September 26, 2012 9:56:15 AM
WASHINGTON -- They may not like it, but they don't see it going away. About 7 in 10 Americans think President Barack Obama's health care law will go fully into effect with some changes, ranging from minor to major alterations, an Associated Press-GfK poll finds.
Just 12 percent say they expect the Affordable Care Act -- "Obamacare" to dismissive opponents -- to be repealed completely.
The law -- covering 30 million uninsured, requiring virtually every legal U.S. resident to carry health insurance and forbidding insurers from turning away the sick -- remains as divisive as the day it passed more than two years ago. After surviving a Supreme Court challenge in June, its fate will probably be settled by the November election, with Republican Mitt Romney vowing to begin repealing it on Day One and Obama pledging to diligently carry it out.
That's what the candidates say. But the poll found Americans are converging on the idea that the overhaul will be part of their lives in some form, although probably not down to its last clause and comma.
Forty-one percent said they expect it to be fully implemented with minor changes, while 31 percent said they expect to see it take effect with major changes. Only 11 percent said they think it will be implemented as passed.
Americans also prefer that states have a strong say in carrying out the overhaul. The poll found that 63 percent want states to run new health insurance markets called "exchanges." They would open for business in 2014, signing up individuals and small businesses for taxpayer-subsidized private coverage. With many GOP governors still on the sidelines, the federal government may wind up operating the exchanges in half or more of the states, an outcome only 32 percent of Americans want to see, according to the poll.
Finally, the poll found an enduring generation gap, with people 65 and older most likely to oppose the bill and those younger than 45 less likely to be against it.
"People are sort of averaging out the candidates' positions," said Harvard School of Public Health professor Robert Blendon, who tracks polling on health care issues. "The presidential candidates are saying there's a stark choice, but when you ask the voters, they don't believe that the whole bill will be repealed or implemented as it is today in law."
Republicans remain overwhelmingly opposed to the overhaul and in favor of repeal. But only 21 percent said they think that will actually come about.
Romney supporter Toni Gardner, 69, a retired school system nurse from Louisville, Ky., said that until a few weeks ago she was sure her candidate fully supported repeal, as she does.
But then Romney said in an interview there are a number of things he likes in the law that he would put into practice, including making sure that people with pre-existing medical problems can get coverage. The Romney campaign quickly qualified that, but the candidate's statement still resonates.
"If Romney gets in, he'll go with parts of it," Gardner said, "and there are parts of that he won't go with."
Gardner thinks expanding coverage will cost too much and may make it harder to get an appointment with a doctor. Besides, she doesn't believe the government can handle the job. She's covered by Medicare -- a government-run health system -- but says "that wasn't a choice that I had."
At 26, Santa Monica, Calif., web developer Vyki Englert has only bare-bones health insurance coverage. Her parents, a preschool teacher and a self-employed photographer, are uninsured. Englert says she thinks the law will largely go into effect as passed. (Among 18- to 29-year-olds, 60 percent think it will be implemented with only minor changes or none at all.)
Englert says that she supports guaranteeing coverage to people with health problems and that provisions such as broader coverage for birth control will help younger women such as her.
"I kind of see a day-to-day way where this law could benefit me," she said. Englert says the health care law dovetails with a trend toward consumerism in her generation. Older Americans "don't have the context of the young people," she added. "They are looking more at the theoretical impact on the budget and the country."
Overall, the poll found Americans divided on the question of repeal, with neither side able to claim a majority. Forty-nine percent said the health care law should be repealed completely, while 44 percent said it should be implemented as written.