There is strong majority support for many of the key elements of the health care reform legislation being considered on Capitol Hill. But the percentage that generally supports the proposals being discussed is far lower – just 34% in the current survey, down from 42% in the immediate aftermath of President Obama’s Sept. 9 address to Congress. Opposition has not moved much; currently, 47% oppose the proposals, compared with 44% last month. At the same time, however, many of those opposed say they would like to see policymakers try to compromise with supporters to make the legislation better, rather than try to prevent any health care legislation from passing this year.

Intense support for the health care proposals being discussed in Congress also has fallen since September. Currently, 20% favor the proposals very strongly, down from 29% last month. Very strong opposition is essentially unchanged at 35% in the current poll (34% in September). Nearly one-in-five (19%) offer no opinion, compared with 14% last month.

One of the largest declines in support from a month ago has come among independents, particularly among those who lean Democratic. Overall, 26% of independents now say they generally favor the bills being discussed in Congress, down from 37% last month. About four-in-ten (42%) Democratic-leaning independents favor the proposals, compared with 62% in September. Democratic support for the legislation also has declined over the same period, from 68% to 59%. Opinion among Republicans and Republican-leaning independents is mostly unchanged.

The debate over health care reform continues to attract extensive coverage. It was the most heavily covered news story Sept. 28-Oct. 4, accounting for 11% of all news coverage, according to the Project for Excellence in Journalism’s News Coverage Index. However, health care reform received considerably more coverage at the time of Obama’s speech to Congress (32% of all coverage).

The proportion of Americans saying they have heard a lot about congressional bills to overhaul the health care system has declined substantially over this period. Currently, 46% say they have heard a lot, down from 60% in the immediate aftermath of Obama’s health care address, and only slightly higher than the number reported in July (41%).

As was the case in July and August – though not last month – people who have heard a lot about the health care bills are much more likely to oppose the proposals than are those who have heard less about them. Currently, 54% of those who have heard a lot about the bills oppose the proposals, while 36% favor them and 10% have no opinion. Views are more divided among those who have heard less about the bills: 41% oppose the proposals, 34% favor them, while 26% offer no opinion.

Notably, a majority of the public continues to find the health care debate difficult to understand. Pew Research’s separate weekly News Interest Index survey, conducted Oct. 2-5, finds that 66% say the issue of health care reform is hard to understand, which is largely unchanged from September (67%) and July (63%).

Many Opponents Favor Compromise

The survey finds there is a greater appetite for compromise on health care reform among the bill’s opponents than among its supporters. Among the public overall, 42% favor compromise on health care legislation; this includes 29% of those who oppose the legislation and 13% of those who favor it.

By comparison, 36% of the public rejects compromise; this includes 20% of the supporters of health care proposals, who want policymakers who support the bill to try to make it as strong as possible, and 16% of the bill’s opponents, who want policymakers who oppose the bill to try to prevent any health care legislation from passing this year.

Nearly four-in-ten Republicans (39%) oppose the bill and want policymakers who oppose the measure to attempt to reach a compromise; that compares with 33% of Republicans who oppose the bills and think policymakers who agree with them should try to prevent anything from passing this year.

More than a third (35%) of Democratic supporters of the health care proposals in Congress want policymakers to make the legislation as strong as possible, while 21% want policymakers to try to compromise to be sure the legislation passes.

Liberal Democrats, in particular, would rather see the bill become stronger than compromise to make sure legislation passes. Half of liberal Democrats favor the legislation in Congress and think policymakers should make the bill as strong as possible; just 18% want policymakers to compromise to get something passed. Conservative and moderate Democrats who favor the proposals are more divided, with 30% in favor of making the bill as strong as possible and 23% willing to compromise.

Most independents oppose the health care proposals in Congress, but a relatively large proportion favors compromise on the issue. Nearly half of independents (47%), including 37% who oppose the bills, prefer to see supporters and opponents compromise on health care reform.

Continued Support for Major Elements of Reform

Since July, there has been virtually no change in the large proportions of the public favoring many of the key elements of the reform packages. More than eight-in-ten (82%) favor requiring insurance companies to sell coverage to people, even if they have pre-existing medical conditions.

Two-thirds (66%) favor the so-called “individual mandate,” which would require that all Americans have insurance, with the government providing financial help to those who cannot afford it. Nearly six-in-ten (59%) favor requiring employers to pay into a health care fund if they do not provide insurance to their employees, and a similar percentage favors raising taxes on upper-income families to help pay for the changes (58%). The so-called “public option,” described to respondents as “a government health insurance plan to compete with private health insurance plans,” is supported by 55% of the public, essentially unchanged from July (52%).

The idea of limiting awards in medical malpractice lawsuits, which has been promoted by congressional Republicans but is not in the main bills before Congress, also is very popular with the public. Two-thirds (66%) favor limits on the amount of money patients can collect in medical malpractice lawsuits. Just 27% oppose this.

All of these proposed changes to the system attracted majority support among Democrats and independents. Republican support is considerably lower for all of the changes except malpractice reform and the requirement that insurance companies cover people with pre-existing conditions. But even among Republicans, more than a third support the individual mandate (43%), requiring employers who do not offer insurance to pay into a government fund (37%), tax increases on wealthy households (37%), and even the “public option” (34%).

Many Opponents Favor Bills’ Key Elements

The specific elements of the health care legislation before Congress attract overwhelming support from those who generally favor the proposals. Majorities of opponents of the bills oppose these specific proposals, but even contentious elements of the proposals attract support from sizable minorities.

More than four-in-ten (44%) opponents of the bills being discussed in Congress favor requiring all Americans to have health insurance, and 40% support requiring employers to pay into a fund if they do not cover their workers. Nearly as many (37%) support a government health insurance plan to compete with private insurance plans. In addition, nearly eight-in-ten (78%) opponents of the congressional bills favor requiring insurance companies to sell policies to people with pre-existing medical conditions.