Poll: Healthcare is Second Most Important Issue Heading into November Elections

Washington, DC—A poll released at the AHIP conference found that voters consider healthcare to be the second most important issue heading into the November 2014 midterm elections, trailing only the economy/jobs. Peter Hart and Bill McInturff, both well known for their work with the Wall Street Journal/NBC News polls, conducted a national telephone survey from February 16 to February 20 of 800 people and asked their views on numerous political topics. One-quarter of the interviews were conducted via cellular phones, and the survey had a margin of error of ±3%.

Asked about their top issue heading into the elections, 36% responded the economy/jobs and 15% said healthcare. The groups most concerned with healthcare were white women, married couples, Republicans, older people, and rural residents, according to Mr. Hart.

Asked about the impact that a candidate’s position on the Patient Protection and Affordable Care Act (ACA) had on determining who to vote for, 51% said it was a “major factor,” 29% said it was a “minor factor,” 10% said it was “not an important factor at all,” and 9% said it was “the most important factor.”

Mixed Reviews on the Law

There were mixed views on the ACA. Of the people surveyed, 34% said they supported the ACA and 23% said they “strongly supported” it, while 45% said they opposed and 36% said they “strongly opposed” the legislation. Mr. Hart said the groups most likely opposed to the ACA included white males, rural residents, Republicans, people in the Midwest, and white independent voters.

The responses were split based on people’s political affiliations. Of the Democrats, 61% supported the ACA and 13% opposed it compared, with 8% support and 79% opposition among Republicans. Half of the independent voters opposed the ACA, while 29% supported the law. Among the independents, 43% do not know if they want a Republican or Democratic Congress, according to Mr. Hart. He added that the Senate elections in November will be worth watching.

“The big story, as we all know, is going to play out on the Senate side,” Mr. Hart said. “If you are a Democrat, it has to be of concern because the Democrats are going to be trying to win Senate seats and hold senate seats in red states like Alabama, Louisiana, Arkansas, South Dakota, Montana, and West Virginia. The pressure for the Democrats is going to be great.”

Of the survey sample, 61% had private health insurance; 47% of people with private health insurance opposed the ACA and 35% supported the law. Of the Medicare recipients, 43% supported the law and 37% opposed it. Of the people who did not have health insurance, 49% opposed the ACA and 23% supported it. Mr. Hart said people without insurance were typically <35 years of age, had no college education, made <$40,000 per year, and were not married.

Meanwhile, 49% of respondents currently without coverage and 54% of people who were in and out of coverage opposed the law, while 23% and 28%, respectively, supported the ACA.

“If you are President Obama and you look at this data, the 1 thing that has to come out to you is, ‘Where is my constituency?’” Mr. Hart said. “None of these 4 groups [people with health insurance, Medicare beneficiaries, people without health insurance, and people dropping in and out of coverage] are a natural constituency where they say, ‘I am clearly with the President on this.’”

In addition, 54% of respondents said they would like to see the ACA fixed, 28% said they wanted the law repealed, and 17% said they wanted the ACA to remain the same as it is now. Among Republican voters, 52% thought the law should be totally eliminated and 44% said it should be fixed compared with 7% and 62% of Democrats, respectively.

“As much as people think about [the ACA], it is not necessarily that they want to throw out the whole thing and start over again, nor are they saying what we have is the best of what we can have,” Mr. Hart said. “What the American public is looking for is recasting, refixing, recalibrating where we are at.”

Weighing the Pros and Cons

According to the survey, the most popular aspects of the ACA were that uninsured Americans can now get coverage, health insurance companies cannot reject people based on preexisting illnesses and can no longer charge people based on age and medical history, and that children can remain on their parents’ coverage until 26 years of age.

“When you track all of the media that has run so far, there are 2 words that are all through the Democratic party’s commercials,” Mr. McInturff said. “That phrase is ‘deny coverage’ because the best way for them to position this law is, ‘Do not turn back. If you turn back, this is what is going to happen in terms of the ‘bad, old days of healthcare.’”

The most unpopular parts of the law were the individual mandate requiring most people to have insurance or face a tax as well as new taxes on insurers, because people believe the costs will be passed along to them through higher premiums.

“The mandate is by far the least popular part of the law,” Mr. McInturff said. “As you talk about the position we are in right now, where every day the Obama administration is changing this law, they understand that you cannot change the individual mandate, but I believe it will be a ‘wink-wink, nod-nod;’ meaning, they are going to be implying or inferring they are not going to work very hard to enforce it in the next year or 2.”

Mr. McInturff said the groups who believe their healthcare costs have increased because of the ACA include people who oppose the law, small business owners, people who drop in and out of health insurance coverage, people who buy their own insurance, and people who work at companies with <100 employees.

In February, the Obama administration delayed another ACA provision and gave companies with between 50 and 100 employees an additional year to provide health insurance coverage to people who work >30 hours per week. Mr. McInturff said that announcement and other delays have been politically motivated.

“The most important thing to understand between now and November is everything will be done to make sure that if you like your own insurance, you can keep it,” Mr. McInturff said. “[The Obama administration] does not want any single negative story between now and the election. Anything they can do to postpone, push off, and avoid that sort of negative story is what you are going to see happen.”