POLL: Obama's Speech Doesn't Turn the Tide

Testing Obama vs. the Republicans in Congress, the president leads in trust to handle health care reform by 48-36 percent. That's down, though, from 55-27 percent in June and, like many other basic health care measures, puts him under 50 percent. Obama also leads in trust to handle the deficit, and, as noted, the economy, but again by smaller margins than previously.

Also, specific to health care, the president and his party far outpoint the Republicans in being seen as making a "good-faith effort" to cooperate – 50 percent say Obama and the Democrats in Congress are trying to cooperate on reform, vs. 31 percent who say the same of the Republicans. And many more chiefly blame the Republicans for the negative tone of the debate, 31 percent, than the Democrats, 17 percent. But a plurality, 49 percent, blames both sides equally.

There's a challenge for Obama and the Democrats embedded in these views: Even as the Republicans are seen as less cooperative, 71 percent say the president and his party should try to change their reform proposals to win Republican support, rather than pushing ahead without it.

PUBLIC OPTION – On specifics in the health care plan, 55 percent support a so-called public option, with 42 percent opposed – slightly less opposition than in last month's 52-46 percent division, but still shy of the initial reaction in June, 62-33 percent support.

That June poll found that support for a public option drops dramatically if it would put many private insurers out of business, as critics claim. This poll shows a flip side: Support for a public option swells to 76 percent if it were available only to people who can't get coverage from a private insurer. The increase is most dramatic among Republicans, a 32-point gain to 59 percent support; and seniors, a 33-point gain to 68 percent. Something like this was suggested by Obama, who said in his address the option would be available only to people who "don't have" insurance; herein may be a path to compromise.

Medical Malpractice and Medicare

Some proponents of reform have described a public option as an essential element; Obama, on the other hand, has not. And as noted, without a public option, this poll finds support for reform's remaining elements at 50-42 percent. (Despite some threats, support among liberals is nearly as high without a public option as with one.)

OTHER ELEMENTS – Another element of reform, limiting medical malpractice awards, is popular, with 63 percent support, up from 57 percent in June. On the other hand it's back to a split on taxing insurance companies when they sell high-end, so-called Cadillac insurance policies – 45 percent in favor, 48 percent opposed. And if the insurance companies passed on the tax by raising the prices of those policies, opposition soars to 71 percent.

Some of the compunctions are considerable. Sixty-five percent think reform would increase the deficit. Forty percent think it'd weaken Medicare, about twice the 22 percent who think it'd strengthen that popular program. Among seniors, 56 percent think reform would weaken Medicare, explaining why opposition to reform peaks in their ranks.

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