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The Washington Post

Public Option Gains Support

Dan Balz and Jon Cohen

A new Washington Post-ABC News poll shows that support for a
government-run health-care plan to compete with private insurers has
rebounded from its summertime lows and wins clear majority support from
the public.

Americans remain sharply divided about the overall packages moving
closer to votes in Congress and President Obama's leadership on the
issue, reflecting the partisan battle that has raged for months over
the administration's top legislative priority. But sizable majorities
back two key and controversial provisions: both the so-called public
option and a new mandate that would require all Americans to carry
health insurance.

Independents and senior citizens, two groups crucial to the debate,
have warmed to the idea of a public option, and are particularly
supportive if it would be administered by the states and limited to
those without access to affordable private coverage.

But in a sign of the fragile coalition politics that influence the
negotiations in Congress, Obama's approval ratings on health-care
reform are slipping among his fellow Democrats even as they are
solidifying among independents and seniors. Among Democrats, strong
approval of his handling of the issue has dropped 15 percentage points
since mid-September.

These numbers underscore the challenges ahead for the president and
Democratic leaders in Congress as they attempt to maintain support
among liberals and moderates in their own party while continuing to win
over at least a few Republican lawmakers.

Overall, 45 percent of Americans favor the broad outlines of the
proposals now moving in Congress, while 48 percent are opposed, about
the same division that existed in August, at the height of angry town
hall meetings over health-care reform. Seven in 10 Democrats back the
plan, while almost nine in 10 Republicans oppose it. Independents
divide 52 percent against, 42 percent in favor of the legislation.

There are also deep splits in the new poll over whether the proposed
changes would go too far or not far enough in expanding coverage and
controlling costs. Twice as many see the plan as leaning toward too
much government involvement, but since last month there has been a
nine-point increase in the number who say government should be more

On the issue that has been perhaps the most pronounced flash point
in the national debate, 57 percent of all Americans now favor a public
insurance option, while 40 percent oppose it. Support has risen since
mid-August, when a bare majority, 52 percent, said they favored it. (In
a June Post-ABC poll, support was 62 percent.)

If a public plan were run by the states and available only to those
who lack affordable private options, support for it jumps to 76
percent. Under those circumstances, even a majority of Republicans, 56
percent, would be in favor of it, about double their level of support
without such a limitation.

Fifty-six percent of those polled back a provision mandating that
all Americans buy insurance, either through their employers or on their
own or through Medicare or Medicaid. That number rises to 71 percent if
the government were to provide subsidies for many lower-income
Americans to help them buy coverage. With those qualifiers, a majority
of Republicans say they support the mandate.

The public option

Faced with a basic choice that soon may confront the administration
and Democratic congressional leaders, a slim majority of Americans, 51
percent, would prefer a plan that included some form of government
insurance for people who cannot get affordable private coverage even if
it had no GOP support in Congress. Thirty-seven percent would rather
have a bipartisan plan that did not feature a public option.
Republicans and Democrats are on opposite sides of this question, while
independents prefer a bill that includes a public option but does not
have Republican support, by 52 percent to 35 percent.

But if there is clear majority support for the public option and the
mandate, there is broad opposition to one of the major mechanisms
proposed to pay for the bill. The Senate Finance Committee suggested
taxing the most costly private insurance plans to help offset the costs
of extending coverage to millions more people. Sixty-one percent oppose
the idea, while 35 percent favor it.


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Nearly seven in 10 say they think that any health-care measure would
increase the federal budget deficit, a possible concern for Obama. But
nearly half of those who see the legislation as growing the deficit
also say the increase would be "worth it."

Concerns about the implications for Medicare continue to cloud the
debate. More than twice as many Americans (43 percent to 18 percent)
say they think the legislation would weaken Medicare. Despite the dip
in opposition to a health-care overhaul among seniors, most, 51
percent, still think reform would hurt the popular program.

Overall, 57 percent approve of the way Obama is handling his job as
president and 40 percent disapprove. While those numbers have moved
only marginally over the past few months, here, too, are fresh signs of
restiveness among the party faithful: "Strong approval" among liberal
Democrats is down 16 percentage points over the past month.

On the economy, 50 percent approve of Obama's efforts, while 48 percent disapprove.

The president receives better marks from all Americans for his
handling of international affairs and his performance as commander in
chief (57 percent approval on each). Slim majorities also approve of
how he is dealing the situation with Iran and his winning of the Nobel
Peace Prize. A majority disapprove of his work on the federal budget

Partisan divide

Despite those mixed reviews on domestic priorities, Obama continues to hold a big political advantage over Republicans.

Poll respondents are evenly divided when asked whether they have
confidence in Obama to make the right decisions for the country's
future, but just 19 percent express confidence in the Republicans in
Congress to do so. Even among Republicans, only 40 percent express
confidence in the GOP congressional leadership to make good choices.

Only 20 percent of adults identify themselves as Republicans, little
changed in recent months, but still the lowest single number in
Post-ABC polls since 1983. Political independents continue to make up
the largest group, at 42 percent of respondents; 33 percent call
themselves Democrats.

The wide gap in partisan leanings and the lack of confidence in the
GOP carries into early assessments of the November 2010 midterm
elections: Fifty-one percent say they would back the Democratic
candidate in their congressional district if the elections were held
now, while 39 percent would vote for the Republican. Independents split
45 percent for the Democrat, 41 percent for the Republican.

The poll was conducted by conventional and cellular telephone from
Oct. 15 to 19 among a random sample of 1,004 adults. The margin of
sampling error for the full poll is plus or minus three percentage

Polling analyst Jennifer Agiesta contributed to this report.

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