The Kaiser Family Foundation/Harvard School of Public Health Health News Index, a series of 39 surveys with a total of over 42,000 respondents from 1996 through 2002, measures how closely Americans follow major health stories in the news and what they understand about the issues covered in those stories. On average, four in ten adults reported following health news stories closely. The public reports paying the most attention to stories about public health, followed by health policy and disease-related stories. While knowledge about health news varies, individuals who follow health news stories closely are significantly more likely to give the correct answer to knowledge questions about those stories.

Public opinion played a prominent role during the recent health care reform debate. Critics of reform pointed to poll results as evidence that a majority of Americans opposed sweeping changes. Supporters cited polls showing that people favored many specific aspects of the legislation. A closer examination of past and present polling shows that opinion tracked with historic patterns and was relatively stable, even if the contentious public debate suggested a volatile public mood in 2009 and 2010. Going forward, the public will begin reacting to reform implementation, primarily by judging it in terms of their perceptions of and experiences with what the new law does and does not do for people. These opinions could in turn influence implementation or future legislation.

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Exit polls showed that health care was a second-tier issue in the 2004 presidential race and that it was more important to Democratic than Republican voters. Those who considered health care the most important issue in their voting decision voted over-whelmingly for John Kerry. An analysis of national opinion surveys and exit polls shows that Republican and Democratic voters expressed dramatically differing views on key health policy issues. With the exception of malpractice reform and reducing federal health spending, health care is not likely to be a top issue for the Bush administration's second term.

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In an age of increasing political polarization, the Affordable Care Act (ACA) stands out as one of the most politically divisive pieces of legislation in recent history. Unlike previous laws making changes to the US health care system, public views of the ACA did not improve measurably as people gained experience with the program, but remained deeply divided on a partisan basis in the more than eight years since its passage. In this article, we examine how the complexity of the law, lack of understanding by the public, and elite partisan messaging have contributed to this enduring partisan divide, and discuss what the future may hold for the measurement of public opinion on major health care legislation.