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The September Kaiser Health Tracking Poll finds that more than a third (36%) of Americans say Medicare is “extremely” important to their vote in the election, compared to 49 percent who describe the economy in such terms and 41 percent who say so about the federal budget deficit. For seniors, Medicare pulls nearly even with the economy as an issue, with 46 percent branding Medicare extremely important to their vote and 51 percent saying the economy is extremely important. Democrats are much more likely to say Medicare is an extremely important factor in their presidential pick, while for Republicans the federal budget deficit is about equal to the economy as their top concern. Even though the Affordable Care Act (ACA) has been the focus of partisan political and legal battles for more than two years, it ties for fourth (with Medicaid and spending on the military) on the list of priorities among the ten issues asked about for all respondents, with 30 percent saying each is extremely important to their vote. The ACA ranked sixth among seniors, picked by 32 percent as extremely important to their vote. The poll finds that a majority Americans do not embrace shifting the Medicare program toward a premium support model at this time. Fifty-five percent prefer that Medicare continue as it is today, while 37 percent favor a premium support (or defined contribution) system with a traditional Medicare option of the sort called for by Republican presidential nominee Governor Mitt Romney and his running mate, Representative Paul Ryan. Support for the status quo is stronger among those 55 and older -- two-thirds of whom want to keep Medicare as it is -- even though Gov. Romney has emphasized in his campaign that this group would not be affected by his proposal. Among adults under 55, half favor the current system and 44 percent favor a defined contribution system. Public opinion on premium support appears to be malleable. The polls finds roughly four in ten of those who originally prefer the Medicare status quo say they would rethink their views after being challenged with arguments made by proponents of premium support. After being told that the switch “is needed to sustain Medicare for future generations,” for instance, 27 percent of the public still want to keep Medicare as it is while 25 percent now say they are more interested in making a change (in addition to the 37 percent who previously favored the change). Similarly, roughly half of those who back premium support initially say they would reconsider their position after being plied with arguments made by opponents. After hearing premium support “will save the federal government money by shifting costs onto seniors,” for example, only 16 percent of the public still favors such a switch, while another 19 percent say they are less interested in change (in addition to the 55 percent who previously preferred the status quo). Seventy-two percent of the public does believe that changes need to be made to Medicare to make sure the program is available for future beneficiaries. Those who believe change is needed are about evenly divided on whether Medicare needs a major overhaul or minor tweaks. Seniors also are on board with the idea that change is necessary, with a solid majority (63%) saying changes are needed to keep Medicare financially viable, while three in ten say the program is fine as it is. The poll also finds that President Obama enjoys a significant edge over Gov. Romney when it comes to whom the public trusts to handle Medicare. Fifty-two percent of the public say President Obama is the candidate they “trust to do a better job” of determining Medicare’s future, compared to 32 percent who pick Gov. Romney. The president’s advantage has increased significantly since July, when 44 percent chose him and 34 percent chose Gov. Romney. However, among Americans 65 and older the gap closes, with 44 percent naming the president and 42 percent picking Gov. Romney. Republicans have accused President Obama of using the ACA to “raid Medicare” and he and the Democrats have strongly refuted the criticism. Thirty-six percent of Americans believe Medicare will be better off because of the ACA, but 30 percent think the program will be worse off. Among seniors, 38 percent say Medicare will be worse off under the ACA compared to 31 percent who say it will be better off. Finally, the poll finds the public as divided as ever about the health reform law overall, with 45 percent saying they had a favorable opinion of it in September and 40 percent an unfavorable one. The seven percentage point uptick in favorable views of the law since August has been driven in part by substantial increases in support among the uninsured and people with lower incomes, two groups who are likely to benefit most under the law. The share of each of the two groups that holds a favorable view of the law jumped by at least 15 percentage points, to 51 percent. Methodology The poll, designed and analyzed by public opinion researchers at the Kaiser Family Foundation, was conducted Sept. 13-19, 2012 among a nationally representative random digit dial telephone sample of 1,534 adults living in the United States. Interviews were conducted by landline (1,033) and cell phone (501) in English and Spanish. The margin of sampling error for the full sample is plus or minus 3 percentage points. For results based on subgroups, the margin of sampling error may be higher. The Kaiser Family Foundation, a leader in health policy analysis, health journalism and communication, is dedicated to filling the need for trusted, independent information on the major health issues facing our nation and its people. The Foundation is a non-profit private operating foundation, based in Menlo Park, California. ### For advertising and promotion on HealthNewsDigest.com please contact Mike McCurdy: tvmike13@HealthNewsDigest.com or 877-634-9180 HealthNewsDigest.com is syndicated worldwide, to thousands of journalists in all media, and health-related websites. www.HealthNewsDigest.com Top of Page 
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