03/22/2010 05:12 am ET Updated May 25, 2011

Congress on Health Reform: From Out in Front to Out Of Touch

Though we were the first to report the fall in support for the health care reform bill(s) - to 50% con, 42% pro in June - we were surprised to find, in our December 23 survey of 1641 registered voters, that 60% want Congress to pass neither the House nor Senate bill, but start over. Only 32% favor passage of either bill or the emerging compromise. Strong opposition was registered by 49%, vs strong support by a mere 19%. If these new data prompt even one House or Senate Democrat to vote against the final bill, it will not pass (unless previously opposed legislators switch).

 We were surprised because we had reported an uptick in support - to dead even - after President Obama's widely viewed September speech to Congress. But our surveys have repeatedly suggested that reform's advocates have not been emphasizing what Americans want in a reform bill. Americans believe coverage should be expanded without new taxes or bigger deficits. They believe this can be done by greater efforts to reduce fraud and waste, and incentives for better medical care, especially for prevention.

 They also prefer the House bill's strict abortion restrictions over the Senate version, by 49 vs 31%, but abortion was decisive for only 5%. The issue that was most often cited as decisive (by 30%) was cost: more so than the "public option," or allowing illegals to use cash for insurance (issues where Americans were evenly split). Finally, Americans believe tort (medical malpractice) reform should be a priority. In fact, as we reported in the fall, it was the single issue most likely to convert opponents into supporters. But Congress turned a deaf ear.

 Last June we marveled that Congress was "leading from the front." We expected public opinion would catch up. But Congress has not emphasized what people care about. Indeed, deal-cutting since our December survey may well have depressed support even further.

 Congress no longer seems out in front, but out of touch. They have lived up to the cartoon that circulated last June, in which President Obama declares that "US health care is wasteful, dangerous, and often fraudulent. So we must offer it to everyone." Congressional leaders: check your voice mail. The people left some clear messages about what they expect you to do.