but do you get a sense in your polling of what they do want in health care?

Newport: Well, they do want a lot of specifics. You know, if you say: Should the government — just very narrowly — say that you cannot be denied health care coverage because of pre-existing conditions, Americans say, “Sure, that’s something the government should do.”

The problem is bundling; that’s how I look at it, having reviewed a lot of the data. When you bundle this all together, then Americans say, “Wait a minute, when you start doing all these things with the bill, then all of a sudden you’ve got government doing a lot.” And Americans are very negative on a number of aspects of the federal government at this point. They think it’s inefficient; they think it’s already too big; there are too many regulations; and so on and so forth.

Hobson: Well, do Americans see the health care issue as a big problem?

Newport: You know, it’s latent vs. manifest — how’s that for an answer? It is a latent concern. If you simply ask Americans: Overall, what’s the most important problem facing the country? — which we just did in March. Five percent mention health care, a very small number. It’s swamped by mentions of the economy; even dissatisfaction with the government is higher than health care. So it’s not top of mind, and partially that’s because most Americans actually have health care coverage which they’re fairly positive about.

But latent concern is what I come back to, because if you read a list to Americans, say: All right, how much do you worry about each of these problems, or how concern are you as a policy issue about blah blah blah? Health care will in fact percolate right up there fairly close to the top. So it’s not top of mind — Americans aren’t vexed by it like they are the job situation. But underneath it all, Americans do think it is a significant problem.

Hobson: Frank Newport is editor-in-chief at Gallup. Thanks so much.

Newport: Great to be with you.


We’re here to help you navigate this changed world and economy.

Our mission at Marketplace is to raise the economic intelligence of the country. It’s a tough task, but it’s never been more important.

In the past year, we’ve seen record unemployment, stimulus bills, and reddit users influencing the stock market. Marketplace helps you understand it all, will fact-based, approachable, and unbiased reporting.

Generous support from listeners and readers is what powers our nonprofit news—and your donation today will help provide this essential service. For just $5/month, you can sustain independent journalism that keeps you and thousands of others informed.