Some Americans, generally younger adults and those in good health, decide on their own not to buy health insurance. But the latest Rasmussen Reports national telephone survey found that 31% of the nation’s adults believe even those who are young and healthy should be required to buy health coverage.

Fifty-six percent (56%) disagree and say that if someone doesn’t want to buy insurance, they shouldn't have to.

What if those who chose not to buy health insurance end up needing Emergency Room care? Seventy-four percent (74%) say they should be treated even if they didn’t pay for insurance. Only 16% say treatment should be denied.

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Mandated insurance coverage is one of the more controversial aspects in the debate over health care reform.

Fifty-nine percent (59%) of American adults believe all companies should be required to buy health insurance for their employees while 30% are opposed.

Democrats, by a 7-to-1 margin, believe companies should be required to provide coverage. Republicans are evenly divided. As for those not affiliated with either major party, 48% favor mandated coverage and 37% are opposed.

As for the self-employed, 46% believe they should be required to buy insurance while 41% disagree. Most entrepreneurs (52%) oppose mandatory coverage for the self-employed. Entrepreneurs include both people who own their own business and the self-employed.

A recent survey of small business owners found that 60% believe that a government mandate to provide health care coverage for employees would have a negative impact on their business. There are 22 million businesses in the nation with five or fewer employees. Seventy-four percent (74%) of these companies do not provide health insurance for employees.

Democrats strongly believe that the self-employed should be required to buy health insurance while Republicans strongly disagree. A plurality of unaffiliated Americans (46%) oppose mandates for the self-employed.

Rasmussen Reports tracks the attitudes of small business owners each month for the Discover Small Business Watch.

Americans are evenly divided on another controversial aspect of health reform—the creation of a government program to compete with private insurance companies.

Overall, 35% of Americans rate the U.S. health care system as good or excellent suggesting there is plenty of room for improvement. But 70% of those with health insurance rate their own coverage as good or excellent. Public opposition is typically strong to any proposal that would force people to change their existing health insurance coverage.

Just 32% say they would be willing to pay higher taxes to provide health insurance for everyone. However, 50% would be okay with extra taxes on alcohol products to help fund universal health care. Only 34% support an extra tax on non-diet soda for health care funding.

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