Maintaining Health and Long-Term Care: A Survey on Addressing the Revenue Shortfall in California

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2 Maintaining Health and Long-Term Care: A Survey on Addressing the Revenue Shortfall in California Data Collected by Woelfel Research, Inc. Report Prepared by Rachelle Cummins Copyright 2002 AARP Knowledge Management 601 E Street NW Washington, DC Reprinting with Permission

3 AARP is a nonprofit, nonpartisan membership organization for people 50 and over. We provide information and resources; advocate on legislative, consumer, and legal issues; assist members to serve their communities; and offer a wide range of unique benefits, special products, and services for our members. These benefits include AARP Webplace at AARP Modern Maturity, and My Generation magazines, the monthly AARP Bulletin, and a Spanish-language newspaper, Segunda Juventud. Active in every state, the District of Columbia, Puerto Rico, and the U.S. Virgin Islands, AARP celebrates the attitude that age is just a number and life is what you make it. Acknowledgements AARP staff from the California State Office, State Affairs, Brand Management, and Knowledge Management contributed to the design and implementation of this study. Special thanks go to AARP staff including Lupe De La Cruz, California State Office; John Luehrs, State Affairs; Clare Hushbeck, State Affairs; Tony Copeland, Brand Management; Gretchen Straw, Knowledge Management; Joanne Binette, Knowledge Management; Erica Dinger, Knowledge Management; and Cheryl Barnes, Knowledge Management. John Woelfel and Leslie Seabright of Woelfel Research insured a timely and high quality survey. Rachelle Cummins, AARP Knowledge Management, managed all aspects of the project and wrote the report. For more information, contact Rachelle Cummins at (202)

4 Background California is experiencing an economic downturn characterized by lower state revenues and higher need for state services. As a result, there is now a nearly $24 billion shortfall in the State budget. In response, the State is recommending about $7.6 billion in program spending cuts. These cuts affect health and long-term care services including medical care for children and long-term care in nursing homes and at home for older persons and those with disabilities. AARP California is greatly concerned about how cuts of this magnitude would affect the current and future health and long-term care needs of Californians, especially those, affected by the economic downturn, who lose health insurance or are unable to get the long-term care they need. Therefore, AARP is examining ways to increase state revenue that would help balance the state budget and generate money for health and long-term care services by Reinstating its vehicle license fee Increasing its tax on tobacco products Temporarily reinstating the 10 percent and 11 percent income tax brackets on high income taxpayers Each source would generate a different amount of revenue for the state. California s current average vehicle license fee is $64. The state has been cutting the fee since By reinstating the fee to $148 per vehicle, California could generate about $4 billion. Increasing the state tax on tobacco products such as cigarettes, cigars, and pipe tobacco could generate about $600 million. Finally, a temporary reinstatement of the 10 and 11 percent income tax brackets, which would affect the top two percent of taxpayers, could generate about $3 billion. This survey measures the opinions of Californians age 18 and older about generating money for California's health and long-term care services. Specifically, this telephone survey of 1,000 randomly selected California adults (weighted n=994) explores: Opinion about current state funding for health and long-term care services Importance of maintaining current levels of state funding for health and longterm care services Attitude toward state candidates who support maintaining the delivery of health and long-term care services even if it means generating additional state revenue Support for three revenue-generating proposals to help balance the state budget and maintain health and long-term care services Maintaining Health and Long-Term Care: A Survey on Addressing the Revenue Shortfall in California

5 An annotated questionnaire, appended to the report, discloses exact question wording and all responses to the survey. Percentages may not add up to 100% due to rounding or non-response. Highlights More than half (56%) of California adults age 18 or older say there is not enough money in the state budget to meet the need and ensure the quality of health and longterm care services compared to just six percent who say there is more than enough and 19 percent who say there is enough money. Nine in ten Californians think that it is important to maintain current levels of state funding for health and long-term care services with eight in ten saying it is very important. Fifty-four percent of Californians would be more likely to vote for a state candidate who supported maintaining the delivery of health and long-term care services even if it means generating additional state revenue while nine percent are less likely to vote for such a candidate. For 26 percent, it would not make a difference. Two out of three proposals to generate money to help balance the state budget and maintain health and long-term care services garner support from at least two-thirds of Californians. Seven in ten support an increase in California s tax on tobacco products. Two in three support reinstating California s 10 and 11 percent income tax brackets, while less than one in four oppose it. A third proposal to reinstate California s vehicle license fee yields more opposition (60%) than support (31%). Maintaining Health and Long-Term Care: A Survey on Addressing the Revenue Shortfall in California 2

6 Findings Nine times more Californians believe there is not enough money in the state budget for health and long-term care services than believe there is more than enough. Fifty-six percent of California adults think that there is not enough money in the state budget to meet the need and ensure quality health and long-term care services while six percent think there is more than enough money. Just 19 percent say there is enough money. Perception of Current State Budget for Health and Long-Term Care Services (n=994) Not Enough 56% More Than Enough 6% Don't Know 19% Enough 19% The majority of Californians believe it is very important to maintain current levels of funding for health and long-term care services. Eight in ten California adults age 18 and older think that it is very important to maintain current levels of funding for health and long-term care services. Another 11 percent think that it is somewhat important. Importance of Maintaining Current Levels of Funding for Health and Long-Term Care Services (n=994) Very Important 82% Somewhat Important 11% Don't Know/ Refused 3% Not Very/ Not At All Important 4% Maintaining Health and Long-Term Care: A Survey on Addressing the Revenue Shortfall in California 3

7 To help balance the state budget and maintain current funding for health and long-term care services, about three times as many Californians strongly support an increase in the tobacco tax and temporarily reinstating the 10 and 11 percent income tax brackets as strongly oppose these revenue sources. California adults were asked whether they support or oppose three proposals to help balance the state budget and maintain current funding for health and long-term care services. Two-thirds or more support the increase in the tobacco tax (71%) and temporary reinstatement of the 10 and 11 percent income tax brackets (67%). However, just about a third support reinstating the vehicle license fee (31%). Nearly six in ten strongly support increasing California s tax on tobacco products to generate about $600 million to maintain health and long-term care services. Another 12 percent somewhat support this tobacco product tax increase. Just over two in five strongly support temporarily reinstating the 10 and 11 percent income tax brackets to generate about $3 billion to maintain health and long-term care services. Another one in five somewhat support the reinstatement of the income tax for high income taxpayers. Two in five strongly oppose reinstating California s vehicle license fee from the current average of $64 to the 1999 average of $148 to generate about $4 billion to maintain health and long-term care services. Almost one in five somewhat oppose the reinstatement of the fee. Support for Proposals to Help Balance the State Budget and Maintain Current Funding for Health and Long-Term Care Services (n=994) 100% 80% 60% 20% 7% 12% 15% 8% 23% 42% 40% 20% 0% 59% Increase Tobacco Tax 44% Reinstate Income Tax Brackets 18% 16% 15% Reinstate Vehicle License Fee Strongly Support Somewhat Support Somewhat Oppose Strongly Oppose Maintaining Health and Long-Term Care: A Survey on Addressing the Revenue Shortfall in California 4

8 Californians are six times more likely than not to vote for a candidate who supports maintaining health and long-term care services even if it means generating additional state revenues. Over half of California adults would be more likely to vote for a candidate for state office who supported maintaining delivery of health and long-term care services even if it means generating additional state revenues, compared to just one in ten who are less likely to vote for such a candidate. For onequarter, it would make no difference. Vote for Candidate Who Supports Maintaining Health and Long-Term Care Services Even by Generating Additional State Revenues (n=994) Don't Know/ Refused 11% More Likely 54% Makes No Difference 26% Less Likely 9% Conclusions Over eight in ten Californians believe it is very important to maintain funding for health and long-term care services. As California seeks ways to generate revenues to pay for health and long-term care services, increasing the tobacco tax and temporarily reinstating the 10 and 11 percent income tax brackets are actions that more than two-thirds of Californians support. Moreover, generating revenues to maintain delivery of health and long-term care services is an issue that could influence voting behavior. Six times as many Californians (54%) would be more likely to vote for a candidate who supports maintaining health and long-term care services even if it means generating additional state revenue than those (9%) who would be less likely to vote for such a candidate. Maintaining Health and Long-Term Care: A Survey on Addressing the Revenue Shortfall in California 5

9 Methodology AARP commissioned Woelfel Research to conduct a random digit dial (RDD) telephone survey of adults age 18 or older in California. Depending on respondent preference, Woelfel Research administered the survey in English or Spanish. From a random sample of 10,598, a total of 1,000 interviews were completed from June 4 June 12, 2002, yielding a 12 percent response rate and 93 percent cooperation rate. 1 The survey has a sampling error of plus or minus 3.2 percent. This means that in 95 out of 100 samples of this size, the results obtained in the sample would fall in a range of 3.2 percentage points of what would have been obtained if every person in California age 18 or older had been surveyed. Survey responses were weighted to reflect the distribution of age, gender, education, and Hispanic origin in the adult population of California. Due to rounding of the weights, the final number of cases for the weighted dataset is 994. Weighted responses to all survey questions are in the attached annotated questionnaire. For more information about this study, contact Rachelle Cummins, AARP Knowledge Management, (202) The response rate is Response Rate 3 and the cooperation rate is Cooperation Rate 3 from the following publication: The American Association for Public Opinion Research Standard Definitions: Final Dispositions of Case Codes and Outcome Rates for Surveys. Ann Arbor, Michigan: AAPOR. Maintaining Health and Long-Term Care: A Survey on Addressing the Revenue Shortfall in California 6

10 Annotated Questionnaire Maintaining Health and Long-Term Care: A Survey on Addressing the Revenue Shortfall in California 7

11 California State Revenue Survey for Health and Long-Term Care Californians age 18+ = 1,000, Response Rate = 12%, Sampling Error = +3.2% (Percentages may not add to 100 percent due to rounding.) (Weighted n = 994) Introduction Hello, this is from Woelfel Research, a national opinion research company. We re conducting a study among California residents about health and long-term care. This is not a sales call and you will not be asked to buy anything either now or later. We would really like to include your opinions in our study and assure you that all of your answers will remain completely confidential. The survey should take only about 7 minutes to complete. Screening Are you a California resident who is 18 years old or older? 1 Yes 2 No [ASK TO SPEAK TO SOMEONE IN HH WHO IS A CALIFORNIA RESIDENT AGE 18 OR OLDER] Hello, this is from Woelfel Research, a national opinion research company. We re conducting a study among California residents about health and long-term care. This is not a sales call and you will not be asked to buy anything either now or later. We would really like to include your opinions in our study and assure you that all of your answers will remain completely confidential. The survey should take only about 7 minutes to complete. 1 CONTINUE 2 REFUSED RECORD GENDER OF RESPONDENT: 48% Male 52 Female Maintaining Health and Long-Term Care: A Survey on Addressing the Revenue Shortfall in California 8

12 What is your age as of your last birthday? [RECORD IN YEARS] 15% Refused Q1. Which of the following best describes California's current funding for health and long-term care services? Do you think.(read LIST. ENTER ONLY ONE RESPONSE.) 6% There is more than enough money in the state budget to meet the need for services and ensure quality? 19 There is enough money in the state budget to meet the need for services and ensure quality? 56 There is not enough money in the state budget to meet the need for services and ensure quality? 19 Don't know <.5 Refused Q2. California currently faces about a $24 billion shortfall in the budget. To help balance the state budget, the state is recommending cuts in spending of about $7.6 billion from programs and services including health care for children and long-term care services for older persons and those with disabilities both in their homes and in nursing homes. How important is it to you for California to maintain current levels of funding for health and long-term care services? 82% Very Important 11 Somewhat Important 2 Not Very Important 2 Not At All Important 3 Don't know <.5 Refused Maintaining Health and Long-Term Care: A Survey on Addressing the Revenue Shortfall in California 9

13 Q3. If a candidate for state office in California supported maintaining the delivery of health and long-term care services even if it means generating additional state revenues, would you be more likely to vote for that candidate, less likely to vote for them, or would it not make any difference? 54% More likely 9 Less likely 26 Would Not Make a Difference 11 Don't know <.5 Refused Q4. California is now considering a number of proposals to help balance the state budget. To maintain current levels of funding for health and long-term care services in California, do you support or oppose..rotate ITEMS AND READ QUESTION FOR EACH ITEM. reinstating California's vehicle license fee from the current average of $64 to the 1999 average of $148 to generate about $4 billion? 15% Strongly Support 16 Somewhat Support 18 Somewhat Oppose 42 Strongly Oppose 9 Don t know <.5 Refused.increasing California's tax on tobacco products such as cigarettes, cigars, and pipe tobacco to generate about $600 million? 59% Strongly Support 12 Somewhat Support 7 Somewhat Oppose 20 Strongly Oppose 2 Don t know <.5 Refused Maintaining Health and Long-Term Care: A Survey on Addressing the Revenue Shortfall in California 10

14 Q4 (CONTINUED). California is now considering a number of proposals to help balance the state budget. To maintain current levels of funding for health and longterm care services in California, do you support or oppose..rotate ITEMS AND READ QUESTION FOR EACH ITEM.. temporarily reinstating California's 10 percent and 11 percent income tax brackets to generate about $3 billion? The 10 percent applies to individuals who have more than $130,000 income or married taxpayers who have more than $260,000 income. The 11 percent applies to individuals who have more than $260,000 income and married taxpayers who have more than $520,000 income. 44% Strongly Support 23 Somewhat Support 8 Somewhat Oppose 15 Strongly Oppose 9 Don t know 1 Refused D1. What is your marital status? Are you currently.. 53% Married, 11 Divorced, 3 Separated, 7 Widowed, 24 Or have you never been married? 2 Living with partner [VOLUNTEERED] <.5 DON T KNOW <.5 REFUSED D2. Are you or your spouse a member of A-A-R-P formerly known as the American Association of Retired Persons? [IF NOT MARRIED ASK, Are you a member ] 17% Yes 82 No <.5 DON T KNOW / NOT SURE <.5 REFUSED Maintaining Health and Long-Term Care: A Survey on Addressing the Revenue Shortfall in California 11

15 D3. Thinking about your state elections for California Governor and Legislators in the last ten years, which of the following best describes your voting behavior? Would you say you always vote, sometimes miss one, rarely vote, or never vote? 42% Always vote 23 Sometimes miss one 9 Rarely vote 24 Never vote <.5 Depends 1 DON T KNOW 1 REFUSED D4. What is the highest level of education you have completed? (READ) 25% Less than high school 20 High school graduate or equivalent 28 Some college or technical training beyond high school 17 College graduate 9 Post-graduate or professional degree? <.5 DON T KNOW 1 REFUSED D5. Which of the following best describes your current employment status? Are you currently. 43% Employed full-time 15 Employed part-time 19 Retired and not working 7 Unemployed and looking for work 6 Homemaker 10 Or something else? [Specify: ] <.5 DON T KNOW 1 REFUSED Maintaining Health and Long-Term Care: A Survey on Addressing the Revenue Shortfall in California 12

16 D6. Are you Hispanic, Spanish, or Latino? 33% Yes 66 No <.5 Don't know (Do Not Read) 1 Refused (Do Not Read) D7. What is your race? 61% White/Caucasian 7 Black/African American 7 Asian 2 Native American or Alaskan Native 22 Other 1 Don't know (Do Not Read) 2 Refused (Do Not Read) D8. Was your annual household income before taxes in 2001 under $100,000 or over $100,000? 81% Under $100, $100,000 or over SKIP TO D10 3 Don't know (Do Not Read) 3 Refused (Do Not Read) D9. Now, for statistical purposes only, please stop me when I get to the category that includes your household s income before taxes in Was it (READ) Weighted Base = 801 with income under $100,000 12% Less than $10, $10,000 but less than $20, $20,000 but less than $30, $30,000 but less than $40, $40,000 but less than $50, $50,000 but less than $75, $75,000 but less than $100,000 7 Don't know (Do Not Read) 2 Refused (Do Not Read) Maintaining Health and Long-Term Care: A Survey on Addressing the Revenue Shortfall in California 13

17 SKIP TO D11 D10. Now, for statistical purposes only, please stop me when I get to the category that includes your household's income before taxes in Was it (READ) Weighted Base = 129 with income $100,000 or higher 33% $100,000 but less than $130, $130,000 but less than $160, $160,000 but less than $190,000 7 $190,000 but less than $260,000 6 $260,000 or more 10 Don't know (Do Not Read) 4 Refused (Do Not Read) D11. What is your 5-digit zip code? Maintaining Health and Long-Term Care: A Survey on Addressing the Revenue Shortfall in California 14

18 AARP Knowledge Management For more information contact Rachelle Cummins (202)