KNOWLEDGE, SUPPORT and VOTE – Given the complexities, it's perhaps surprising that a majority of Americans, 55 percent, feel they have a good basic understanding of the changes being proposed to the health care system. And this sense of knowledge works in favor of advocates of change: Support for the reform proposed by Obama and Congress rises to 56 percent among people who feel they understand the proposals, compared with 38 percent support among those who find the changes too complicated to understand clearly.
That said, views continue to break sharply along partisan and ideological lines; overall support, 75 percent among Democrats, drops to fewer than half of independents, 45 percent, with 52 percent opposed. Among Republicans a mere 13 percent support the proposal; not only are 85 percent of Republicans opposed, but are 73 percent "strongly" so. That helps opponents lead in intensity – among all Americans 39 percent strongly oppose reform, vs. 30 percent strong support.
The direction of that intensity is reflected, modestly, in a measure of vote impact: Twenty percent say they'd be much more likely to oppose a candidate who backed health care reform, vs. 13 percent much more apt to support one. Republicans overwhelmingly rate it as a strong negative, but it's also a factor among independents: Twenty-three percent much more apt to oppose a reform backer, 11 percent much more apt to support one.
OTHER ISSUES – Holding the line on health care is far from Obama's only challenge. He's got a precarious 51 percent approval rating on handling the economy, and remains lower on dealing with two other top issues – Afghanistan, 45 percent approval, with 48 percent disapproving; and handling the deficit, 42 percent approving while 53 percent disapprove. On handling terrorism, 53 percent approve, but disapproval is up by 7 points to a new high, 41 percent.
There's also the public's general woe, fueled chiefly by the economy. Forty-four percent say the country's headed in the right direction overall, but a majority, 55 percent, says it's still seriously off on the wrong track, a number that's held steady since August after a spate of relative optimism in the spring and early summer.
It could be far worse – "wrong track" is down from a record 90 percent in October 2008. But it's a reflection of the public's continued economic pain and the hazard that poses for Obama, his in-power party and indeed all incumbents.
Just 38 percent in this poll say they're inclined to re-elect their representative in Congress; 50 percent instead are inclined to look around for someone else. That "look around" number has been higher, peaking at 58 percent before the 1994 elections in which the Republicans took control of the House. But it's also been as low as 41 percent. It's a reminder that for all the other issues facing the country, as goes the economy, likely goes 2010.
METHODOLOGY – This ABC News/Washington Post poll was conducted by telephone Nov. 12-15, 2009, among a random national sample of 1,001 adults, including landline and cell-phone-only respondents. Results for the full sample have a 3.5-point error margin. Click here for a detailed description of sampling error. Sampling, data collection and tabulation by TNS of Horsham, Pa.