Many Americans don't want their coverage to be upended

— -- Only two in 10 Americans say their health insurance coverage and the quality of the health care they receive will improve if a bill passes Congress this year, despite President Obama's promises to improve the system for those with and without insurance.

A USA TODAY/Gallup Poll taken after the president's speech to a joint session of Congress on Sept. 9 found that more than seven in 10 of those polled say their costs and their care will either stay the same or get worse if the legislation Obama and congressional Democrats are pushing becomes law this year.

"It'll definitely get worse because they're going to have to find the money to pay for all this stuff," says Janene Sholes, 48, of Tampa. "And where are they going to get it from? Us."

The findings underscore the challenges facing Obama and Congress as they try to reduce costs in the unwieldy health care system and provide coverage to millions of Americans without insurance.

Although there is widespread agreement that changes must be made in the USA, a strong majority say they are satisfied with what they have and don't want it upended.

• Eight in 10 say they are satisfied or very satisfied with the quality of the medical care available to them and their families.

• Six in 10 say they are satisfied or very satisfied with the cost of the medical care for themselves and their families.

• More than half say rising health care costs such as insurance premiums and out-of-pocket expenses are either no problem or a minor problem for them.

• Nearly two-thirds say reductions in what their insurance plan covers is either no problem or a minor problem.

"All people have heard are negative stories about the health care industry," says Robert Zirkelback of America's Health Insurance Plans. But "the vast majority of Americans are very satisfied with their health care coverage."

Democratic pollster Mark Mellman says he's not surprised the poll picked up some anxiety as well.

"Any time you make significant change, you make people nervous, especially when they're already nervous because of their economic situation," he says. "I think the president did a very good job of selling the program in his speech (to Congress), but I think the White House recognizes, Capitol Hill recognizes, everybody recognizes there's still a lot of selling to be done."

The poll, taken Sept. 11-13, found two-thirds cite high costs, the uninsured and insurance companies' greed as the biggest problems with health care in the United States.

"It is just terrible to see people without insurance," says Dee Gagliari, 55, a homemaker from Kensington, Conn.

Obama wants a government-run program to help provide insurance to those who don't have coverage but says he is open to other methods, such as non-profit health cooperatives.

He promises improvements for those who have insurance.

"What this plan will do is make the insurance plan you have work better for you," he told a boisterous crowd at the University of Maryland last week.

Steve Clements, 32, of Wausau, Wis., a youth pastor with the Evangelical Free Church of America, says he and his family are "overall happy" with the care they've received through the insurance coverage that comes with his job, despite an uptick in his premiums and deductibles.

He says he's wary of a government fix.

"Taking some of the decision-making and consumerism out of the health care equation could be a dangerous thing."

Rick Scott, founder of Conservatives for Patients' Rights, says the poll reflects the flaws in Obama's plan. "When people look at these bills (in Congress), it just doesn't make sense to them that costs are going to go down," he says. "People are pretty logical."

There are some who support Obama's plan — even if it might drive their costs up and limit their coverage.

"It may actually hurt me personally," says Rennie Moore, 43, an electrical contractor from Charleston, S.C., "but as long as it helps people overall, I am for it."

The survey of 1,030 adults has a margin of error of +/-4 percentage points.

Contributing: Susan Page, Andrew Seaman