Barack Obama wins three to one against Mitt Romney among those voters who say that health care is their primary concern, researchers at the Harvard School of Public Health learned. Overall, with voters ranking health care as the second most important factor in determining their presidential choice for the first time since 1992, Obamas lead among that category of voters may prove significant.

With the passage of the Affordable Care Act, weve started a debate about one of the biggest pieces of health care legislation in U.S. history, said Robert J. Blendon, a School of Public Health professor who authored the study. Because its so large and so controversial, it really has become a voting issue.

Controversy over Obamas 2010 health care legislation, combined with campaign trail talk about Medicare policy, shifted voters attention to the issue of health care, Blendon said.

With Romney pledging to repeal Obamas Affordable Care Act and to follow his vice presidential candidate Paul D. Ryans plan to offer seniors a fixed voucher for either private insurance or Medicare, the divide between the candidates positions on health care seems stark.

Suddenly, you have two candidates representing vastly different policies on different elements of health care, and voters are taking notice and beginning to choose sides. Three times to one, that side was with Obama, Blendon said.

John M. Benson, a research scientist at the School of Public Health, said, We are always interested in what role health care has in the election. We wanted to, in this case, look at the issues that have been in the campaign, which would be the ACA, Ryans Medicare proposal, block grants for Medicaid, and more restrictions on abortionthe big four health care issues...and to look at the people who said health care and Medicare specifically was going to alter their vote.

To measure the significance of issues to the voters, Benson, Blendon, and their colleagues gathered polling data from citizens nationwide. After determining that a subject was registered and planning to vote in the 2012 election, poll administrators presented subjects with a list of issues: the economy and jobs, health care and Medicare, federal budget deficit and taxes, abortion, the war in Afghanistan, and immigration. They asked, What is your single top issue when it comes to your choice of a presidential candidate?

For 51 percent of the respondents, the economy and jobs was the most important issue. Health care and Medicare beat out the other options with 20 percent of votes.

Those who selected health care as their top issue were then presented with sets of issues that presidential candidates are talking about regarding nationwide health care and the candidates respective stances. Participants chose the specific decisions important to them.

The last time health care ranked as so many voters main concern was 20 years ago, when former President Bill Clinton ran in 1992 on implementing nationwide health insurance.

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HSPH Study Suggests Health Care is a Deciding Factor for Voters