Prospective voters and the new health care law

A comprehensive review of national opinion polls, including newly released data, shows that those who say they intend to vote for a Democratic congressional candidate in 2010 and those who say they intend to vote for a Republican in their district hold starkly different views of what they want the future of health reform legislation to be, mirroring the divide between Democratic and Republican leaders in Congress on this issue.

Nearly three-fourths (73%) of registered voters who say they intend to vote for a Democratic candidate favor the health care legislation passed earlier this year. In contrast, 80% of those who say they intend to vote for a Republican candidate oppose the legislation.

Voters for the two parties' candidates also have completely different views about what effect the health care law will have on the nation's economy. Nearly half (48%) of registered voters who say they intend to vote for a Democratic candidate believe the law will not make much difference to the economy; more think the nation's economy will be better off than worse off (39% to 9%) because of the law. In contrast, three-fourths (75%) of those who say they intend to vote for a Republican candidate believe that the nation's economy will be worse off because of the health care law.

Nearly half (47%) of registered voters who say they intend to vote for a Democratic candidate want Congress to make changes in the health care law to increase government's role, and one-fourth (27%) want to implement the law as it is. Of those who say they intend to vote for a Republican candidate, an overwhelming majority (71%) prefer repealing and replacing most of the law's major provisions.

The analysis, by the Harvard School of Public Health's Robert J. Blendon, Professor of Health Policy and Political Analysis, and Research Scientist John M. Benson appears Wednesday, Oct. 27, 2010 as an Online First Perspective on the website of the New England Journal of Medicine (www.nejm.org). This is the fourth in a series of such Perspective articles by the authors examining the public's views about the health care reform debate.

"The significance of this election for health care is that although the national reform law has been enacted, most of its provisions do not take effect for years into the future, and some of these could be altered by the next Congress," said Blendon. "The polling results suggest that on the eve of the 2010 Congressional election, there is considerable political uncertainty about the future of the health care law based on the outcome of the election."

The 2010 Congressional elections occur at a time when the public is divided in its views about the health care law passed earlier this year. On the one hand, many of the elements of the law are highly popular. On the other hand, many believe that the law will have a harmful effect on the nation's economy, the federal budget deficit, and the taxes people pay. These beliefs about the future may or may not be accurate, but they are the ones the public holds just prior to the election. They are important because of the high priority potential voters in the 2010 election place on the nation's economy, the federal budget deficit, and taxes as voting issues.