A new poll finds that when Americans shift through the misinformation and politics of health care reform, they actually like what they see. According to January’s Kaiser Health Tracking Poll, conducted before the Massachusetts Senate vote, 42% support health care reform, while 41% oppose it. “However, a different and more positive picture emerged when we examined the public’s awareness of, and reactions to, major provisions included in the bills. Majorities reported feeling more favorable toward the proposed legislation after learning about many of the key elements, with the notable exceptions of the individual mandate and the overall price tag.” Some elements of the legislation “were popular enough to prompt a majority of skeptics to soften their opposition“:

- 62% of current opponents said including the tax credits for small businesses made them supportive of reform.

- 59% of current opponents said the fact that most people’s existing insurance arrangements would not change made them more supportive of reform.

- 55% of current opponents said if there was a stipulation that no federal money would go to abortion they would be more supportive of reform.

The poll also found that 17 of 27 different provisions made respondents feel more positively about the bills, including the exchanges, the new insurance regulations, and closing the Medicare “doughnut hole.” All this suggests that the public is fed up with the process and politics of health care reform, but they’re supportive of what Democrats are actually trying to accomplish. Which brings us back to the argument that Democrats are seriously misreading the Massachusetts election results.

On Tuesday, Massachusetts voters elected a Republican candidate who defended a reform bill that’s very similar to what the House and Senate Democrats have supported. Far from suggesting that health care reform would lose elections, the Massachusetts results actually suggest that when Americans see the benefit of health care reform, they tend to politically reward the candidate who vows to protect it.

Senator-elect Scott Brown (R-MA) supports Massachusetts’ 2006 health care reform but opposes the near-identical Senate health care bill. During the campaign, Brown promised to provide the 41st vote for any national reform effort that required states like Massachusetts to finance reform elsewhere:

Thank you for the question, the health care plan is not good for Bay State Health Center here in Springfield, I worked on that health care bill, the problem with it is that we have 98% of our people insured and we have to look at pricing it’s getting out of control – but the Federal plan, taking a half trillion from Medicare, why would we go and subsidize the failure of other states – not only would we be paying for our plan, we’d be paying for everyone else – and look at the back door deals – I think people have lost confidence – and I think that we need to go back – I’d work on it – why do we need a one size fits all government approach we already did it.

Watch it:

But if Brown believes that Americans should not have to finance other states’ reform efforts, he should return the federal dollars that subsidize Massachusetts’ Medicaid expansion. After all, the state’s 2006 health care reform legislation included an expansion of Medicaid for children up to 300% of the federal poverty level and increased enrollment caps on existing Medicaid programs for adults. Massachusetts relied “very heavily on federal Medicaid funds to finance the plan, including $385 million in annual federal Medicaid payments that would have been lost in the absence of a plan to reduce the number of uninsured.”

Massachusetts used federal funds because, like all states, it lacked the economic capacity to invest in something as big as health care reform. Only the federal government can fix the systematic problems plaguing the health care system and improve the system in an equitable manner. Brown’s insistence that states can do reform on their own, is just a back door way for preserving the status quo that denies millions of Americans the kind of reforms that they’re financing in Massachusetts.

While House Speaker Nancy Pelosi (D-CA) is insisting that Democrats “don’t (think) a state that already has health care should determine whether the rest of the country should,” several prominent Democrats are misinterpreting Senator-elect Scott Brown’s (R-MA) surprise victory in Massachusetts as a referendum on national health care reform and are urging Congressional leaders to slow down the process:

- Sen. Jim Webb (D-VA): “In many ways the campaign in Massachusetts became a referendum not only on health care reform…I believe it would only be fair and prudent that we suspend further votes on health care legislation until Senator-elect Brown is seated.”

- Sen. Evan Bayh (D-IN): “There’s going to be a tendency on the part of our people to be in denial about all this, [but] if you lose Massachusetts and that’s not a wake-up call, there’s no hope of waking up.” “Whenever you have just the furthest left elements of the Dem party attempting to impose their will on the rest of the country — that’s not going to work too well.”

- Rep. Barney Frank (D-MA): If Martha Coakley had won, I believe we could have worked out a reasonable compromise between the House and Senate health care bills…. But our respect for democratic procedures must rule out any effort to pass a health care bill as if the Massachusetts election had not happened.

- Rep. Anthony Weiner (D-NY): “It’s not the end of the world. Look, we can come back to healthcare.” “It wouldn’t be the worst thing in the world to step back and say, look, we’re going to pivot to do a jobs thing. We’re going to try to include some healthcare pieces in it.”

Public hostility towards health reform certainly helped propel Brown to victory, but as economist Austin Frakt explains, “[t]he real lesson seems to be less about policy and far more about politics.” After all, Brown doesn’t make a very convincing messenger for opposing the policy behind health reform. As a state senator, Brown voted for Massachusetts 2006′s reform law which, like the Senate and House bills, includes an individual health insurance mandate, insurance exchanges, government affordability credits and insurance regulations. As a result of the law, 98% of Massachusetts residents have health insurance and 79% want the law to continue. Unlike voters in more conservative states, Massachusetts residents don’t fear national reform because it would result in a government take over of health care — they’ve already benefited from the provisions in the Senate health care bill and they support them.

Brown’s campaign tapped into voter frustration with skyrocketing premiums (unlike the national bills, Massachusetts reform did not include cost containment) and the political sausage making process to cast the national reform as an unnecessary effort that could only increase costs for Massachusetts residents. “[W]hy do we need a one size fits all government approach we already did it?” Brown asked voters during a debate with Coakley. “[T]he Federal plan, taking a half trillion from Medicare, why would we go and subsidize the failure of other states – not only would we be paying for our plan, we’d be paying for everyone else – and look at the back door deals – I think people have lost confidence – and I think that we need to go back – I’d work on it,” he said. Brown localized the reform issue. He stripped it of its policy clothes and presented the effort as a hindrance to the state’s successful program. He promised to be the 41st vote against reform because Massachusetts had already passed its own health reform bill, arguing that the state shouldn’t pay for the national effort?

It’s unclear how many voters voted for Brown because of his opposition to the national health reform effort, but at least one poll suggests that enthusiasm for reform was greater than the movement against it. According to Rasmussen Reports election night poll, 63% of Coakley voters said health care was the most important issue in determining their vote, while 52% of Brown voters said it was their top issue.

Since national dissatisfaction with reform coincided with the Senate’s effort to water-down the bill, Democrats shouldn’t distill the legislation further or put it off altogether. “If the Democrats run for cover, if we become pale carbon copies of the opposition, we will lose–and deserve to lose,” Ted Kennedy once said. “The last thing this country needs is two Republican parties.”