New Poll: Americans Still Confused by President Obama’s Health Care Plan

September 18, 2009

Siegel+Gale survey finds dramatic lack of understanding of basic points in plan, even among Democrats

Only 36.9% of Americans believe they understand the plan

NEW YORK, SEPTEMBER 18, 2009 – As President Obama prepares to make back-to-back appearances on the Sunday morning talk shows and David Letterman in an effort to garner support for his proposed health care plan, his primary challenge will be in helping his audience to understand what the plan entails.

According to a recent survey commissioned by global strategic branding firm Siegel+Gale, Americans across the political spectrum are significantly confused by major points of the President’s proposed health care plan – even after his nationally televised address to Congress.

The online survey of 1,042 adults and 102 health activists from WEGO Health, conducted last weekend following President Obama’s health care address to Congress, finds that even among supporters of the President and his plan, most Americans could not correctly identify key aspects of the proposal – including funding, who would be covered by a public option, and when the plan would go into effect.

“Clearly the whole health care issue is fraught with complexity, political in-fighting, and emotion that is not helped by poor media coverage. So I’m not surprised that the American people have thrown up their hands – even sophisticated consumer advocates are not clear about the plan,” says Alan Siegel, Chairman and Founder of Siegel+Gale.

Key findings include:

  • Only 16.5% of the public believes the plan would not add “one dime” to the federal deficit, and 36.1% believe that the plan will add a “massive amount” to the deficit
  • When asked about how the plan would be funded, less than one-third of the respondents cited one of the key funding sources that Obama mentioned – fines to be levied on large companies that don’t offer health insurance to their employees
  • Almost 20% of respondents answered that funding would come from a fine levied against wealthy individuals – an answer included in the survey questions that has never even been discussed
  • While health activists – online consumer health opinion leaders – were significantly more accurate than the average consumer on most points, the majority also reported a low understanding of the President’s plan
  • Online health activists also confirmed that typical consumers they encountered online had a poor comprehension of the Obama health care plan

Taking the nation’s temperature

Conducted on the weekend following the President’s September 9th speech, the Siegel+Gale survey asked respondents whether they understood the proposal, and inquired about its details based on President Obama’s speech. Among the general population, just 36.9% said that they understood the President’s plan. Of those who actually watched the September 9th address to Congress, the number was higher: 57.9% claimed to understand it. Yet even these respondents provided incorrect answers with surprising frequency.

The Siegel+Gale poll reveals that many aspects of the proposal – particularly the impact it will have on the U.S. deficit – are widely misunderstood or not believed.

Perhaps the most significant conclusion of the survey is that only 32.4% of the public actually supports the President’s proposal at this time. Even among WEGO Health’s health care activists – a group that leans predominantly Democratic according to the survey – fewer than half (44.7%) support the plan.

Fear of mounting deficit

Despite the President’s statement that, “I will not sign a plan that adds one dime to our deficits, either now or in the future,” only 16.5% of the public believes this. 12.8% believe it will add “a modest amount,” and 36.1% believe it will add “a massive amount” to the deficit. Of those who watched the speech and claim to understand the proposal, 28.8% believe the plan will add a massive amount to the deficit.

Source of confusion: funding

While the President cited three sources of funding – savings from reforms, fees from insurance companies, and fees from large companies that don’t offer health insurance to employees – there remains widespread confusion about how President Obama proposes to finance the plan. Despite the President’s assurances, people think funding will come from the sources below:

Source of fundingPresidentPublic
Through higher health insurance premiumsNo11.0%
Through higher taxesNo28.4%
By increasing the federal deficitNo25.3%
Through savings from reforms to the health care systemYes32.1%
Through fees paid by insurance companies that sell expensive health insurance plansYes20.2%
Through fees paid by large companies that don’t offer health insurance to their employeesYes26.7%
Through reductions in Medicare benefitsNo18.7%
Through special levies against wealthy individualsNo19.6%
I don’t know40.1%

Confusion also reigns when it comes to abortion coverage, one of the most emotional issues. Among the general public/health care activists, 19.6/16.5% believe the Obama proposal will pay to terminate pregnancies, 28.9/36.9% believe it won’t, and 51.5/46.6% don’t know. Even those who watched the speech and claim to understand the proposal are split: 23.2% say yes, 48.8% say no, and 28.2% still don’t know.

Lack of clarity about the “public option”

The majority of the public acknowledges that the plan still contains a “public option,” but it is confused about who would participate in it. Again, even those who watched the speech and claim to understand the plan betray a lack of understanding of the meaning of the “public option,” as evidenced below:

Who would be required to participate in the “Public Option”?Percent
Everyone except for certain groups of individuals such as members of Congress15.8%
Those who do not currently have insurance42.5%
No one17.9%
I don’t know5.3%

When would the plan be implemented?

The President cited 2013 as the target date for full implementation of the plan. Despite that, over 40% just don’t know:

Effective DatePercent
Whenever it is approved by Congress30.2%
I don’t know41.3%

Confusion over business’s role

The public also does not understand what the Administration is asking of large businesses. Again, even the cognoscenti who watched the speech demonstrate confusion: 42.8% say all large companies will be required to offer health insurance to their employees, 47.0% understood the President to say that large companies that don’t offer health insurance will be required to help cover the cost of making insurance affordable to individuals. And, among the general public, 34.6% have no idea.

What the speech did accomplish

Among those who claimed to understand the President’s proposal, the speech did increase the percentage of people who can identify certain specific aspects of the plan correctly:

  • 91.2% of those who watched said the President’s plan will cover all U.S. citizens, versus 84.8% of those who did not watch the speech but still claim to understand the proposal
  • Only 18.6% believe the plan will cover those who are in the country illegally, versus 37.4% among those who did not watch the speech
  • 36.1% stated that the plan will add nothing to the deficit compared to 17.2% among those who did not watch
  • 28.8% of those who watched the speech said the plan will add “a massive amount” to the deficit, versus 59.6% among those who did not watch
  • 87.6% state that people with insurance coverage today can keep that coverage if they want to, versus only 51.6% of those who did not watch the speech

Of those who listened to the speech and claimed to understand it, 67.4% came away convinced that the plan incorporates ideas from both Republicans and Democrats.

Who supports the proposal?

The public still needs a lot of convincing to support the plan. 56.7% of Democrats support the President’s plan, while just 54.0% of Independents who lean Democratic support it. Less than 10% of Republicans and Independents who lean Republican support the plan. Of the 16.3% of the respondents who identified themselves as true Independents, only 21.2% of them support the plan.

Political IdentificationSupport Plan
Independent who leans Democratic54.0%
Independent who leans Republican8.5%
None of the above21.2%

Interestingly, those with lower incomes – who are more likely to be part of the public option – are less likely to be supportive of the proposal than are those with higher income levels, suggesting that the outreach and educational efforts might be profitably focused on that audience:

Household IncomeSupport Plan
Under $25,00028.8%
$25,000 - $49,00031.9%
$50,000 - $99,99935.7%
$100,000 - $149,99936.5%
Over $150,00040.9%

African-Americans are much more likely to support the plan than are other ethnic segments:

EthnicitySupport Plan
Asian or Pacific Islander38.5%

The Bottom Line

“The bottom line,” says Alan Siegel, “is that this survey reinforces in very dramatic terms that the American people are extremely confused about the President’s well-intentioned desire to bring universal health care to our broken system. The White House, in my opinion, should outline the basic architecture of the plan instead of reacting to criticisms and emotional issues brought by critics.”

Survey Methodology

The survey was conducted by Siegel+Gale LLP, a strategic brand consulting firm in New York City. The survey of the general public was conducted on September 12-14, 2009 among 1,042 individuals 18+ years of age using Greenfield Online’s consumer panel. The maximum sampling error of the survey is +3.0 percentage points at the 95% level of confidence.

The survey of health care activists was taken by 102 members of Boston-based WEGO Health’s panel of health care experts, bloggers, and other activists. The maximum sampling error of this survey is +9.7 percentage points at the 95% level of confidence.

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About Siegel+Gale

Siegel+Gale is a global strategic branding firm committed to building world-class brands through elegantly simple, unexpectedly fresh strategies, stories and experiences. With Simple is Smart as its operating philosophy, Siegel+Gale delivers powerful services in brand development, identity design, simplification, research and analytics, and digital strategy.

Since its founding by branding pioneer Alan Siegel in 1969, Siegel+Gale has helped drive business results for brands such as Aetna, American Express, Bank of America, China Youth Development Foundation, Dell, Dow Chemical Company, The Four Seasons Hotels and Resorts, The Internal Revenue Service, The King Abdullah University of Science and Technology, Microsoft, Motorola, Pfizer, SAP, Sony PlayStation, Yahoo! and the YMCA.

Siegel+Gale has offices in New York, Los Angeles, San Francisco, London, Hamburg, Dubai, Shanghai and Beijing and strategic partnerships around the world as a member of the Omnicom Group of companies.

For more information please contact Gail Nelson at 212.453.0400 or

About WEGO Health

WEGO Health ( is first online home for consumer Health Activists, social media’s most active 10 percent, passionate about helping others lead healthier lives. Health Activists – organizers, connectors, leaders and contributors – meet at WEGO Health, then carry knowledge, content and relationships back to the health social Web. In addition, WEGO Health’s Activist Social Network is the trusted community liaison to pharmaceutical and health marketers, who engage the Activist Social Network through innovative sponsorships, industry advisory panels, collaborative content development, widget distribution and more. Founded in 2007 and led by online health pioneers Jack Barrette and Bob Brooks, WEGO Health gives consumer health activists a voice to industry, and helps the world’s top health brands support, navigate, and participate in the evolving world of health social media.

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