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Support Wanes When Costs Considered for Congressional Action to Guarantee Health Insurance: Evidence

A previous post analyzing Reason-Rupe poll data demonstrated popular support for the new health care law's community rating provision when considered in isolation of costs, yet support wanes when increased premiums, wait times, taxes, or decreased health care quality are considered.

In the 1990s, Gallup asked similar questions and found similar results. In 1994 Gallup found that 79 percent of Americans supported "a health care reform package that guarantees every American private health insurance that can never be taken away." A slightly smaller majority (59 percent) continued to favor guaranteed coverage if taxes increased and a slim majority (50 percent) if premiums increased.

If guaranteed coverage created major costs for small businesses, opposition reached a majority (55 percent). More strikingly, if guaranteed coverage "limited the availability of health services" support plummeted and opposition reached 69 percent.

Similar to the Reason-Rupe poll findings, Gallup found that Americans are not willing to sacrifice health care quality and availability of services in exchange for the benefits promised with guaranteed coverage.

Gallup's 1994 Question

Reason-Rupe 2012 Question


Gallup's Question Wording:

22. Would you support or oppose a health care reform package that guarantees every American private health insurance that can never be taken away?

25. Suppose the effect of guaranteed coverage was to limit the availability of health services. Would you still favor guaranteed coverage if you thought that the availability of health services would be limited, or not?

27. Suppose the effect of guaranteed coverage was to cause individual Americans' taxes to go up. Would you still favor guaranteed coverage if you thought that individual Americans' taxes would go up, or not?

29. Suppose the effect of guaranteed coverage was to cause individual americans to pay more for health care. Would you still favor guaranteed coverage if you thought it would cause individual Americans to pay more, or not?

31. Suppose the effect of guaranteed coverage was to create major new costs for many small businesses. Would you still favor guaranteed coverage if you thought it would create major new costs for many small businesses, or not?

Source: Gallup/CNN/USA Today, January 28-30 1994 Wave 2, accessed through Roper Center iPoll.

Reason-Rupe Question Wording

30. The new health care law has a provision that prohibits health insurance companies from charging some customers higher premiums based on pre-existing conditions or medical history. Do you favor or oppose this provision?

31. Suppose the effect of this pre-existing conditions provision were to increase taxes. Would you be willing to pay higher taxes in order for health insurance companies to not charge higher premiums based on medical history?

32. Suppose the effect of this pre-existing conditions provision were to increase wait times to see your doctor or specialist. Would you be willing to wait longer to see a doctor or specialist in order for health insurance companies to not charge higher premiums based on medical history?

33. Suppose the effect of this pre-existing conditions provision were to increase premiums. Would you be willing to pay higher premiums in order for health insurance companies to not charge higher premiums based on medical history?

34. Suppose the effect of this pre-existing conditions provision were to lower health care quality. Would you be willing to have lower quality health care in order for health insurance companies to not charge higher premiums based on medical history?

Source: Reason-Rupe March 2012, March 10-20th 2012

Full Reason-Rupe March 2012 poll results found here.

Emily Ekins is the director of polling for Reason Foundation where she leads the Reason-Rupe public opinion research project, launched in 2011. Follow her on Twitter @emilyekins.

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