Despite ongoing debate over the Patient Protection and Affordable Care Act, a new Kaiser Family Foundation poll finds that the PPACA isn't the top health priority among voters—even for Republicans who have insisted their opposition to the law and promised work on its repeal.

Both Medicare and high health costs were cited by 73 percent as "extremely" or "very important" to their vote in Kaiser's August Health Tracking Poll. Just 59 percent of those polled say the PPACA is a key health care issue for the election.

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More people (at 72 percent) said they were more sure on what President Barack Obama is proposing to do with health care if he wins reelection, as compared to Governor Mitt Romney (45 percent).

Even half of Republicans say they aren't sure what Romney's plan on health care is, but the majority (79 percent) still believe his approach to health care would be different than that of Obama. And 80 percent of Republicans say they trust Romney to make the "right decisions" about the future of the PPACA.

Romney's running mate pick, Congressman Paul Ryan, has put a renewed spotlight on Medicare. It's worth noting, though, that most interviews in the August 7-12 poll were conducted before Romney announced Ryan as his running mate on August 11.

Still, according to another recent Kaiser survey, conducted in partnership with The Washington Post, most Republicans (55 percent) prefer the idea of keeping Medicare as it is rather than changing to a system in which seniors are guaranteed a fixed amount of money that could be used to purchase coverage "either from traditional Medicare or from a list of private plans." 

Medicare advisor Danielle Kunkle argues it's important to note that Medicare and health reform go hand in hand.

"A huge amount of funding for the PPACA bill will come from massive cuts to the Medicare Advantage program ($500 billion), and the act does nothing at all to address the continued scheduled funding cuts to providers, so we are facing a critical shortage of providers just as baby boomers are aging into Medicare at record rates," she says. "Because of these factors, implementation of the PPACA itself will necessitate major changes to Medicare."

Kunkle says Medicare will definitely be a hot topic this election simply because it's "fiscally unsustainable as is."

"Someone will have to reform it in some way if the program is to survive even the next decade. All too often politicians try to kick this can down the road, because nobody wants to aggravate the largest voting block in the United States."

Romney and Ryan have proposed converting Medicare into a premium support program, with the House Republican budget plan spearheaded by Ryan calling for such a change to begin in 2023.

 

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