A large majority of Nevadans believe health care reform -- which President Barack Obama has promised will not add one dime to the budget deficit -- will result in tax increases, according to a poll commissioned by the Review Journal.
The telephone poll of 500 registered voters found 77 percent of Nevadans, including two-thirds of voters from Obama's own Democratic Party, believe the estimated cost of almost $1 trillion over 10 years for a health care reform package will require tax increases.
And overall, more people continue to oppose the reform than support it, the poll found.
When he ran for president, Obama repeatedly pledged not to impose new taxes on families making less than $250,000 in order to pass health care reform.
Republicans have already argued that proposed fines for failure to purchase health insurance and a reduction in the tax break available for medical expenses will amount to new taxes on all Americans, including the middle class.
"The president has to be very careful regarding his campaign pledge," said Brad Coker, managing partner of Washington, D.C.-based Mason-Dixon Polling & Research Inc., which conducted the poll Tuesday through Thursday. "He has to remember what happened to the first (President) Bush."
Many political analysts believe former President George H.W. Bush's violation of his "Read my lips: No new taxes" pledge contributed heavily to his unsuccessful bid for re-election in 1992.
Coker said it's doubtful, "particularly in this economy," that all 77 percent of the Nevadans who think taxes will rise are from families making more than $250,000 a year.
"It may be that unlike a Republican, a Democrat can get away with breaking a campaign pledge of not raising taxes," Coker said. "Voters expect Democrats to raise taxes and vote in Republicans in so taxes aren't raised. Republicans can't get away with it. As far as Democrats go, it could come down to whether they think the taxes are worth it or not."
In all, 43 percent of Nevadans support Obama's proposal to reform health care -- that's slightly up from 40 percent who responded to the same question in an August poll. In this week's survey, nearly half -- 49 percent -- oppose the initiative, one point down from the 50 percent who voiced opposition in August.
But the difference between how Republicans and Democrats responded is huge -- 74 percent of Democrats back the Obama initiative while only 9 percent of Republicans approve.
"Obama simply hasn't been able to convince the majority of people on the worthiness of his plan," said Erik Herzik, a political scientist at the University of Nevada, Reno.
The poll results have a margin of error of plus or minus 4.5 percentage points. In doing the survey, Mason-Dixon made sure the number of Democrats, Republicans and independents polled reflected their percentages of statewide voter totals. About one-third of the people surveyed were from rural Nevada and Washoe County, which also reflects their percentages of the voter totals.
When it comes to the best way to reduce the number of uninsured Americans and reduce long-term health care costs, 36 percent of Nevadans prefer allowing insurance companies to compete across state lines. A public health insurance option is favored by 25 percent while 11 percent favor expanding eligibility for existing programs such as Medicare and Medicaid. Only 8 percent believe no action is necessary.
That Nevadans believe that better competition between insurance companies will solve the problems of the uninsured and reduce costs shows that Republicans are winning the debate in Nevada, said David Damore, a political scientist at the University of Nevada, Las Vegas.
"One of the major successes of the conservative movement is the notion of less government and letting markets work, whether it's true or not," he said.
Herzik said the fact that only 8 percent don't want change is compelling.
"People believe something has to be done," he said. "They're just not sure what."
Nearly half of Nevadans polled -- 46 percent -- believe health care reform will result in rationing of care. Similarly, 45 percent believe reform will result in major cuts to Medicare programs. But again that breaks down along party lines, with more than 60 percent of Republicans expressing those concerns and fewer than 30 percent of Democrats doing so.
Damore said Democrats largely believe heath care is already rationed, given that there are nearly 40 million uninsured. And Democrats, he said, trust that Obama can be true to his word and only cut the waste in Medicare. Republicans argue that the savings Obama has repeatedly said will come from trimming the fat in Medicare -- and help fund health care reform -- can only come by trimming programs.
On the issue of requiring all Americans to have health insurance, which Democrats back as part of their reform package because they believe a larger pool lowers costs, 48 percent of Nevadans approve while 42 percent disapprove. Only 24 percent of Republicans support such a requirement; 72 percent of Democrats back it.
Herzik said Republicans are showing their Libertarian streak on the issue, saying in effect to government, "You can't make me do something."
If U.S. Senate Majority Leader Harry Reid, D-Nev., were to try to circumvent the filibuster rule and to get a health reform bill through the Senate with only 50 votes, only 32 percent of the state's voters would approve.
"If he does that, he is resigning himself to not being re-elected," Coker said.
Contact reporter Paul Harasim at email@example.com or 702-387-2908.