Friday, December 25, 2009

Via, here are some interesting overview articles about health care polling, from Frank Newport of Gallup (link) and Bruce Drake of Kaiser (link).

Happy holidays and best wishes for the new year!

Tuesday, December 22, 2009

Political strategist Mark Mellman has produced a memo for Democratic party senators, summarizing polling results that he claims demonstrate the popularity of specific provisions in health care reform legislation (via Daily Kos). Mellman also delves into the topic of opposition from the left, which may evolve into support if many liberals begin to accept the pending legislation as a substantial, albeit flawed, accomplishment. In fact, in line with other recent surveys, a new CNN poll (in the field December 16-20) shows that the combination of respondents who favor the bill before the Senate (42%) and those who oppose it for not being liberal enough (13%) comprises a clear majority of 55%.

UPDATE: Gary Andres and Whit Ayres provide a rebuttal to Mellman (via

Thursday, December 17, 2009

How "P.O.'d" are Voters at the Dropping of the P.O.?

Early this week, word began filtering down from Senate Majority Leader Harry Reid (D-NV) that all semblance of the public option (opt-out, trigger, and even the Medicare buy-in that would have been limited to 55-64 year-olds) would be dropped from the Senate's health care reform bill.

The new NBC-Wall St. Journal poll was in the field December 11-14, during which rumblings of the reform bill being trimmed to accommodate Sen. Joe Lieberman (I-CT) emanated out of the nation's capital. Thus, the poll was able to gauge respondents' (anticipatory) reactions to changes associated with the public option. Of particular interest is the following item (with preface):

As health care legislation is being debated in Congress, some changes to the legislation are being proposed. I am going to read you some of these proposed changes, and for each one, please tell me whether that proposed change is acceptable to you or not acceptable to you.

The proposed legislation would no longer create a public health care plan administered by the federal government to compete directly with private health insurance companies.

Respondents saying "not acceptable" (45%) outnumbered those saying "acceptable" (42%). We cannot, of course, determine causation from correlational data, but there at least seems to be a plausible case from the NBC-WSJ poll that the Democrats' jettisoning of the public option and related proposals has harmed overall support levels for the bill. Now, just 32% of respondents say the Obama health care plan is a "good idea" (vs. 47% calling it a "bad idea"); in October, the last time this question was asked, 38% said the plan was a good idea. Also, 44% percent said it was better "to not pass this plan and keep the current health care system," compared to 41% favoring passage. The two previous times this item had been asked (in October and September), passage was preferred by identical 45-39 margins.

Not all recent polls are so pessimistic for the Obama/Democratic health bills, however. A Gallup poll in the field December 11-13 found nearly a dead heat, with 46% of respondents saying they would advise their representatives in Congress to vote for the bill and 48% saying they would advise against.

Saturday, December 12, 2009

Breaking Down Nov-Dec Decline in Support for HC Reform

As many observers have noted, support in public opinion polls for the overall health care reform bills before Congress has slipped several percentage points from October to mid-December. (Support for the public-option aspect remains high, but that will not be addressed in the present posting.)

Though the trend for support of overall reform bills is clearly down, not every poll follows this pattern. Take, for example, the FOX News and Economist-You Gov polls that were in the field right around the same time (December 8-9 and 6-8, respectively). FOX showed 34% support for reform, whereas the Economist showed 51%. That's quite a difference!

My first inclination when seeing apparent oddities in polling results is to investigate the partisan composition in polls' samples (i.e., what percentages of respondents are self-identified Democrats, Republicans, and Independents?). Indeed, the FOX poll contained the same percentages of Democratic and GOP respondents, whereas in the Economist poll, Democrats outnumbered Republicans by 14 percentage points.'s aggregate averages currently have the Democrats up approximately 9 percentage points in general-adult samples and roughly 4.5 points up in registered- and likely-voter samples. Thus, FOX and the Economist each appear to diverge from middle-of-the-road estimates, albeit in different directions.

To test my hunch that differences in party ID composition might account in good part for different polls' health care reform support levels, I obtained a scatter plot and correlation coeffcient between the two variables. The resulting graphic is shown below (you can click on all graphics to enlarge them). I had hoped to restrict the polls in the analysis to very recent ones, but in order to have enough data points, I had to go back almost to the beginning of November; some otherwise usable polls did not report party ID breakdown, about which I continue to be frustrated and disappointed.

In addition to FOX and the Economist, I included the most recent polls from Public Policy Polling, Rasmussen (results; party ID), Ipsos, Democracy Corps, CBS News, ABC-Washington Post (results, party ID), Pew, Public Opinion Strategies, and Associated Press-GfK. (I used a correlation-graphing website to generate the plot, then took a screen capture and annotated the display in PowerPoint.)

As can be seen, there is a clear positive, linear relationship (.61 correlation, where 1.0 is the maximum possible), indicating that the greater the Democratic edge over Republicans in sample composition, the higher the support for health care reform.

Party ID turns out to be a substantial, but by no means comprehensive, factor in accounting for the various polls' differences in support for reform. Statistically, the .61 correlation must be squared, yielding the result that party ID accounts for 37% of the variance in support levels. More intuitively, one can see that even when holding partisan composition constant (such as in the two polls with +5 Democratic edges or three polls with +14 Democratic margins), support for reform still varies. Some of the predictive imperfection of party ID margin (as operationally defined as D minus R) might also stem from the fact that each poll's percentage of Independents is not taken into account (e.g., a poll with 40% D, 35 R, and 25 I, would be treated identically, as D+5, to one with 30 D, 25 R, and 45 I).

I next examined each poll's cross-tabs (where available) for reform support among Democrats, Republicans, and Independents, which are summarized in the following chart.

Support for reform among Republicans was very consistent from poll to poll, almost always at or near 10%. Support among Democrats varied widely (from 57-79%), as did support from Independents (25-47%). For whatever reason, the Economist-You Gov and ABC-Washington Post polls had not only the largest Democratic advantages in sample composition (along with Pew), but also the highest levels of support for health care reform among Democrats and Independents.

Regarding variation in reform support among self-identified Democrats, the issue of opposition to pending bills from the left -- due to many liberals' perception that their preferred reforms are being watered down in congressional negotiations -- has gotten attention recently, both on the present blog and elsewhere. Perhaps different polls' item wordings and question sequencing put Democratic respondents in different frames of mind, sometimes leading them to focus on what they would consider positive aspects of the pending bills (e.g., providing coverage to millions of uninsured) and sometimes making salient the negative aspects (e.g., the watering down).

I will leave this issue -- and possible reasons for Independents' varying levels of support in different polls -- for other analysts to explore.

Thursday, December 10, 2009's Mark Blumenthal has an essay today on the recent decline in support for general health care reform, with a focus on the matter of opposition from the left.

Wednesday, December 9, 2009

A component of the latest Senate proposal to expand health insurance coverage is to let 55-64 year-olds purchase a policy under Medicare, the established government program for individuals 65 and older that is funded in large part by payroll taxes.

The Kaiser Family Foundation has polled for many months on the item "Expanding Medicare to cover people between the ages of 55 and 64 who do not have health insurance." As shown in this document, the percent of Americans supporting the idea has consistently been in the 70s.

Some of the provisions currently being considered in the Senate may not map exactly onto the policy implied in the survey item, however. For example, the survey's phrase "[e]xpanding Medicare to cover people..." may suggest to some respondents that 55-64 year-olds could participate in Medicare on the same basis as individuals 65 and older (i.e., with some of the costs financed by taxpayers), not that those 55-64 must "buy in" on their own (or possibly with some degree of subsidy).

Also, the qualifier "...who do not have health insurance" could be open to different meanings. It could theoretically refer to anyone 55-64 years old, as someone with employment-linked health insurance could drop it (and in that sense, not have insurance) and then purchase Medicare. Or it could refer only to people who have lacked health insurance for some length of time or with some chronicity. In the actual legislation, the segment of 55-64 year-olds eligible to purchase Medicare could be even narrower, as described in this article: "primarily those who have been uninsured for a certain amount of time, have a history of poor health or are unable to get insurance because of a preexisting condition."

Back in May, KFF issued a detailed study of health insurance coverage and health status of 55-64 year-olds. This report may be of interest to our more policy-wonkish readers.