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Vote could change direction of healthcare reform
WASHINGTON (Reuters) - With most Americans ambivalent about President Barack Obama's signature healthcare overhaul or openly hostile to it, next Tuesday's elections could have a big impact on the reforms, experts said on Wednesday.
Major Republican gains could mean years of hold-ups on implementing the legislation -- but if Democrats manage to prevail against the odds, they may reward their base with even more extensive reforms, Robert Blendon and John Benson of the Harvard School of Public Health said.
They analyzed 17 recent major polls and said they show healthcare is an important but secondary voting issue in this election.
Between 41 percent and 49 percent said health care or health care reform would be extremely important, compared with 55 to 62 percent who consider the economy extremely important, Blendon and Benson wrote in the New England Journal of Medicine.
Broken down by party, 67 percent of Democrats said they would be more likely to vote for a candidate who supported the new law, while 72 percent of Republicans said they would be more likely to vote against such a candidate.
Some aspects of the law are universally popular, such as tax breaks for small businesses and expansion of Medicare's prescription drug benefits.
But 65 percent of those polled believe the law will increase the federal debt and 67 believe it will raise their taxes in five years. "These beliefs about the future may or may not be accurate, but they hold sway at the time of the election," Blendon and Benson wrote.
Polls show that 31 percent want reform to go even further -- perhaps adding a public insurance option -- but 41 percent believe Congress should repeal most of the major provisions.
Congress cannot repeal the legislation -- Obama would certainly veto that -- but Republicans could block funding to implement it, Blendon and Benson noted.
But if Democrats keep control of the House and Senate, they will be likely to expand healthcare reform, because their supporters want it.
Independent analysts project Republicans will pick up at least the 39 Democratic seats they need for control of the House of Representatives [ID:nN26176744]. Big gains in the Senate are considered less likely.
A second commentary in the Journal looked at legal challenges to the healthcare reform law.
More than 20 states have joined a suit in Florida and the state of Virginia has filed its own suit.
Earlier this month a U.S. judge upheld the law against a challenge by the Thomas More Law Center in Michigan arguing that the provision requiring Americans to buy coverage by 2014 under threat of penalty was beyond Congress' authority and an unconstitutional tax.
"The fundamental goal of the Affordable Care Act is no less than the preservation of the U.S. health care system," wrote Sara Rosenbaum of George Washington University Medical center in Washington.
"In a country that depends on health insurance to finance care, preservation cannot happen without a comprehensive regulatory scheme that reaches from coast to coast and sets the minimum rules of market entry and operation for health insurers," added Rosenbaum, an expert in health law and policy.
"The glide path to this new system is long and complex, but the law's end point is clear and visionary, and its constitutionality -- at least in this first round -- is incontrovertible."
(Editing by David Storey)
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