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1 AARP Survey of Idaho Registered Voters ages 30 64: State Health Insurance Exchange Prepared by Jennifer H. Sauer State Research, AARP State health insurance exchanges are a provision of the new health law passed by Congress in States can establish and run their own exchange or one will be developed and run by the federal government. All states must have an exchange in place by January 1, The Governor of Idaho is favorable toward the creation of a state run health insurance exchange. As of January 6, 2012, a state health insurance exchange bill was sent for consideration to the full state Legislature. In its continued efforts to be a strong voice for consumers of health care, AARP in Idaho commissioned a survey of 703 registered voters ages As mostly workers with families, this age group will be greatly impacted by the final state health insurance exchange legislation. This survey was fielded in December 2011 and explores health insurance status, costs, and concerns and gauges respondent support for a state run health insurance marketplace. This survey has a margin of error of ± 3.7 percent. An annotated survey begins on page 4 and the full methodology is on page 3. Survey In Brief: While most (87%) Idaho voters ages 30 to 64 indicate having some kind of health care coverage, over one in ten (12%) say they have no coverage. Additionally, among those with health care coverage, over one in ten (13%) report a time over the past two years when they were without it. Unemployment and affordability are key factors among those with no coverage or those who went without. About one in six (16%) registered voters in Idaho ages 30 to 64 say they pay $500 or more each month in out-ofpocket medical expenses including prescription drugs, insurance premiums, deductibles, and co-pays. Another quarter (25%) indicate they pay between $200 and $500 each month, and half (49%) are paying up to $200 per month in out-of-pocket medical expenses. Over half (53%) of all respondents say paying these monthly out-ofpocket medical expenses is difficult, with nearly one-quarter (22%) saying it is extremely or very difficult for them. Over the past two years, the majority of respondents to this survey report having taken at least one of the actions tested in the survey due to the cost of their health care. Purchasing a generic drug (78%), delaying seeing a doctor/nurse when needed (40%), or scheduling fewer routine check-ups (39%) are the top three reported actions taken by respondents. Moreover, 41 percent indicate having taken three or more negative actions. Over half (53%) of all respondents (those with or without health care coverage) are extremely or very worried about having to pay more for their health care. Additionally, among those respondents with health coverage, nearly half (48%) are extremely or very worried about an increase in personal insurance premiums. Most respondents to this survey support a state health insurance marketplace with almost half indicating strong support. In fact, over half say it is extremely (29%) or very (29%) important that Idaho develop a health insurance marketplace. Moreover, half of all respondents indicate a representative group of consumers, insurance companies, small businesses, and government should oversee a state health insurance marketplace. Level of Support: State Health Insurance Marketplace (weighted n=703 ID registered voters ages 30-64) Who Should Oversee State Health Insurance Marketplace? (weighted n=703 ID registered voters ages 30-64) Strongly support Somewhat support 28% 45% A representative group of consumers, insurance companies, small businesses, government 50% Neither support/oppose 10% A state government agency 27% A federal government agency 9% Other 26% Somewhat oppose Strongly oppose 3% 7% Not sure 7% 0% 20% 40% 60% 80% 100% AARP Survey of Idaho Registered Voters Ages 30 to 64, January

2 DEMOGRAPHICS OF RESPONDENTS (703 Registered Voters ages 30 64) GENDER Male 50% PARTY AFFILIATION Female 50% Democrat 15% WORK STATUS Employed FT 51% Republican 43% Employed PT 17% Independent 26% Retired Unemployed 10% 21% Other 11% EDUCATION POLITICAL VIEW Post graduate study/degree College degree 16% 25% Conservative 58% Post HS education no degree 34% Moderate 21% HS diploma or GED 21% Liberal 15% No HS diploma 2% MARITAL STATUS Not sure 2% Married/Living with Partner Separated/Divorced/Widowed Never married 8% 6% 86% Children living in household (n=609)* Yes 71% RACE No 22% White/Caucasian Black/AA 0% 92% 0% 20% 40% 60% 80% 100% Hispanic/Latino 4% Native American/Alaskan Native 1% INCOME Less than $30k 17% $30k <$60k $60k <$150k 37% 33% $150k or more 6% 0% 20% 40% 60% 80% 100% *Asked of those respondents who indicate they have children: 609 or 87 percent of all respondents. AARP Survey of Idaho Registered Voters Ages 30 to 64, January

3 FULL METHODOLOGY AARP commissioned RDD Field Services to conduct the 2011 Idaho Telephone Survey on Health Tradeoffs and the Health Insurance Exchange, a survey of Idaho registered voters Age The survey was conducted between December 13, 2011 and December 16, 2011 and a total of 700 interviews were completed. A sample of this size has a margin of error plus or minus 3.7 percent at a 95 percent confidence level and a margin of error plus or minus 4.88 percent at a 99 percent confidence level. Survey responses were weighted to reflect the actual distribution of age and gender of Idaho registered voters age Interviewing was completed with a final response rate of 3.35 percent, cooperation rate of percent and refusal rate of 4.55 percent. The response, cooperation and refusal rates were calculated according to AAPOR standards RR3, CCOP3, REF3. 2 The questionnaire was developed and reviewed by AARP staff. In order to improve the quality of the data, the questionnaire was pretested with a small number of respondents. The pretest interviews were monitored by RDD and AARP staff 2 Calculated using AAPOR s Outcome Rate Calculator Version 2.1, May AARP Survey of Idaho Registered Voters Ages 30 to 64, January 2012

4 2011 SURVEY OF REGISTERED VOTERS IN IDAHO AGE 30 TO 64 ABOUT HEALTH CARE AARP s Idaho State Office commissioned this survey to explore the views of registered voters in Idaho, age 30 to 64 years, on their experiences and opinions about their health care. RDD Field Services conducted this survey December 13-16, 2011, and completed a total of 703 interviews. A sample of this size has a margin of error of plus or minus 3.7 percent at a 95 percent confidence level. Survey responses were weighted to reflect the actual distribution of age and gender of Idaho registered voters age Interviewing was completed with a final response rate of 3.35 percent, a cooperation rate of percent, and a refusal rate of 4.55 percent. The response, cooperation, and refusal rates were calculated according to AAPOR standards RR3, COOP3, and REF Idaho Telephone Survey on Health Tradeoffs & the Health Insurance Exchange Survey of Idaho Registered Voters Age 30 to 64 Years of Age (Weighted n=703) M-1. Do you have any kind of health care coverage, including health insurance or government plans such as Medicare or Medicaid? Yes 87.2% No [SKIP TO QUESTION M-4] 12.3% Not sure [DO NOT READ], SKIP TO M-3 0.4% Refused [DO NOT READ], SKIP TO M-3 0.1% M-2. ASK IF M-1=YES. And are you covered [INTERVIEWER NOTE: IF RESPONDENT GIVES NAME OF INSURER OR SPECIFIC COMPANY NAME, ASK WHETHER THEY PAY FOR THE POLICY ON THEIR OWN OR IF IT IS PAID EITHER FULLY OR PARTIALLY BY AN EMPLOYER/PREVIOUS EMPLOYER AND RECORD APPROPRIATELY] (n=613) Through your current employer 45.2% Through your spouse s employer 30.8% On your own, through an individually purchased insurance policy 25.8% Through a previous employer [MAY BE RETIREMENT BENEFIT] 10.8% Through a spouse s previous employer [MAY BE RETIREMENT BENEFIT] 6.3% Through Veterans or military benefits 6.9% Through Medicaid or other state paid plan 6.0% Through Medicare 6.7% Through some other way: [PLEASE SPECIFY: ] 9.7% M-3. During the past 2 years, that is all of 2010 and 2011, was there a time that you, [IF MARRIED OR LIVING WITH PARTNER, ADD OR YOUR SPOUSE OR OR YOUR PARTNER, ACCORDINGLY], [IF CHILDREN, ADD OR YOUR DEPENDENT CHILDREN ], did not have any health insurance or coverage? (n=616) Yes 12.7% No [SKIP TO QUESTION M-5] 87.3% Not sure [SKIP TO QUESTION M-5] [DO NOT READ] 0.0% Refused [SKIP TO QUESTION M-5] [DO NOT READ] 0.0%

5 M-4. [IF M-1=NO, ASK: What is the reason you, [IF MARRIED OR LIVING WITH PARTNER, ADD OR YOUR SPOUSE OR OR YOUR PARTNER, ACCORDINGLY], [IF CHILDREN, ADD OR YOUR DEPENDENT CHILDREN ], are without health care coverage? ] [DO NOT READ LIST. CODE APPROPRIATE RESPONSE ACCORDING TO WHETHER OR NOT RESPONDENT IS CURRENTLY UNINSURED OR WAS UNINSURED. ] (n=87; Those without health insurance) I lost my job and health benefits 4.7% I am unemployed 5.8% I am self-employed and cannot afford health insurance 13.5% Health benefits not offered through my employer 8.8% Health benefits offered through my employer but cannot afford the premiums 8.1% I cannot afford to purchase health insurance 29.8% No health insurance is available because of a pre-existing medical condition 1.2% It is less expensive to pay for medical care out of pocket than through insurance 3.5% I can get free medical care at the hospital 0.0% Other [Specify: ] 21.1% Not sure [DO NOT READ] 2.3% Refused [DO NOT READ] 1.2% M-4a. What was the main reason you, [IF MARRIED OR LIVING WITH PARTNER, ADD OR YOUR SPOUSE OR OR YOUR PARTNER, ACCORDINGLY], [IF CHILDREN, ADD OR YOUR DEPENDENT CHILDREN ], were without health care coverage? [DO NOT READ LIST. CODE APPROPRIATE RESPONSE ACCORDING TO WHETHER OR NOT RESPONDENT IS CURRENTLY UNINSURED OR WAS UNINSURED.] (n=78; Those currently with health insurance who where without health insurance within the last 2 years) I lost my job and health benefits 15.6% I was unemployed 13.0% I was self-employed and could not afford health insurance 10.4% Health benefits not offered through my employer 2.6% Health benefits offered through my employer but could not afford the premiums 2.6% I could not afford to purchase health insurance 33.9% No health insurance was available because of a pre-existing medical condition 2.6% It was less expensive to pay for medical care out of pocket than through insurance 2.6% I could get free medical care at the hospital 0.0% Other [Specify: ] 16.8% Not sure [DO NOT READ] 0.0% Refused [DO NOT READ] 0.0% Page 2

6 M-5. About how much do you typically pay each month in out-of-pocket medical expenses including prescription drugs, insurance premiums, deductibles, and co-pays? Would you say you pay? [READ EACH ANSWER CATEGORY] Less than $50 per month 17.4% $50 but less than $100 per month 15.5% $100 but less than $200 per month 16.4% $200 but less than $500 per month 25.0% $500 but less than $1000 per month 12.5% $1000 or more per month 3.8% Typically pay nothing 4.6% Refused [DO NOT READ] 1.4% Not sure [DO NOT READ 3.5% M-6. How difficult is it for you to pay for these monthly out-of-pocket medical expenses? Is it.? Extremely difficult 11.7% Very difficult 10.5% Somewhat difficult 30.4% Not very difficult 23.2% Not at all difficult 22.6% Not sure [DO NOT READ] 1.5% Refused [DO NOT READ] 0.2% M-7. In the past 2 years, that is all of 2010 and 2011, have you [IF MARRIED, ADD OR YOUR SPOUSE OR OR YOUR PARTNER, ACCORDINGLY], [IF CHILDREN, ADD OR YOUR DEPENDENT CHILDREN ], taken any of the following actions because of the cost of your health care? [RANDOMIZE A-E; THEN F-H]. a. Scheduled fewer routine check-ups or physicals with a doctor 38.6% b. Delayed seeing a doctor or nurse when not feeling well 40.4% c. Cut back on items such as food, clothing, and housing 33.0% d. Delayed or declined any prescribed physical therapy 17.8% e. Delayed or declined any mental health treatments 7.8% f. Took less medication than prescribed to make it last longer 17.7% g. Delayed getting a prescription filled 22.1% h. Purchased a generic drug 78.2% M-8. How worried are you about.? [RANDOMIZE A-K] Are you extremely worried, very worried, somewhat worried, not very worried, or not at all worried.? a. Having to pay more for your health care Extremely worried 26.5% Very worried 26.5% Somewhat worried 27.2% Not very worried 10.1% Not at all worried 8.6% Not sure [DO NOT READ] 0.9% Refused [DO NOT READ] 0.2% Page 3

7 b. Being able to afford the health care services you think you will need Extremely worried 17.1% Very worried 22.4% Somewhat worried 29.6% Not very worried 16.5% Not at all worried 13.3% Not sure [DO NOT READ] 0.9% Refused [DO NOT READ] 0.1% c. Having a major medical problem and not being able to afford the care needed Extremely worried 22.0% Very worried 19.5% Somewhat worried 26.5% Not very worried 18.0% Not at all worried 13.4% Not sure [DO NOT READ] 0.6% Refused [DO NOT READ] 0.1% d. Having access to health care services that you need Extremely worried 11.8% Very worried 14.2% Somewhat worried 26.8% Not very worried 24.4% Not at all worried 22.2% Not sure [DO NOT READ] 0.5% Refused [DO NOT READ] 0.0% e. Being able to afford the prescription drugs that you need Extremely worried 12.4% Very worried 13.9% Somewhat worried 27.6% Not very worried 25.5% Not at all worried 20.6% Not sure [DO NOT READ] 0.1% Refused [DO NOT READ] 0.0% Page 4

8 f. The quality of the health care services that you or your family receives Extremely worried 9.7% Very worried 13.1% Somewhat worried 26.2% Not very worried 24.6% Not at all worried 24.2% Not sure [DO NOT READ] 1.8% Refused [DO NOT READ] 0.3% g. Your [INSERT AS APPROPRIATE: CURRENT, SPOUSE S, PREVIOUS, SPOUSE S PREVIOUS] employer dropping your health care insurance. (n=473) Extremely worried 7.6% Very worried 9.0% Somewhat worried 18.0% Not very worried 26.9% Not at all worried 36.4% Not sure [DO NOT READ] 1.5% Refused [DO NOT READ] 0.5% h. Your [INSERT AS APPROPRIATE: CURRENT, SPOUSE S, PREVIOUS, SPOUSE S PREVIOUS] employer increasing the cost of your health care insurance. (n=473) Extremely worried 14.3% Very worried 20.4% Somewhat worried 30.4% Not very worried 16.6% Not at all worried 15.6% Not sure [DO NOT READ] 1.7% Refused [DO NOT READ] 1.0% i. [IF HAVE HEALTH INSURANCE FROM EMPLOYER] Not being able to change jobs or retire in order to keep your health insurance benefits (n=284) Extremely worried 11.4% Very worried 19.8% Somewhat worried 27.9% Not very worried 16.7% Not at all worried 21.2% Not sure [DO NOT READ] 2.0% Refused [DO NOT READ] 1.1% Page 5

9 j. [IF HAVE HEALTH INSURANCE FROM SPOUSE'S EMPLOYER] Your Spouse not being able to change jobs or retire in order to keep your health insurance benefits. (n=195) Extremely worried 16.7% Very worried 16.2% Somewhat worried 22.9% Not very worried 20.8% Not at all worried 17.4% Not sure [DO NOT READ] 4.2% Refused [DO NOT READ] 1.8% k. [IF HAVE HEALTH INSURANCE] An increase in the insurance premiums you pay (n=612) Extremely worried 22.8% Very worried 25.4% Somewhat worried 30.9% Not very worried 9.6% Not at all worried 10.6% Not sure [DO NOT READ] 0.5% Refused [DO NOT READ] 0.3% M-9. A health insurance marketplace is a place where individuals and small businesses can purchase health insurance. Such a marketplace may help individuals and small businesses get more competitive prices for their health insurance and more variety in their health insurance options. Idaho s Governor and the state legislature are considering setting up a health insurance marketplace. Do you support or oppose Idaho establishing a health insurance marketplace that would help individuals and small businesses get more competitive prices and more variety in health insurance options? Do you? [READ OPTIONS] Strongly support 44.6% Somewhat support 27.5% Neither support or oppose 10.4% Somewhat oppose 3.3% Strongly oppose 6.5% Not sure [DO NOT READ] 6.6% Refused [DO NOT READ] 1.1% M-10. How important is it that Idaho develop this type of health insurance marketplace? Is it? [READ OPTIONS] Extremely important 29.2% Very important 28.8% Somewhat important 22.5% Not very important 4.5% Not at all important 6.3% Not sure [DO NOT READ] 7.3% Refused [DO NOT READ] 1.4% Page 6

10 M-11. Who should oversee this type of health insurance marketplace? Should it be? [READ ALL OPTIONS BEFORE GETTING AN ANSWER SO RESPONDENT CAN HEAR ALL OPTIONS] A state government agency 27.2% A federal government agency 8.8% A representative group of consumers, insurance companies, small businesses, and government 50.2% Any other groups [PROBE AND RECORD VERBATIMS] 25.7% M-12. How important is it that this type of health insurance marketplace put the needs of individuals and small businesses before the needs of health insurance companies? Extremely important 40.7% Very important 32.9% Somewhat important 16.3% Not very important 1.9% Not at all important 2.4% Not sure [DO NOT READ] 3.8% Refused [DO NOT READ] 2.1% DEMOGRAPHIC QUESTIONS D-1. Record gender Male 50.0% Female 50.0% D-2. What is your age as of your last birthday? 30 to 39 years 18.3% 40 to 49 years 25.2% 50 to 59 years 37.2% 60 to 64 years 18.3% Refused 1.0% D-3. What is the highest level of education that you completed? [READ OPTIONS, IF NECESSARY] 0-12th grade (no diploma) 2.2% High school graduate (or equivalent) 20.8% Post-high school education (no degree) 13.1% 2-year college degree 20.6% 4-year college degree 24.6% Post-graduate study (no degree) 4.6% Graduate or professional degree(s) 11.7% Don t know [DO NOT READ] 0.4% Refused [DO NOT READ] 2.0% Page 7

11 D-4. Are you of Hispanic, Spanish, or Latino origin or descent? Yes 3.8% No 93.4% Don t know [DO NOT READ] 0.5% Refused [DO NOT READ] 2.3% D-5. Which of the following best describes your race? READ EACH ANSWER CATEGORY]? White or Caucasian 91.9% Black or African American 0.1% Native American or Alaskan Native 1.1% Asian 0.6% Native Hawaiian or other Pacific Islander 0.1% Or are you some other race? 2.5% Not sure [DO NOT READ] 0.4% Refused [DO NOT READ] 3.2% D-6. What is your 5-digit ZIP Code? D-7. Do you consider yourself to be a [INSERT A-C IN RANDOM ORDER, THEN ADD OR SOMETHING ELSE AT END]? a. Democrat 14.8% b. Republican 42.8% c. Independent 26.0% Something else 11.2% Not sure [DO NOT READ] 1.4% Refused [DO NOT READ] 3.8% D-8. In general, would you describe your political views as very conservative, somewhat conservative, moderate, somewhat liberal, or very liberal? Very conservative 24.9% Somewhat conservative 32.7% Moderate 21.4% Somewhat liberal 10.3% Very liberal 4.5% Not sure [DO NOT READ] 2.4% Refused [DO NOT READ] 3.8% Page 8

12 D-9. We realize income is a private matter and so rather than ask you anything specific about your income, I d like to ask you to please stop me when I get to the category that your includes your household s income before taxes in Was it.[read EACH ANSWER CATEGORY]? Less than $10, % $10,000 to less than $20, % $20,000 to less than $30, % $30,000 to less than $40, % $40,000 to less than $50, % $50,000 to less than $60, % $60,000 to less than $75, % $75,000 to less than $100, % $100,000 to less than $150, % $150,000 to less than $200, % $200,000 or more 1.6% Not sure [DO NOT READ] 1.9% Refused [DO NOT READ] 7.9% S-6. What is your current marital status? Are you.? [READ EACH ANSWER CATEGORY]? Married 85.5% Living with your partner or significant other 0.7% Separated 1.1% Divorced 4.7% Widowed 1.9% Or are you currently single and never married 5.9% Not sure [DO NOT READ] 0.0% Refused [DO NOT READ] 0.1% S-7. Which of the following best describes your current employment status? [READ EACH ANSWER CATEGORY] Self-employed full-time 12.9% Self-employed part-time 5.9% Employed full-time 37.6% Employed part-time 11.2% Retired and not working at all 10.4% Unemployed and looking for work 6.4% Or are you not in the labor force for other reasons 14.5% Not sure [DO NOT READ] 1.1% Refused [DO NOT READ] 0.0% Page 9

13 S-8. Do you have any children? [INTERVIEW NOTE: IF MENTION IS MADE ABOUT STEP-CHILDREN OR OTHERS THEY CONSIDER AS THEIR CHILDREN, PLEASE INCLUDE AS YES] Yes, GO TO QUESTION S % No, SKIP TO QUESTION M % Not sure [DO NOT READ], SKIP TO QUESTION M-1 0.1% Refused [DO NOT READ], SKIP TO QUESTION M-1 0.0% S-9. Are any of your children? [READ ITEMS A THROUGH C BELOW] (n=609) a. Under the age of 18 and living with you? 48.6% b. 18 years of age or older and living with you? 22.2% c. Away at college? 22.3% Page 10

14 AARP is a nonprofit, nonpartisan organization with a membership that helps people 50+ have independence, choice, and control in ways that are beneficial and affordable to them and society as a whole. AARP does not endorse candidates for public office or make contributions to either political campaigns or candidates. We produce AARP The Magazine, the definitive voice for 50+ Americans and the world's largest-circulation magazine with over 35.1 million readers; AARP Bulletin, the go-to news source for AARP's millions of members and Americans 50+; AARP VIVA, the only bilingual U.S. publication dedicated exclusively to the 50+ Hispanic community; and our website, AARP.org. AARP Foundation is an affiliated charity that provides security, protection, and empowerment to older persons in need with support from thousands of volunteers, donors, and sponsors. We have staffed offices in all 50 states, the District of Columbia, Puerto Rico, and the U.S. Virgin Islands. The views expressed herein are for information, debate, and discussion, and do not necessarily represent official policies of AARP. AARP Research and Strategic Analysis For more information, please contact Terri Guengerich at: or tguengerich@aarp.org Page 11