AP-GfK Poll: Raw feelings ease over health law

AP - WASHINGTON – As lawmakers shaken by the shooting of a colleague return to the health care debate, an Associated Press-GfK poll finds raw feelings over President Barack Obama's overhaul have subsided.

Ahead of a vote on repeal in the GOP-led House this week, strong opposition to the law stands at 30 percent, close to the lowest level registered in AP-GfK surveys dating to September 2009.The nation is divided over the law, but the strength and intensity of the opposition appear diminished. The law expands coverage to more than 30 million uninsured, and would require, for the first time, that most people in the United States carry health insurance.
The poll finds that 40 percent of those surveyed said they support the law, while 41 percent oppose it. Just after the November congressional elections, opposition stood at 47 percent and support was 38 percent.
As for repeal, only about one in four say they want to do away with the law completely. Among Republicans support for repeal has dropped sharply, from 61 percent after the elections to 49 percent now.
Also, 43 percent say they want the law changed so it does more to re-engineer the health care system. Fewer than one in five say it should be left as it is.
"Overall, it didn't go as far as I would have liked," said Joshua Smith, 46, a sales consultant to manufacturers who lives in Herndon, Va. "In a perfect world, I'd like to see them change it to make it more encompassing, but judging by how hard it was to get it passed, they had to take whatever they could get."
His extended family has benefited from the law. A sister-in-law in her early 20s, previously uninsured, was able to get on her father's policy. "She's starting out as a real estate agent, and there's no health care for that," said Smith. The law allows young adults to stay on a parent's plan until they turn 26.
Congress stepped back last week to honor victims of the rampage in Tucson, Ariz., that left Rep. Gabrielle Giffords, D-Ariz., facing a long and uncertain recovery from a bullet through her brain.
There's no evidence the gunman who targeted Giffords was motivated by politics, but the aftermath left many people concerned about the venom in public life. A conservative Democrat, Giffords had been harshly criticized for voting in favor of the health overhaul, and won re-election by a narrow margin.

House Republican leaders say they're working to keep this week's debate — and expected vote Wednesday from degenerating into a shouting match, but it depends on the Democrats, too. Republicans want a thoughtful discussion about substantive policy differences, said Brad Dayspring, a spokesman for Rep. Eric Cantor, the No. 2 GOP leader. The AP-GfK poll was under way when the attack in Tucson took place Jan. 8.
Opposition to the law remains strongest among Republicans. Seventy-one percent of them say they're against it, as compared with 35 percent of independents and 19 percent of Democrats. Republicans won back control of the House partly on a promise to repeal what they dismissively term as "Obamacare."
"I just think that the liberal left is more going for socialized medicine, and I don't think that works well," said Earl Ray Fye, 66, a farmer from Pennsylvania Furnace, Pa., and a conservative Republican. "It just costs too much. This country better get concerned about getting more conservative."
One of the major Republican criticisms of the law found wide acceptance in the poll, suggesting a vulnerability that GOP politicians can continue to press.
Nearly six in 10 oppose the law's requirement that people carry health insurance except in cases of financial hardship. Starting in 2014, people will have to show that they're covered either through an employer, a government program, or under their own plan.
Rich Johnson, 34, an unemployed laborer from Caledonia, Wis., said he thinks the heart of the law is good. "The problem I have with it is mandating insurance so that you have to have it or you'll get fines," said Johnson, an independent. "I just don't think people should be forced to have it. The rest of it, I have no problem with."
The individual mandate started out as a Republican idea during an earlier health care debate in the 1990s. More recently, Massachusetts enacted such a requirement under GOP Gov. Mitt Romney and the Democratic Legislature. Nowadays, most conservatives are against it, and GOP state attorneys general are suing to have the mandate overturned as unconstitutional.Other major provisions of the law, including a requirement that insurers accept people with pre-existing medical conditions, got support from half or more of the public in the poll.
Loralyn Conover, 42 a former music teacher with multiple sclerosis, says she hopes repeal goes nowhere. Senate Democrats say they'll block it.
The new law "opens the door for people like me to have some kind of pay-as-you-go health insurance," said Conover, of Albuquerque, N.M. "It's nice to be able to have something . and not be dropped in the cracks of society." She couldn't get health insurance when she was first diagnosed, but is now covered by Medicare.
The AP-GfK Poll was conducted Jan. 5-10 by GfK Roper Public Affairs and Corporate Communications. It involved landline and cell phone interviews with 1,001 adults nationwide, and has a margin of sampling error of plus or minus 4.2 percentage points.

Obama order on abortion locks in health care votes

President Barack Obama and House Democratic leaders struck a last-minute deal Sunday with abortion foes to secure the final few votes needed to remake America's health care system, writing a climactic chapter in a century-old quest for near universal coverage.

The House argued its way through a thicket of Republican objections toward an evening vote on the bill to extend coverage to 32 million Americans who lack it, ban insurers from denying coverage on the basis of pre-existing medical conditions and cut deficits by an estimated $138 billion over a decade.
A shouting band of protesters outside the Capitol dramatized their opposition, and one man stood up in the House visitor's gallery shouting, "Kill the bill" before he was ushered out — evidence of the passions the yearlong debate over health care has stirred.
Passage of a central health care bill already cleared by the Senate would send it to Obama for his signature. That still would leave one more step, a companion package of changes would go to the Senate.
Obama lobbied by phone from the White House, then took the crucial step of issuing an executive order that satisfied a small group of Democrats who demanded that no federal funds be used for elective abortions. "We're well past 216" votes, a majority, said Rep. Bart Stupak of Michigan, swinging behind the bill after leading the holdouts in a rebellion that had left the outcome in doubt.
Democratic aides confirmed his vote count.
After more than a year of political combat — certain to persist into the fall election campaign for control of Congress — debate on the House floor fell along predictable lines.
"The public has been grievously and purposely lied to," by Republicans in their efforts to defeat the legislation, said Rep. Louise Slaughter, D-N.Y., a clear reference to GOP accusations that included the claim that there would be death panels for elderly patients.
Republicans opposed the measure as a takeover of government health care that would cut Medicare and raise taxes by nearly $1 trillion combined. Rep. David Dreier, R-Calif., criticized the Democrats for their tactics on the House floor, but said, "the greatest outrage has always been for the bill itself."
Over and over, Democrats stressed the historic nature of the day.
"Health care isn't only a civil right, it's a moral issue," said Rep. Patrick Kennedy, D-R.I. He said his late father, Sen. Edward M. Kennedy, D-Mass., had worked his entire career for nationwide health care, and President John F. Kennedy before him.
Slaughter, read a message President Franklin Roosevelt sent Congress in 1939 urging lawmakers to address the needs of those without health care, and said Democrat Harry Truman and Republican Richard Nixon had also sought to broaden health insurance coverage.
Obama has said often that presidents of both parties have tried without success to achieve national health insurance, beginning with Theodore Roosevelt early in the 20th century.
The 44th president's quest to succeed where others have failed seemed at a dead end two months ago, when Republicans won a special election for a Massachusetts Senate seat, and with it, the votes to prevent a final vote.
But the White House, House Speaker Nancy Pelosi, D-Calif., and Senate Majority Leader Harry Reid, D-Nev., soon came up with a rescue plan that required the House to approve the Senate-passed measure despite opposition to many of its provisions, then have both houses pass a fix-it measure incorporating numerous changes.
Under the order of the day, set down by Democrats, the House was voting first on the Senate-passed bill, sending it to Obama for his signature. A final vote on the fix-it bill would follow. Its passage would set up a final showdown in the Senate, where Reid says the votes are in hand for its final approval.
Under the legislation, most Americans would be required to purchase insurance, and face penalties if they refused. Much of the money in the bill would be devoted to subsidies to help families at incomes of up to $88,000 a year pay their premiums.
The legislation would also usher in a significant expansion of Medicaid, the federal-state health care program for the poor. Coverage would be required for incomes up to 133 percent of the federal poverty level, $29,327 a year for a family of four. Childless adults would be covered for the first time, starting in 2014.
The insurance industry would come under new federal regulation. They would be forbidden from placing lifetime dollar limits on policies, from denying coverage to children because of pre-existing conditions and from canceling policies when a policyholder becomes ill.
Parents would be able to keep older kids on their coverage up to age 26. A new high-risk pool would offer coverage to uninsured people with medical problems until 2014, when the coverage expansion goes into high gear.
Once enacted, the two bills would create a series of so-called "insurance exchanges" beginning in 2014 where consumers could shop for individual coverage that meets federal standards.
To pay for the changes, the legislation includes more than $400 billion in higher taxes over a decade, roughly half of it from a new Medicare payroll tax on individuals with incomes over $200,000 and couples over $250,000. A new excise tax on high-cost insurance policies was significantly scaled back in deference to complaints from organized labor.
In addition, the bills cut more than $500 billion from planned payments to hospitals, nursing homes, hospices and other providers that treat Medicare patients. An estimated $200 billion would reduce planned subsidies to insurance companies that offer a private alternative to traditional Medicare.
The insurance industry warned that seniors would face sharply higher premiums as a result, and the Congressional Budget Office said many would return to traditional Medicare as a result.
The subsidies are higher than those for seniors on traditional Medicare, a difference that critics complain is wasteful, but insurance industry officials argue goes into expanded benefits.

Obama Targets Insurers, Sells Reform Plan

WASHINGTON (Reuters) - President Barack Obama launched a sharp attack on health insurers on Monday and called on his fellow Democrats to rise above politics and pass a healthcare overhaul in the next few weeks.

Hitting the road to rally support in the final push for healthcare reform, Obama used a campaign-style speech to urge Democrats to approve a bill and quickly end the political wrangling that has consumed Washington since July.
"There have been plenty of folks in Washington who have said that the politics is just too hard. They've argued now is not the time for reform," Obama said at Arcadia University in Glenside, Pennsylvania.
"My question to them is: When is the right time? If not now, when?" he asked, shrugging off warnings of a political backlash in November for Democrats who back the overhaul.
"I don't know how passing healthcare will play politically, but I do know that it's the right thing to do," he said.
Obama also offered his toughest criticism yet of a health insurance industry that he said placed profits ahead of patients. "Every year, they raise premiums higher and higher," Obama said "They will keep doing this for as long as they can get away with it."
Turning up the heat, Health Secretary Kathleen Sebelius sent a letter to top companies such as Aetna Inc and Wellpoint Inc asking them to justify rate increases by making public information about costs, enrollment changes and other details.
"It's time for these insurance company CEOs to do their part to make the system more transparent for the American people," Sebelius said. "If insurance companies are going to raise rates, the least they can do is tell us why."
The Obama administration has targeted health insurers in its final push for an overhaul designed to rein in costs, regulate insurers and expand coverage to tens of millions of Americans.
Obama said failure to pass a healthcare overhaul this year would leave intact a broken $2.5 trillion healthcare system that is ravaged by greedy health insurers.

INSURERS MAKE 'A CALCULATION'
"These insurance companies have made a calculation," Obama said "They're OK with people being priced out of health insurance because they'll still make more by raising premiums on the customers they keep.
The House of Representatives is expected to vote by the end of March on the Senate's version of the healthcare bill, with Democratic House Speaker Nancy Pelosi searching for the 216 votes to pass it. The House approved its version with only three votes to spare in November.
Republican leaders say they will make healthcare reform a top issue in November's elections and urged Republican candidates to focus on the Democratic-crafted bills, which polls show are unpopular with the public.
"A vote for this bill opens an entirely new line of attack on House Democrats," Johnny Destefano, a House Republican campaign committee official, said in a memo to Republican House candidates.
"Now is the time to apply pressure and force your opponents into taking a stand on whether they will walk Speaker Pelosi's plank by supporting her last-ditch healthcare push," he said.
Republican Senate leader Mitch McConnell said the new push on healthcare would be a replay of the frantic maneuvering that marked Senate passage just before Christmas.
"Americans don't like this bill any more today than they did three months ago," he said.
But in Pennsylvania, Obama sought the public's help in rallying Congress to pass the overhaul. "It's time to make a decision," Obama said. "The time for talk is over."
The overhaul looked dead in January when Republicans deprived Democrats of their crucial 60th Senate vote by winning a Massachusetts special election, stopping negotiations to merge bills already passed by the House and Senate.
But changes to the Senate bill sought by Obama and House Democrats will be considered separately using a procedure that allows a majority vote in the 100-member Senate rather than the 60 votes needed to clear Republican procedural hurdles.
Obama proposed revisions to the Senate bill last week to ease the concerns of House Democrats, including watering down a tax on expensive insurance plans and boosting federal subsidies to make coverage more affordable.
"I think there's a lot more determination in the Congress now to get it passed," Democratic Senator Arlen Specter of Pennsylvania told reporters after Obama's speech.
"I really think there's sort of reaction on the Democratic side of getting a little angry over the duration and intensity of obstruction and a lot more determination to see it through."
In her letter to insurers, Sebelius asked executives to post on their websites the justification for any individual or small group rate increases they implemented or proposed in 2010, and continue to do so in the future.
The heads of Cigna Corp, UnitedHealth Group Inc and privately held Health Care Service Corp also received the letter.
Health insurer shares were down for the day. The Morgan Stanley Healthcare Payor index was down about 0.4 percent and the S&P Managed Health Care index was off 1 percent.
The CEO of Manpower, a global employment services company that provides temporary workers, said the uncertainty of the healthcare debate in Washington was keeping U.S. employers from hiring.
"The concern is that we have a political system that is too broken to fix systemic issues," CEO Jeff Joerres told Reuters.

President Obama open to adding GOP ideas to health plan

Associated Press Writer Erica Werner,
reported this about 8 mins ago

WASHINGTON – President Barack Obama said Tuesday he was open to four new Republican proposals on health care legislation, a gesture of bipartisanship meant to jump-start his stalled drive to overhaul the system.
Obama detailed the ideas, all of which were raised at a bipartisan health care summit last week, in a letter to congressional leaders. In a nod to his 2008 presidential rival, Obama also said he had eliminated a special deal for Medicare Advantage beneficiaries in Florida and other states that drew criticism at the summit from Sen. John McCain, R-Ariz.
The proposals Obama listed are: sending investigators disguised as patients to uncover fraud and waste, expanding medical malpractice reform pilot programs, increasing payments to Medicaid providers and expanding the use of health savings accounts.
"I said throughout this process that I'd continue to draw on the best ideas from both parties, and I'm open to these proposals in that spirit," wrote Obama, who will make remarks Wednesday at the White House on a path forward for his legislation.
He rejected the GOP's preferred approach of scrapping the existing sweeping overhaul bills and starting afresh with step-by-step changes.
House Speaker Nancy Pelosi, D-Calif., said Obama's letter "brings us just another step closer to passing the bill."
"We hope to incorporate some of the suggestions," she said.
Obama's announcement did not appear to win over any Republicans, who complained the underlying legislation remained fatally flawed, and the Senate GOP leader warned of reprisals in this fall's midterms elections if the Democrats go forward. But it could give wavering Democrats political cover by showing the White House has been willing to compromise in the wake of last week's summit.
"We're anxious to get health care done, which we will get done," Senate Majority Leader Harry Reid, D-Nev., said after Obama released the letter. Democrats proceed at their own political peril, said Senate Minority Leader Mitch McConnell, R-Ky.
"I want to assure our Democratic friends that if they are somehow able to pass this bill in the House, it will be the issue in every race in America," McConnell said.
At its core the Democrats' legislation would extend coverage to 30 million uninsured Americans over 10 years with a first-time mandate for nearly everyone to buy insurance and a host of new requirements on insurers and employers. However, the package soon to reach the House will be less expensive than the one the House passed in November and will contain no government-run insurance program to compete with private insurers, making it more appealing to some moderates.

Democrats are eyeing a controversial procedure known as "budget reconciliation" to get the legislation to Obama. Under this process, the House would pass the Senate-passed overhaul bill, and both chambers would pass a package of changes to the legislation designed to appeal to House Democrats. The changes — they could include Obama's suggested Republican ideas — could pass under budget rules allowing a simple majority vote in the Senate. It's Democrats' only way forward because Republicans control 41 Senate votes, just enough block the 60-vote supermajority usually required for action.
But the approach infuriates Republicans, even though they've used it in the past, and makes some Democratic moderates uneasy. White House chief of staff Rahm Emanuel defended the tactic after emerging from a meeting at the Capitol with Reid and House Speaker Nancy Pelosi, D-Calif.
"Reconciliation is a vehicle that's been used many times," Emanuel said. "This is a normal procedure, nothing different out of it."
Obama said he was open to these four GOP ideas:

Conducting undercover investigations of Medicare and Medicaid providers to search for waste, fraud and abuse, an idea put forth by Sen. Tom Coburn, R-Okla., at least week's summit.

 Experimenting with specialized health courts as an alternative to jury trials in medical malpractice cases to cut down on defensive medicine. That idea has been promoted both by Democrats and Republicans, including Coburn and Sen. Mike Enzi, R-Wyo., who attended the summit.
The approach calls for an expert judge — not a jury — to hear the evidence and make a final determination in cases where a patient has suffered harm. Trial lawyers are strongly opposed to the concept.
Months ago, Obama budgeted $23 million for states to experiment with alternatives to malpractice litigation, but at the time he stopped short of endorsing health courts. The president now says he wants to more than double the budget for state experiments to $50 million.
Obama also agreed that health savings accounts would be offered in new markets his plan sets up for individuals and small business to purchase coverage. Sen. John Barrasso, R-Wyo., brought up the idea at the summit.
The president said he's open to the tax-sheltered accounts, which go hand-in-hand with high-deductible health insurance policies. Premiums on those policies are lower than for regular health insurance, and people who have them use the health savings accounts to pay their out-of-pockets costs.
Obama also suggested increasing reimbursements to Medicaid providers, a concern raised by Sen. Charles Grassley, R-Iowa.
"That's just one thing," Coburn said of the president's desire to incorporate his proposal. "We need to start over," Coburn said, contending the bill doesn't address underlying issues of health care costs and quality.
Grassley said Obama's willingness to include his idea didn't change his opposition to the overall legislation. "There are other things more important," like its lack of caps on liability damages and its inclusion of an individual mandate, he said.
Democrats argue that the GOP calls to scrap the existing legislation and start anew further their argument that Republicans have been unreasonably opposed to almost any compromise, justifying the White House decision to push for passage with no GOP help at all.
Sen. Bill Nelson, D-Fla., said he hadn't seen Obama's proposal to eliminate the provision he championed to let about 800,000 Florida seniors enrolled in Medicare Advantage plans keep their extra benefits. But, Nelson said, "I do not think it should be removed."