2020 health care priorities presentation january 2020 · bipartisanship on health care reform of...

2020 HEALTH CARE PRIORITIES PRESENTATION

January 2020

Presenter

Presentation Notes

Thank you for the introduction, Bill. As Bill said, my name is Caroline Bye and I am the Managing Director of Client Services at Morning Consult. This is my eighth project with the Bipartisan Policy Center, and my second project with the healthcare team, specifically. For those of you unfamiliar with Morning Consult, we are a technology company that specializes in collecting, organizing, and sharing public opinion research. We are collecting about 15,000 interviews globally every day, and outside of the D.C. region, we work with over 250 major companies on brand management. Inside the beltway we are probably best known for our editorial partnerships, namely our weekly poll with Politico. In D.C., we work with a large array of advocacy groups and nonprofits, which is what brings us here today. We’ve been working with the Bipartisan Policy Center for just over a year, doing a wide array of projects, from early childhood education to immigration to healthcare. This is actually our second project with BPC’s Healthcare team, and I’d like to thank Marilyn, Joanne, Kevin, and Jordan for their work on this project. I’d also like to thank Claire Taylor from the DC team at Morning Consult for shepherding this project with the BPC team.

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Introduction

B P C | 2 0 2 0 H E A L T H C A R E P R I O R I T I E S

2

1

2

3 Where is there room for bipartisan reform on health care?

What do voters see as the biggest public health issue in their communities?

Where does health care fall among other issues heading into 2020?

Presenter

Presentation Notes

So when we spoke with BPC’s healthcare team at the end of 2019, and thought about the goals for this project, 3 main objective became clear: First, we wanted to figure out how important healthcare is to voters heading into 2020. We know it was a defining policy issue in 2018, and we wanted to see if that importance was carrying forward into 2020. Secondly, we wanted to learn more about what public health issues voters saw as the most pressing in their local communities. And, lastly, we wanted to look to future health policy and figure out where there might be room for bipartisan reform. In order to meet these objectives, we surveyed 2,000 registered voters across the country and paired this nationwide research with 3 state oversamples in Iowa, New Hampshire, and South Carolina. In each of these early primary states, we collected interview from 300 registered voters.

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Key Points


3

IMPORTANCE OF HEALTH CARE TO 2020 VOTE

Sixty-six percent of Democrats, 54% of independents, and 46% of Republicans select health care as one of the most important issues in their 2020 vote choice.

COMMON PUBLIC HEALTH ISSUES IN LOCAL COMMUNITIES

Of the public health issues tested, voters are most likely to say illicit drugs and opioids are common in their local community, followed by mental and behavioral health issues.

BIPARTISANSHIP ON HEALTH CARE REFORM

Of the heath care reforms tested, improving the current health care system, rather than repealing and replacing the ACA or Medicare-for-All, receives the most bipartisan support.

Presenter

Presentation Notes

Now, to give a high-level overview of the answers we found for each of the objectives: When it comes to how important healthcare will be in 2020, it seems clear that healthcare will continue to be a defining issue in the election. And, while healthcare is typically thought of as a “D” issue, the data shows that this is clearly important to voters across the political spectrum. Looking at the public health issues gripping local communities, voters say that drugs and opioids, as well as mental health are the most common of the tested issues. And, when it comes to bipartisan solutions to future healthcare reform, the most middle ground is found in improving the current healthcare system. And, this isn’t stated here, but something we’ll get to later in the presentation that is true across party lines is: no matter your party, voters certainly do not want politicians to reduce the current Medicare benefits as a way to maintain funding for health care programs in the U.S. �

IMPORTANCE OF HEALTH CARE TO 2020 VOTE

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56%

44%

33%

31%

30%

23%

16%

13%

13%

12%

11%

7%

7%

4%

Health care

The economy

Immigration

Taxes

Gun control

Environmental policy

Education policy

Abortion

Criminal justice

Foreign policy

Infrastructure

Trade policy

Energy policy

Other, please specify5

% Selected

Top Issues in 2020 Election

Thinking about who you will vote for in the 2020 presidential election, which of the following issues will be most important in your vote choice?Select your top three areas.

Presenter

Presentation Notes

Looking at the following question, it’s clear that healthcare is an important issue to a majority of voters. In this question in particular, we see 56% of voters select healthcare as a top three issue when it comes to their vote choice in 2020. I do want to call out that in this particular question, we allowed voters to select three issue areas, rather than a forced choice of 1 issue area. We did, however, do an exercise with respondents, where, after selecting their top three issues, they were forced to rank their top issue areas. In this exercise, healthcare still performs at the top, statistically tying with the economy for the #1 spot: 44% of those who selected healthcare as a top 3 issue area rank it as their #1 issue, while 45% of those who selected the economy as a top 3 issue area rank it as their #1 issue.

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66%

34%

20%

24%

42%

35%

54%

45%

29%

30%

23%

26%

46%

55%

52%

39%

23%

7%

Health care

The economy

Immigration

Taxes

Gun control

Environmental policy

Independents Republicans

6

Democrats

* Displaying top six issues


Presenter

Presentation Notes

Breaking the top issues out by party ID, healthcare is important to voters across party lines. 2 in 3 Democrats rank it as a top 3 issue, 54% of independents rank it as a top 3 issue, and 46% of Republicans rank it as a top 3 issue. Healthcare is the #1 most selected issue among Democrats and independents, and it is the 3rd most selected for Republicans, falling after the economy and immigration.

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IA Voters NH Voters SC Voters

59%

43%

32%

26%

20%

30%

60%

49%

31%

24%

30%

28%

56%

51%

36%

20%

32%

21%

Health care

The economy

Immigration

Taxes

Gun control

Environmental policy7


* Displaying top six issues

Presenter

Presentation Notes

And looking at early primary states, healthcare is still a frontrunner across the issue options, receiving majority selection in all three of these states.

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Thinking about your health care, which of the following are most significant to you and/or your family? Select your top three concerns.


64%

57%

44%

40%

22%

15%

15%

2%

14%

Out of pocket costs

Prescription drug costs

Quality of health care received

Difficulty in getting affordable or sufficientinsurance

Difficulty getting appointments with specialistsand other providers in my area

Long distances to receive medical services

Difficulty getting appointments with primary careproviders in my area

Other, please specify

Don’t know/No opinion8


% Selected

Presenter

Presentation Notes

We also wanted to be sure to have insight into what, exactly, about healthcare is so important to voters. So, we asked which of the following issues are most significant to voters and their families. Costs and quality of care rise to the top. Out of pocket costs, prescription drug costs, the quality of care received, and the affordability of insurance are more selected than things like the proximity and availability of providers.

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64%

60%

45%

45%

23%

15%

17%

62%

50%

42%

39%

20%

15%

12%

65%

60%

44%

35%

23%

16%

15%

Out of pocket costs



Difficulty in getting affordable orsufficient insurance

Difficulty getting appointments withspecialists and other providers in my

area

Long distances to receive medicalservices

Difficulty getting appointments withprimary care providers in my area9

* Showing top seven issues


Independents RepublicansDemocrats


Presenter

Presentation Notes

Cost and quality of care having the most significant impact on voters is a trend that spans party lines.

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68%

65%

40%

39%

23%

21%

11%

71%

60%

37%

42%

24%

15%

13%

70%

64%

42%

47%

21%

12%

12%

Out of pocket costs



Difficulty in getting affordable or sufficient insurance

Difficulty getting appointments with specialists andother providers in my area

Long distances to receive medical services

Difficulty getting appointments with primary careproviders in my area

1 0



Presenter

Presentation Notes

And additionally, spans geography – from Iowa to New Hampshire to South Carolina.

COMMON PUBLIC HEALTH ISSUES IN LOCAL COMMUNITIES

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Thinking about the current public health issues in the U.S., which of the following are most common in your local community? Select up to three.


48%

41%

33%

30%

25%

19%

17%

14%

4%

2%

14%

Illicit drugs and opioids

Mental and behavioral health issues

Smoking and vaping

Obesity and/or lack of nutrition and physicalactivity

Heart disease, stroke, and cancer

Alcohol addiction

Addiction to technology, including socialmedia

Suicide

HIV/AIDS

Other, please specify

Don't know/No opinion1 2

Public Health

% Selected

Presenter

Presentation Notes

Now, thinking about the public health issues being experienced in local communities, drugs and opioids rises to the top and this is followed by mental and behavioral health. Third in the ranking here is a story that has gotten a lot of attention from news outlets in the recent months, smoking and vaping.

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46%

46%

32%

31%

28%

19%

16%

15%

5%

46%

40%

31%

29%

21%

23%

17%

11%

5%

51%

36%

36%

30%

25%

18%

20%

14%

3%


Mental and behavioral healthissues

Smoking and vaping

Obesity and/or lack of nutrition andphysical activity


Alcohol addiction

Addiction to technology, includingsocial media

Suicide

HIV/AIDS1 3

* Showing top seven issues

Public Health


Presenter

Presentation Notes

Looking at public health issues by Party ID, drugs and opioids really pops for Republicans, while for Democrats, drugs and opioids is tied as the most selected with mental and behavioral health. And though there are differences in the percent selection, general trends of most selected to least selected hold true across party lines.

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Public Health

44%

44%

33%

28%

24%

19%

18%

12%

9%

42%

42%

33%

30%

24%

16%

18%

14%

3%

58%

35%

33%

32%

26%

26%

16%

14%

2%



Smoking and vaping

Obesity and/or lack of nutrition andphysical activity


Alcohol addiction

Addiction to technology, including socialmedia

Suicide

HIV/AIDS1 4

Suburban RuralUrban

Presenter

Presentation Notes

And, considering this data by community-type, we see drugs and opioids and alcohol addiction are disproportionately selected by rural respondents.

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37%

47%

29%

39%

28%

25%

24%

20%

2%

69%

47%

37%

29%

12%

26%

17%

14%

1%

51%

45%

34%

40%

34%

24%

21%

13%

7%



Smoking and vaping

Obesity and/or lack of nutrition and physicalactivity


Alcohol addiction

Addiction to technology, including social media

Suicide

HIV/AIDS1 5

Public Health



Presenter

Presentation Notes

Lastly, I wanted to highlight the early primary states here. New Hampshire voters really stick out here because of their selection of drugs and opioids. And, in comparison to Iowa and South Carolina voters they have a lower selection of issues like obesity, and tradition diseases such as heart diseases, stroke and cancer. Meanwhile, in Iowa, mental and behavioral health is the most selected public health issue, followed by obesity and drugs and opioids. We also see increased selection percentage for suicide among Iowa voters. South Carolina follows most of the nationwide trends of selection, though obesity and traditional diseases such as heart disease, stroke, and cancer see higher levels of selection in South Carolina.

BIPARTISAN SUPPORT FOR HEALTH CARE REFORM

Presenter

Presentation Notes

Last section here, and we’ll cover potential reforms proposed to the healthcare system and see where there’s potential to create middle ground.

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Currently, the presidential candidates are debating many plans to reform the U.S. health care system. Of the following options, which health care reform plan do you support the most?

Health Care Reform


23%

39%

22%

16%

Repealing and replacing the Affordable Care Act

Improving the current health care system

Transforming to a Medicare for All-style single-payer health care system with

government-provided insurance for everyone

Don’t know/No opinion

1 7

Presenter

Presentation Notes

We asked respondents, on a scale from repeal and replace to Medicare for All, where they stood. A plurality selects the middle ground solution: improving the current healthcare system.

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Health Care Reform


7%

46%

35%

13%

20%

38%

22%

20%

45%

32%

7%

16%1 8

Repealing and replacing the Affordable Care Act

Improving the current health care system

Transforming to a Medicare for All-style single-payer health care system with

government-provided insurance for everyone

Don’t know/No opinion

Currently, the presidential candidates are debating many plans to reform the U.S. health care system. Of the following options, which health care reform plan do you support the most?


Presenter

Presentation Notes

And, when we break this out by party ID, we see that a plurality of Democrats and independents selected the middle ground option, and 1 in 3 Republicans also select the middle ground option. Words like “repeal and replace” and “Medicare-for-all” are charged and have been used in partisan ways up to this point, so we do expect partisan divides based on the colloquial usage and messaging on these terms, but we also see that despite the messaging that’s occurred over the past years from both sides of the aisle, neither repeal and replace nor Medicare for all receive majority support from their respective party’s base. The most room for bipartisanship, based on these results, is through improving the current healthcare system.

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As you may know, experts say that federal spending on major health care programs is expected to substantially increase over the next ten years. Knowing this, do you support or oppose the following ways to maintain funding for health care programs in the U.S.?B P C | 2 0 2 0 H E A L T H

C A R E P R I O R I T I E S

41%

28%

24%

17%

12%

11%

5%

5%

4%

24%

31%

36%

21%

25%

24%

14%

9%

5%

12%

21%

25%

15%

18%

21%

15%

17%

12%

11%

10%

9%

18%

18%

19%

19%

20%

15%

12%

10%

6%

28%

27%

25%

46%

49%

63%

Increase federal taxes on the wealthy segment of society

Allow the government to negotiate for prescription drugs andother services within government programs, like Medicare

Change the way medical providers are paid to be based onthe value of services rather than the volume of services

Require work as a condition for receiving Medicaid services

Increase federal taxes on all Americans based on a slidingscale for income

Allow the government to set prices for health care goods andservices

Delay Medicare eligibility from 65 to 67 years of age

Increase Medicare premiums

Reduce Medicare benefits

Strongly support Somewhat support Don't know/Noopinion

Somewhat oppose Strongly oppose

1 9

Health Care Reform

Presenter

Presentation Notes

Lastly, working with the BPC team, we wanted to ask specifically about ways to maintain funding for healthcare programs. We tested a large array of proposals from increasing federal taxes on wealthy segments of society to reducing Medicare benefits. We can see here that the proposals that received the highest level of support include increasing federal taxes on the wealthy segment of society, allowing the government to negotiate for prescription drugs and services within government programs, and lastly, changing the way medical providers are paid to be based on value of service rather than volume of service. Even stronger than the support for these top tier proposals is the opposition to the bottom tier of proposals. Delaying Medicare eligibility from 65 to 67, increasing Medicare premiums, and reducing Medicare benefits receive very intense opposition.

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Net Support* for Ways to Maintain Funding for Health Care Programs by Party ID

All Voters Democrats Republicans

Increase federal taxes on the wealthy segment of society +42 +75 +8

Allow the government to negotiate for prescription drugs and other services within government programs, like Medicare

+39 +42 +38

Change the way medical providers are paid to be based on the value of services rather than the volume of services

+45 +50 +44

2 0

As you may know, experts say that federal spending on major health care programs is expected to substantially increase over the next ten years. Knowing this, do you support or oppose the following ways to maintain funding for health care programs in the U.S.?

Health Care Reform

*Net support = (strongly support + somewhat support) – (somewhat oppose + strongly oppose)

Presenter

Presentation Notes

Looking at the top three proposals by party ID, we can see that the most bipartisan solution is around value-based care, while the federal tax increase on wealthier Americans sees much higher levels of Democratic support than Republican support. And, to take a second to explain the numbers you’re looking at here – these are the net support for these proposals. Meaning we take the total percentage of support and subtract that by the total percentage of opposition. So, this still means that more Republicans support this increased tax on the wealthy than oppose the tax, but that it’s more controversial among this base.

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Net Support* for Ways to Maintain Funding for Health Care Programs by Party ID

All Voters Democrats Republicans

Require work as a condition for receiving Medicaid services -8 -31 +21

Increase federal taxes on all Americans based on a sliding scale for income -8 +4 -26

Allow the government to set prices for health care goods and services -9 +4 -23

Delay Medicare eligibility from 65 to 67 years of age -46 -56 -39

Increase Medicare premiums -55 -51 -58

Reduce Medicare benefits -69 -72 -67

*Net support = (strongly support + somewhat support) – (somewhat oppose + strongly oppose)

2 1

As you may know, experts say that federal spending on major health care programs is expected to substantially increase over the next ten years. Knowing this, do you support or oppose the following ways to maintain funding for health care programs in the U.S.?

Health Care Reform

Presenter

Presentation Notes

Now looking at the lower tier proposals, or proposals that receive less support, there is clear partisanship on the proposal for Medicare work requirements. This proposal receives net positive support from Republicans -- +21, and net negative support from Democrats -- -31. Now looking at proposed Medicare changes – these proposals are underwater with both Democrats and Republicans. Touching Medicare and reducing Medicare benefits is not something voters want to see taken up as a way to maintain funding for healthcare programs in the U.S.

Presenter

Presentation Notes

So, I know we’ve covered a lot here – healthcare, as we all know is a complicated issue, but it’s an important issue for voters. This data reveals that heading into 2020, healthcare is still top of mind for voters. We also see that voters are concerned most with cost and quality when it comes to healthcare. In seeking common ground, the bipartisan route forward seems to be through improving the current healthcare system, not repeal-and-replace or Medicare-for-All.

2020 health care priorities presentation january 2020 · bipartisanship on health care reform of...

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