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Study: Most People Support Health Plan with Shared Responsibility Between Individuals and Government

By Daniela Feldman, CQ Staff

April 22, 2009 -- A majority of Americans support a "shared-responsibility" plan for health coverage that couples an individual mandate with expanded employer, government, and insurer roles, according to a study published this week on the Health Affairs Web site.

The study, which is based on a survey conducted in February 2008, also notes that the most popular choice for a health insurance mandate is one that would require health care for all children by obligating parents to provide coverage for their children or request aid from the government. Sixty-five percent of survey respondents indicated they wanted to see all children granted insurance.

Overall, fifty-nine percent of those asked about a shared-responsibility mandate supported it, compared with 48 percent of people overall who support an individual mandate, according to the report. The 1,704-person telephone survey was split into two groups; one half of respondents was asked about the individual mandate proposal and the other half was asked about the shared-responsibility proposal.

"The administration and key congressional Democrats, such as Senate Finance Committee Chair Max Baucus, D-Mont., have put forward shared-responsibility approaches to expanding coverage," Bob Blendon, one of the study's authors and a professor of health policy and political analysis at Harvard School of Public Health, said in a news release. "The individual mandate provides the vehicle for universal coverage, but public support for mandate-based reform increases markedly, particularly among African Americans and upper-income people, if requirements for government, employers, and insurers are also included."

The Senate Finance Committee has scheduled three roundtables, including one held Tuesday, on ways to overhaul health care. The committee plans private meetings in which members will be asked to react to legislative proposals it is considering.

According to the study, the most significant comparison between supporters for shared mandates and individual mandates comes from respondents who earn between $80,000–$100,000 and respondents who are African American. Seventy percent of respondents within that income bracket supported a shared responsibility approach, versus 27 percent who supported a stand-alone mandate, according to the survey results. Eighty percent of African American respondents said they support a shared-responsibility mandate, compared with 56 percent who said they support an individual mandate approach, the survey said.

Fifty-six percent of self-identified Democrats and 36 percent of self-described Republicans supported the individual mandate, the survey said.

The survey, designed by researchers at National Public Radio, the Kaiser Family Foundation, and the Harvard School of Public Health, also asked participants to indicate reasons why they support a national mandated health care program. The three top reasons were: "making sure everyone has health insurance is the right thing to do"; "people with health insurance will get preventive and more continuous care"; and "by requiring the uninsured to get insurance, people won't face higher health care costs to cover the unpaid medical bills of those who don't have insurance."

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