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April 1, 1994

AMERICANS OVERWHELMINGLY SUPPORT HEALTH REFORMTHATPUTS THE CONSUMER IN CHARGE

By Michael G. Franc Director of Congressional Relations - U.S. House of Representatives

For the first time since President Clinton unveiled his health reform plan, polls now show that more Americans oppose the Clinton plan than support it. Meanwhile, large majorities have regis- tered support for the central features of consumer choice health care reform, such as the bill introduced in the Senate by Don Nickles (R-OK) and in the House by Cliff Steams (R-FL). A Timel CNN survey conducted March 2-3, 1994, found that opponents of the Clinton plan now outnumber its supporters by 45 percent to 41 percent. Other polls conducted since mid-February have identified - a similar negative trend among ordinary Americans for Clinton's brand of health reform. From Clinton's perspective, perhaps the worst news contained in these polls is the finding that Americans who understand the plan the best like it the least. The ABCIWashington Post survey, for example, found that 51 percent agreed that "the more I hear about the Clinton plan, the less I like it." Similarly, a survey by Fabrizio, McLaughlin & Asso- ciates found a more than two-to-one ratio of disapproval among those who said they knew a "great deal" about the plan, considerably higher than the level of dissatisfaction among those who knew either a "fair amount" or "very little" about it:

From what youve read or hea4 do you favor or oppose President's Clinton's health care plan? Knowledge of Clinton Plan Favor Oppose Know o great deal 28% 62% Know a fair amount 42% 48% Know very fiffie 33% 42%

The movement away from Clinton's plan cuts across many politically important groups such as Independents, senior citizens, and Perot voters:

Group Favor Oppose Indopendonts 35% 46% Ovor ago 65 26% 47% Porot supporters 25% 56% Other notable findings are that groups that the Clintons clearly are counting on for a strong show- ing of support are lukewarm with respect to the plan. Examples include individuals with incomes be- low $20,000-split 38 percent for and 38 percent against the plan-and The baby boomers, who oppose the plan 47 percent to 37 percent.

The Consumer Choice Alternative With the Clinton plan unraveling both inside and outside the Washington Beltway, Capitol Hill is taking a closer look at approaches to health reform that enjoy broader support among the American people. One plan that, according to a recent poll, enjoys this sort of support is the Nickles-Steams -Consumer-Choice and Health Security Act (S. 1743/H.R. 3698). In October 1993, the polling fmn of Fabrizio, McLaughlin & Associates conducted a survey on behalf of The Heritage Foundation that presented respondents with two starkly different approaches to health care reform-Plan A, a set of reforms modeled on the Clinton plan, and plan B, an altema- tive approach that closely resembles the Nickles-Steams legislation. The results of that poll indicate that the American people overwhelmingly support health care reform that puts them-rather than the government-in control of their health care. Respondents were asked the following five questions.

Question 1. Plan A does not provide tax breaks for out@-of pocket medical expenses. Plan B would Plan A - 12% allow tax breaks for out-of-pocket medical expenses and allow you to save money for future Plan B - 82% medical expenses tax-free. Knowing this. would you favor Plan A or Plan B? Refused -6% Quesfion 2. Plan A would require your employer to deduct monies from your paycheck to help pay for plan A - 29% a health care plan designed by the federal government. Plan B would allow you to take the monies Plan B - 64% your employer now spends on your health care and allow you to spend as much as you want on whatever health plan you choose. Knowing thit would you favor Plan A or Plan B? Refused -7%

Quo" 3. Under Plan A. a government board would decide the services that are Induded In your PlanA-11% health care plan, thereby forcing you to pay out of your pocket for additional medical expenses. Under Plan B - 85% Plan B, you would decide on your own health care plan. thereby determining the services you want Refused -4% Included or excluded. Knowing thK would you favor Plan A or Plan B? Quedion 4L Under Plan A. your employer would decide whether to provide you with health coverage Plan A - 12% or place you Into a government-run health alliance. Under Plan B, you would decide whether to remain Plan 9 - 83% with your employer's health coverage or another group such as a union, church or farm bureau to obtain Refused -5% coverage. Knowing this, would you favor Plan A or Plan B?

Quedon 5. Now, having heard some of the differences between Plan A and Plan B, overall, would you Plan A - 14% say you favor Plan A or Plan B? Plan B - 77% Refused --9%

Overall, 77 percent chose the consumer choice plan over the President's approach. Significantly, a majority of every single voter group opted for the consumer choice approach, including strong support from the following groups: Overall, do you prefer Plan A or Plan B?

Plan B Plan A Voter Group (Consumer Choice Man) (Clinton Plan)- Uninsured 81% 15% Blacks 76% 15% independents 76% 16% Union Members 74% 15% Income $20,000 or Less 74% 14% Not Satisfied With Quality of Health Cam 73% 17% Democrats 71% 18% Clinton Supporters 67% 21%

Aside from traditional Republican and conservative voter groups, the groups recording the highest levels of support for the consumer choice approach were:

Man B Plan A Voter Group (Consumer Choice Plan) (Clinton Plan) Age 18 to 25 89% 9% Married with Children 82% 12% Women under age 40 84% 10% Perot Supporters 82% 12%

While there was widespread support across all income groups for the consumer choice approach, respondents from households with incomes below $40,000 were far more likely to support the key elements of the Nickles/Steams legislation than were respondents with incomes over $100,000:

Plan B Man A Income Group (Consumer Choice Plan) (ClintDn Plan)) Less than $40,000 78% 13% $40,000 to $100,000 80% 12% Over $100,000 61% 28%

Also, of all the groups surveyed, there was a near unanimous endorsement of the tax credit approach among those without health insurance (91 percent).

Public Approval. of Clinton's Health Care Plan Drops as More Details Emerge