MENLO PARK, CA – A majority of Americans continue to favor healthcare reform despite advertisements and a volatile political climate, according to the August Kaiser Health tracking poll.

According to the poll, 53 percent believes health reform is more important than ever, compared to 42 percent who said the nation can't afford to take on healthcare reform right now.

The gap between the two points of view has narrowed in recent months.

The August poll was conducted during a period in which the public vented fears and hopes about reform plans in widely publicized town hall meetings with elected officials, and at a time when an increasing number of Americans (45 percent compared to 31 percent in July) reported seeing advertisements having to do with proposed changes in the healthcare system.

"The August health reform wars about hot button issues have definitely made the public more anxious but they have not caused public support to unravel," said Kaiser President and CEO Drew Altman. "When the Congress returns the debate will refocus on core issues such as how to pay for health reform and meet the public’s expectations for help with their health insurance problems."

The intensifying debate appears to have impacted some key tracking poll indicators over the last month. One key indicator in the debate is the percentage of Americans who think they or their families would be better off if the president and Congress enacted major health reform legislation. The largest group (36 percent) continues to say their family will be better off – a proportion that has held relatively steady all year. However, those who believe their family will be worse off has jumped 10 percent since July and now stands at 31 percent.

Public backing for key individual elements of health reform remains steady. Majorities continue to support individual reform components designed to expand coverage, including a public plan option (59 percent), an expansion of state programs such as Medicaid (80 percent), an individual mandate (68 percent) and an employer mandate (68 percent).

There is heightened attention to health reform, with 33 percent of Americans saying they are following the debate "very closely," up from 27 percent in July. Those who think they will be worse off if health reform is enacted are more likely to say they are following the debate "very closely" than those who think they will be better off (55 percent to 30 percent).

Asked which terms describe their feelings about health reform plans being discussed in Washington, most said "hopeful" (63 percent), followed by "frustrated" (57 percent), "optimistic" (50 percent), "confused" (46 percent), "pessimistic" (42 percent) and "afraid" (41 percent). Overall, 62 percent of those over age 65 say they are "confused" about healthcare plans being considered by Congress, compared to 43 percent of those under age 65.

Much of the recent debate has focused on the concerns of seniors and a discussion of how Medicare would be affected by any reform proposal. Seniors are more likely to see Medicare as worse off than better off under health reform (37 percent vs. 20 percent), with 26 percent believing reform will not impact the program and another 17 percent unsure about what reform will mean.

"Seniors tell us they are confused about health reform," said Mollyann Brtodie, Kaiser's vice president and director of public opinion and survey research. "They are hearing both positive and negative things about how it will affect them and they are not sure what to believe. Whether they will support any final proposal remains unclear – and may depend heavily on what the specifics are and whether any sweeteners for seniors are included in the bill.”