The October Health Tracking Poll finds, one week before the presidential election, the economy remains the primary concern on voters’ minds, but health policy issues remain in the mix.

The new survey finds that roughly a third of likely voters name the Affordable Care Act (37%), Medicare (36%), and Medicaid (30%) as “extremely important” to their vote, compared to half (52%) who say the same about the economy and jobs. But separate health care issues stand out for different groups. For Democratic voters, Medicare (43%), Medicaid (43%), and the ACA (41%) all share the top spot with the economy (43%). The economy is the winner (67%) for Republican voters, with the most important health issue, the ACA (49%), ranking third behind the deficit (58%). And senior voters prioritize Medicare (50%), coming in a close second to the economy (54%).

Six in ten likely voters (61%) continue to oppose the idea of changing Medicare to a premium support system, in which the government would guarantee each senior a fixed amount of money to help them purchase coverage either from traditional Medicare or from private insurers. Senior voters are the most likely to oppose switching to premium support: 72 percent prefer keeping Medicare as is, compared to 58 percent of likely voters under 65.

Yet opinion against the Medicare premium support idea – which GOP nominee Governor Mitt Romney backs and President Barack Obama opposes – does not appear to have translated into an advantage with seniors for the president when it comes to Medicare. The poll finds that senior voters are just as likely to pick Governor Romney as President Obama when asked which candidate “would do a better job of determining the future of the Medicare program” (48% Governor Romney, 43% President Obama, a difference that is not statistically significant).

As the election approaches, President Obama’s edge on several key health issues appears to be narrowing, following the general tightening in the polls. While the president continues to hold a large advantage on women’s health, his double digit lead in September on the ACA, health costs and Medicaid is now in the single digits (in the range of 7 to 8 percentage points) and his edge on Medicare is now a draw, with 46 percent of likely voters saying they trust President Obama on Medicare and 41 percent Governor Romney.

Meanwhile, the public’s views on the Affordable Care Act continue to be deeply divided, with 38 percent of Americans having a favorable view of the law and 43 percent an unfavorable one. The law appears to be motivating opponents and supporters about equally: Likely voters with favorable views are just as likely as those with unfavorable views to say the ACA will be “extremely important” in their vote choice (39% and 38%, respectively).

The October poll is the latest in a series designed and analyzed by the Foundation’s public opinion research team.

Findings (.pdf)

Chartpack (.pdf)

Toplines (.pdf)

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