By RICARDO ALONSO-ZALDIVAR and JENNIFER AGIESTA, Associated Press

 WASHINGTON (AP) — They may not like it, but they don’t see it going away. About 7 in 10 Americans think President Barack Obama’s health care law will go fully into effect with some changes, ranging from minor to major alterations, an Associated Press-GfK poll finds.

 Just 12 percent say they expect the Affordable Care Act — “Obamacare” to dismissive opponents — to be repealed completely.

 The law — covering 30 million uninsured, requiring virtually every legal U.S. resident to carry health insurance and forbidding insurers from turning away the sick — remains as divisive as the day it passed more than two years ago. After surviving a Supreme Court challenge in June, its fate will probably be settled by the November election, with Republican Mitt Romney vowing to begin repealing it on Day One and Obama pledging to diligently carry it out.

 That’s what the candidates say. But the poll found Americans are converging on the idea that the overhaul will be part of their lives in some form, although probably not down to its last clause and comma.

 Forty-one percent said they expect it to be fully implemented with minor changes, while 31 percent said they expect to see it take effect with major changes. Only 11 percent said they think it will be implemented as passed.

 Americans also prefer that states have a strong say in carrying out the overhaul. The poll found that 63 percent want states to run new health insurance markets called “exchanges.” They would open for business in 2014, signing up individuals and small businesses for taxpayer-subsidized private coverage. With many GOP governors still on the sidelines, the federal government may wind up operating the exchanges in half or more of the states, an outcome only 32 percent of Americans want to see, according to the poll, which was developed with researchers from Stanford University and the University of Michigan.

 Finally, the poll found an enduring generation gap, with people 65 and older most likely to oppose the bill and those younger than 45 less likely to be against it.

 ”People are sort of averaging out the candidates’ positions,” said Harvard School of Public Health professor Robert Blendon, who tracks polling on health care issues. “The presidential candidates are saying there’s a stark choice, but when you ask the voters, they don’t believe that the whole bill will be repealed or implemented as it is today in law.”

 Republicans remain overwhelmingly opposed to the overhaul and in favor of repeal. But only 21 percent said they think that will actually come about.

 Romney supporter Toni Gardner, 69, a retired school system nurse from Louisville, Ky., said that until a few weeks ago she was sure her candidate fully supported repeal, as she does.

But then Romney said in an interview there are a number of things he likes in the law that he would put into practice, including making sure that people with pre-existing medical problems can get coverage. The Romney campaign quickly qualified that, but the candidate’s statement still resonates.

 ”If Romney gets in, he’ll go with parts of it,” Gardner said, “and there are parts of that he won’t go with.”

 Gardner thinks expanding coverage will cost too much and may make it harder to get an appointment with a doctor. Besides, she doesn’t believe the government can handle the job. She’s covered by Medicare — a government-run health system — but says “that wasn’t a choice that I had.”

 At 26, Santa Monica, Calif., web developer Vyki Englert has only bare-bones health insurance coverage. Her parents, a preschool teacher and a self-employed photographer, are uninsured. Englert says she thinks the law will largely go into effect as passed. (Among 18- to 29-year-olds, 60 percent think it will be implemented with only minor changes or none at all.)

 Englert says that she supports guaranteeing coverage to people with health problems and that provisions such as broader coverage for birth control will help younger women such as her.

 ”I kind of see a day-to-day way where this law could benefit me,” she said. Englert says the health care law dovetails with a trend toward consumerism in her generation. Older Americans “don’t have the context of the young people,” she added. “They are looking more at the theoretical impact on the budget and the country.”

 Overall, the poll found Americans divided on the question of repeal, with neither side able to claim a majority. Forty-nine percent said the health care law should be repealed completely, while 44 percent said it should be implemented as written.

 The notion that the law will be implemented with changes, captured in the poll, mirrors a discussion going on behind the scenes in Washington, particularly among some Republicans.

 ”Whoever wins the election, the (health care law) is going to be modified,” Mark McClellan, who ran Medicare under former President George W. Bush, said in a recent interview.

Congressional Republicans say if tax increases are on the table in a budget negotiation with a re-elected Obama next year, changes to the health care law — including possible delays in implementation — also must be considered. For now, White House officials refuse to be drawn in on that question.

 Some parts of the law already are in effect; its big coverage expansion for the uninsured doesn’t come until 2014.

 Public opinion about the law itself has barely budged since the summer of 2010, soon after it passed. At the time, 30 percent supported the law. It’s now 32 percent. And 40 percent opposed the overhaul. That’s now 36 percent.

 And misconceptions about the law that reigned two years ago continue to live on, including former Alaska Gov. Sarah Palin’s widely debunked charge that it would create “death panels” to decide on care for the elderly and disabled. In 2010, 39 percent believed the law would set up committees to review individual medical records and decide who gets care paid for by the government. Forty-one percent currently hold that view, according to the poll.

 The poll asked people to say whether 18 different items were in the law or not and to rate how certain they were about their answers. Just 14 percent were right most of the time and sure of it.

Still, knowledge about what the law actually does is growing. More people are aware of provisions that allow adult children to stay on their parents’ coverage until age 26, impose insurance mandates on individuals and businesses, and protect those with pre-existing medical conditions.

 The poll was conducted Aug. 3-13 and involved interviews with 1,334 randomly chosen adults nationwide. It has a margin of sampling error of plus or minus 3.4 percentage points.

The survey was conducted online by GfK using its KnowledgePanel sample, which first chose people for the study using randomly generated telephone numbers and home addresses. Once people were selected to participate, they were interviewed online. Participants without Internet access were provided it for free.

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AP News Survey Specialist Dennis Junius contributed to this report.

 

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Topline results are available at http://www.ap-gfkpoll.com and http://surveys.ap.org.

Online:

http://www.ap-gfkpoll.com

AP-GfK Poll: Disapproval, doubt dominate on Ebola

By LAURAN NEERGAARD and EMILY SWANSON

WASHINGTON (AP) — Americans have at least some confidence that the U.S. health care system will prevent Ebola from spreading in this country but generally disapprove of the way President Barack Obama and the Centers for Disease Control and Prevention have handled the crisis so far.

Most disapprove of Obama’s handling of the Ebola outbreak, according to an Associated Press-GfK Poll. Just 1 in 5 approve of the CDC’s work on Ebola so far, and only 3 in 10 say they trust that public health officials are sharing complete and accurate information about the virus. And only 18 percent have deep confidence that local hospitals could safely treat a patient with Ebola.

Amid worry here, most Americans say the U.S. also should be doing more to stop Ebola in West Africa. Health authorities have been clear: Until that epidemic ends, travelers could unknowingly carry the virus anywhere.

“It seems to me we have a crisis of two things. We have a crisis of science, and either people don’t understand it or … they don’t believe it,” said Dr. Joseph McCormick, an Ebola expert at the University of Texas School of Public Health. And, “we have a crisis in confidence in government.”

Some findings from the AP-GfK poll:

HEALTH CARE GETS MIXED REVIEWS

Nearly a quarter of Americans are very confident the U.S. health care system could prevent Ebola from spreading widely, and 40 percent are moderately confident.

But nearly half don’t think their local hospital could safely treat an Ebola case, and 31 percent are only moderately confident that it could.

After all, Thomas Eric Duncan, the first Ebola patient diagnosed in the U.S., at first was mistakenly sent home by a Dallas emergency room, only to return far sicker a few days later. Then, two nurses caring for him somehow became infected. The family of one of the nurses, Amber Vinson, said Wednesday doctors no longer could detect Ebola in her as of Tuesday evening.

Asked how the Centers for Disease Control and Prevention handled those cases, 42 percent of people disapprove and 22 percent approve.

FEAR VS. KNOWLEDGE

Despite months of headlines about Ebola, nearly a quarter of Americans acknowledge they don’t really understand how it spreads. Another 36 percent say they understand it only moderately well.

Ebola doesn’t spread through the air or by casual contact, and patients aren’t contagious until symptoms begin. Ebola spreads through close contact with a symptomatic person’s bodily fluids, such as blood, vomit, feces, urine, saliva, semen or sweat.

People who say they do understand are less concerned about Ebola spreading widely in this country. Among those who feel they have a good grasp on how it spreads, 46 percent are deeply concerned; that rises to 58 percent among those who don’t understand it as well.

Likewise, a third of those with more knowledge of Ebola are confident in the health system’s ability to stem an outbreak, and 27 percent think their local hospital could safely treat it. Among those who don’t understand Ebola, fewer than 1 in 5 shares either confidence.

WHAT SHOULD BE DONE

A whopping 93 percent of people think training of doctors and nurses at local hospitals is necessary to deal with Ebola, with nearly all of them, 78 percent, deeming it a definite need.

Nine out of 10 also think it’s necessary to tighten screening of people entering the U.S. from the outbreak zone, including 69 percent who say that’s definitely needed.

Some would go even further: Almost half say it’s definitely necessary to prevent everyone traveling from places affected by Ebola from entering the U.S. Another 29 percent say it’s probably necessary to do so.

More than 8 in 10 favor sending medical aid to Ebola-stricken countries and increasing government funding to develop vaccines and treatments.

SOME NEW STEPS

The CDC had issued safe-care guidelines to hospitals long before Duncan arrived last month, and it made some changes this week after the unexpected nurse infections. Now, the CDC says hospitals should use full-body garb and hoods and follow rigorous rules in removing the equipment to avoid contamination, with a site manager supervising. Possibly more important, workers should repeatedly practice the donning and doffing and prove they can do it correctly before being allowed near any future patients.

While Duncan wasn’t contagious during his flight, his arrival spurred U.S. officials to begin checking passengers arriving from Liberia, Sierra Leone and Guinea for fever, an early Ebola symptom, just like they’re checked before leaving those countries.

Wednesday, the CDC moved to fill a gap in that screening: Starting next week, all of those travelers must be monitored for symptoms for 21 days, the Ebola incubation period. They’ll be told to take their temperature twice a day and must report the readings to state or local health officials.

That’s not just for West African visitors. It includes U.S. government employees, who had been doing their own 21-day fever watches upon return from fighting the epidemic, as well as doctors and other workers for aid organizations and journalists.

The AP-GfK Poll was conducted Oct. 16-20, using KnowledgePanel, GfK’s probability-based panel designed to be representative of the U.S. population. It involved online interviews with 1,608 adults and has a margin of sampling error of plus or minus 2.8 percentage points for all respondents. Respondents were first selected randomly using phone or mail survey methods and later interviewed online. People selected for KnowledgePanel who didn’t otherwise have access to the Internet were provided with the ability to access the Internet at no cost to them.

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Online:

AP-GfK Poll: http://www.ap-gfkpoll.com


AP-GfK Poll: Americans want tighter Ebola screening, concerned government hasn’t done enough

By LAURAN NEERGAARD and EMILY SWANSON, Associated Press

WASHINGTON (AP) — Americans overwhelmingly want tougher screening for Ebola, according to a poll released as federal health authorities took new steps to do just that.

Many are worried about Ebola spreading here, and two-thirds say the government hasn’t done enough to prevent that from happening, according to an Associated Press-GfK poll.

Some things to know:

THE PUBLIC WANTS MORE TRAVEL SCRUTINY

The AP-GfK poll found 9 out of 10 people — unusually high agreement on any issue — think it’s necessary to tighten screening procedures for people entering the U.S. from the outbreak zone in West Africa, including 69 percent who say it’s definitely needed.

Some would go even further: Almost half say it’s definitely necessary to prevent everyone traveling from places affected by Ebola from entering the U.S. Another 29 percent say it’s probably necessary to do so.

The Centers for Disease Control and Prevention has warned since summer that an infected traveler eventually would arrive in the U.S., and it finally happened last month when Thomas Eric Duncan developed symptoms of Ebola a few days after arriving from Liberia. He died on Oct. 8.

WHAT IS THE GOVERNMENT DOING

While Duncan wasn’t contagious during his flight, his arrival spurred U.S. officials to begin checking passengers arriving from Liberia, Sierra Leone and Guinea for a fever, an early Ebola symptom, just like they’re checked before leaving those countries.

The AP-GfK poll suggested that wasn’t enough.

Wednesday, the CDC moved to fill a gap in that screening: Starting next week, all of those travelers must be monitored for symptoms for 21 days, the Ebola incubation period. They’ll be told to take their temperature twice a day and must report the readings to state or local health officials.

That’s not just for West African visitors. It includes U.S. government employees, who had been doing their own 21-day fever watches upon return from fighting the epidemic, as well as doctors and other workers for aid organizations, and journalists.

WHY NOT A TRAVEL BAN

The Obama administration says that’s not on the table. Already, there are no direct flights to the U.S. from the outbreak zone, and the airport with the most travelers from West Africa — New York’s Kennedy airport — has averaged 34 travelers a day since entry screening began. Health experts say a travel ban would prevent medical supplies and health workers from reaching West Africa, and could drive travelers underground and hinder screening of potential Ebola carriers.

AMERICANS FEAR EBOLA’S SPREAD HERE

Nearly half of Americans are very or extremely concerned that Ebola will spread widely in the U.S. After all, two nurses caught it while caring for Duncan.

Health experts had hoped that fear would start to dwindle, considering that people who shared an apartment with Duncan while he was sick emerged healthy from quarantine this week — showing the virus isn’t all that easy to catch.

FEAR VS. KNOWLEDGE

But despite months of headlines about Ebola, nearly a quarter of Americans acknowledge they don’t really understand how Ebola spreads. Another 36 percent say they understand it only moderately well.

People who say they do are less concerned about Ebola spreading widely in this country. Among those who feel they have a good grasp on how it spreads, 46 percent are deeply concerned; that rises to 58 percent among those who don’t understand it as well.

Ebola doesn’t spread through the air or by casual contact, and patients aren’t contagious until symptoms begin. Ebola spreads through close contact with a symptomatic person’s bodily fluids, such as blood, vomit, feces, urine, saliva, semen or sweat.

The AP-GfK Poll was conducted Oct. 16-20, using KnowledgePanel, GfK’s probability-based panel designed to be representative of the U.S. population. It involved online interviews with 1,608 adults, and has a margin of sampling error of plus or minus 2.8 percentage points for all respondents. Respondents were first selected randomly using phone or mail survey methods, and later interviewed online. People selected for KnowledgePanel who didn’t otherwise have access to the Internet were provided with the ability to access the Internet at no cost to them.

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Online:

AP-GfK Poll: http://www.ap-gfkpoll.com