38 Percent A new national survey highlighting the new political realities on health care

Transcription

1 38 Percent A new national survey highlighting the new political realities on health care October 16, 2013

2 Methodology: cell and demographic change This presentation is based on our latest national survey conducted by Greenberg Quinlan Rosner for Democracy Corps and Women s Voices. Women Vote Action Fund. The survey of voters (1150 unweighted) nationwide, including 860 likely 2014 voters, was conducted from October 6-8, Unless otherwise noted, overall margin of error= +/-3.18 percentage points at 95% confidence. New this year, we now reach 50 percent of our respondents by cell phone, in order to account for everchanging demographics and trying to accurately sample the full American electorate. Among voters reached on landline, 100 percent received a named Congressional ballot. Among those reached via cell phone 63 percent received a named Congressional ballot.

3 Key Findings Just 38 percent of voters opposed because the law is too big. While voters divide evenly on the plan (44 percent to 46 percent), 8 percent are opposed because it does not go far enough. Just 38 percent are opposed because it is big government. Exactly the same 38 percent minority believe lawmakers should repeal the healthcare law rather than implement and fix it. By significant margins, voters want lawmakers to implement and fix the law, rather than repeal it. By a 20-point margin, 58 percent to 38 percent, voters say lawmakers should implement and fix the law rather than repeal it. Additionally, intensity favors implementation 38 percent strongly favor implementing the law while 28 percent strongly favor repeal. Strong opposition to the law has dropped a net 10 points since 2010 now at 34 percent. This is a totally different context than 2010, when Democrats paid the price for the ACA and Republicans took control of the House These shifts are driven by movement among key voters and are not political. They are driven by experience. The biggest shifts on favorability since 2010 come from not from partisans but from independents and key groups, including unmarried women, white noncollege-educated voters, and seniors. These are also the groups that are most likely to report that they are seeing the benefits of the law. This is not being driven by partisans aligning their views; this is being driven by relevance of the changes to people s lives.

4 Key Findings, cont d Unmarried women, independents, white non-college voters, and seniors are beginning to see the effects of the ACA. While many still report too early to tell, the percent of unmarried women, independents, baby boomers, white non-college-educated voters, and seniors who say that they are beginning to see the effects of the ACA has doubled since March from 11 percent to 21 percent. By a 17-point margin (49 to 32), voters say they trust Democrats more than Republicans on implementing the Affordable Care Act. The more Republicans make the period ahead about how to stop implementation, the more voters trust Democrats to do a better job in government. Voters see this as a first draft and understand that it will take time to get it right. In focus groups with unmarried women, voters see it as a big change and believe it will take some time to get it to work well but they want it to be implemented so Americans can begin to reap its benefits and make those important changes. Positive information and messaging moves support for the ACA even further. Focusing on the law s protections for consumers and the improved insurance benefits moves voters to a more positive position on the ACA. Messaging and policies on both sides produce a net 11- point shift in the number saying they expect positive benefits with health care reform. The gain is even greater among those who are most likely to be impacted near 20 points for baby boomers and unmarried women, and nearly 30 points for young people.

5 Key Findings, cont d Among all voters, as well as unmarried women and the Rising American Electorate, the biggest concerns are about jobs and premiums going up. However, voters do not see the ACA as the main enemy insurance companies are. Messages and information centered on insurance and insurance companies is the core of the most positive message for the ACA and produce big shifts at the end of the survey. Supporters of the law should want the health care debate--particularly for unmarried women and the RAE, who produce the biggest shifts after hearing information and messages for and against the ACA. A working women s agenda, including health care reform, is empowering for unmarried women. Unmarried women see healthcare as one essential part of broader economic goals for women. Because many unmarried women have to make healthcare choices based on basic household finances, a message connecting healthcare to pocketbook policies for working women is very powerful for this group and aligns closely with how they think about healthcare.

6 Country wants to implement; repeal a minority position 6

7 7 Main choice and intensity favor implementation; only 38 percent want to repeal and replace I'm going to read you a pair of statements. After I read both statements, please tell me which ONE comes closer to your own opinion, even if neither is exactly right. We should implement and fix the health care reform law. We should repeal and replace the health care reform law Implement and fix Repeal and replace

8 8 Two thirds of Rising American Electorate want to see ACA implemented almost half strongly I'm going to read you a pair of statements. After I read both statements, please tell me which ONE comes closer to your own opinion, even if neither is exactly right. We should implement and fix the health care reform law. We should repeal and replace the health care reform law Implement and fix Repeal and replace Implement and fix Repeal and replace Rising American Electorate Unmarried women

9 9 As well as majorities of swing groups I'm going to read you a pair of statements. After I read both statements, please tell me which ONE comes closer to your own opinion, even if neither is exactly right. We should implement and fix the health care reform law. We should repeal and replace the health care reform law Implement Repeal Implement Repeal Implement Repeal Implement Repeal Independents White seniors White non-college Suburban

10 10 Just 38 percent now oppose the healthcare law because it goes too far: combined, 53 percent support the law or want it to go farther Overall, do you favor or oppose the health care reform law that passed in 2010? (IF OPPOSE) Would you say you oppose the health care reform law because it goes too far in changing health insurance, or because it doesn't go far enough in changing health insurance? favor: 53% oppose: 38% Favor Oppose Favor Oppose: not far enough Oppose: law goes too far

11 Jan-10 Feb-10 Mar-10 Apr-10 May-10 Jun-10 Jul-10 Aug-10 Sep-10 Oct-10 Nov-10 Dec-10 Jan-11 Feb-11 Mar-11 Apr-11 May-11 Jun-11 Jul-11 Aug-11 Sep-11 Oct-11 Nov-11 Dec-11 Jan-12 Feb-12 Mar-12 Apr-12 May-12 Jun-12 Jul-12 Aug-12 Sep-12 Oct-12 Nov-12 Dec-12 Jan-13 Feb-13 Mar-13 Apr-13 May-13 Jun-13 Jul-13 Aug-13 Sep-13 And strong opposition down steadily since 2010 Overall, do you favor or oppose the health care reform law that passed in 2010? Favor Oppose Strongly oppose Favor Oppose Strongly Oppose *Note: Question was not asked in March 2011, March 2012, or August November

12 12 Key groups becoming more favorable to ACA since 2010 Net ACA Favorability Among Key Groups Group 2010 Average October 2013 Net shift Likely voters Unmarried women White older women White women Independents White non-college Women Seniors White seniors Unmarried White over age White age

13 Shift in support parallels shift in actually experiencing personal benefits in last six months 13 Now I'm going to read you a few short statements about the health care reform law. After I read all the statements, please tell me which one of these statements comes closest to your experience I am beginning to see benefits in the new health care law March October March October March October March October March October March October March October March October White unmarried women Unmarried women White Older women Baby boomers Age 50+ White noncollege Seniors

14 14 Democrats want this debate: Democrats have an 18-point advantage when the debate is about implementation I am going to read you an issue and I want you to tell me whether, overall, you think the Democrats or the Republicans would do a better job with that issue. If you do not know, just tell me and we'll move on. Democrats much better Republicans much better Democrats Republicans Democrats Republicans Implementing the Affordable Care Act Health care reform

15 15 And Republicans are paying the price in their districts and with their own voters Republicans in Congress have said they will only vote for a budget if that budget defunds or delays or changes the Affordable Care Act or Obamacare. No budget became law, and as you may know, most government operations shut down on October first. Republican (Congressperson s Name) voted to defund Obamacare, producing no budget and the government shutdown. Does this make you more or less likely to vote for (Congressperson s name)? Less likely to vote for Republican incumbent More likely to vote for Republican incumbent Likely Voters in Republican Districts Less likely to vote for Republican incumbent More likely to vote for Republican incumbent Voting for Republican in Republican Districts

16 16 As people hear more positive and negative information, they are significantly more likely to think reform will make things better All in all, do you think the health care reform law will make it better or harder for you, or will it not have much effect? Before information Net change: +11 After information Better Harder Better Harder Likely 2014 Voters

17 17 Biggest shifters All in all, do you think the health care reform law will make it better or harder for you, or will it not have much effect? Democrats (39%) Youth (18%) African- Large metro Americans (22%) (13%) Moms (19%) Unmarried women (23%) RAE (47%) Women (53%) Suburban (18%)

18 But voters still lack information, presume it is a start and want to make fixes 18

19 19 Most voters still looking for information and waiting to see its impact Now I'm going to read you a few short statements about the health care reform law. After I read all the statements, please tell me which one of these statements comes closest to your experience. Beginning to see benefits Making it harder for me Not really seeing how it is helping yet Too early to tell March 2013 October 2013

20 20 In focus groups, lots of uncertainty about how the law will work, what it does It would be great, however, if they could ever decide exactly what it covers and what it doesn t and whether you re canceling their because there s so many questions. And from yesterday to three o clock this morning, it changed again. I m undecided, like really unsure of what it exactly covers and what it doesn t cover because it is constantly changing. It is confusing because there s so much dissention about it that we re just kind of left here, the ones that are affected, we don t really understand.

21 21 Voters presume the law will need to improve, rather than just implement it as-is I'm going to read you a pair of statements. After I read both statements, please tell me which ONE comes closer to your own opinion, even if neither is exactly right. We should implement and fix the health care reform law. We should repeal and replace the health care reform law. +20 We should implement the health care reform law. We should repeal the health care reform law Implement/fix Repeal/replace Implement Repeal

22 22 In focus groups, women quick to see the Affordable Care Act as a first draft It was a work in progress and that I was hopeful about it. And it s kind of like a rough draft. Like there s going to be several changes to it over the next decade. I think they re going to, as it plays out, they re going to make little changes here and there. They re going to revamp it so many times. But I think it s a starting point.

23 Best new benefits of Affordable Care Act 23

24 24 Protections from insurance companies dominate new changes particularly can t drop because sick I'm going to read you some recent changes you may have noticed to health insurance and health care. After I read each one, I want you to tell me whether that will make things better or harder or have no effect for you. Insurance companies cannot charge higher premiums or drop your health coverage if you become sick. No one can be denied health insurance for a pre-existing condition by any insurance company. Insurance companies cannot be able to put lifetime limits on what they will pay for medical care. All new insurance plans must cover preventive health care for women, such as mammograms, screenings for cervical cancer, etc. Insurance companies must justify any rate increase of 10 percent or more to prevent sudden rate increases. All insurance plans provided must provide a standard set of basic medical benefits, such as preventative care. Insurance companies can no longer charge women higher premiums than men. Young people are allowed to stay on their parents health insurance until they are 26 years old. RAE RAE RAE RAE RAE RAE RAE RAE Much better

25 25 Preexisting conditions an important point for unmarried women They can't take into consideration the preexisting conditions, and no lifetime limits. I do like the fact that they cannot take into consideration preexisting conditions. I really do like that. One of the things that I like best about it is no pre-existing condition restrictions. The pre-existing condition thing is a big thing but also hopefully it will take the strain off the health system in general.

26 26 Second tier of benefits, but Medicaid and reproductive care critical for RAE I'm going to read you some recent changes you may have noticed to health insurance and health care. After I read each one, I want you to tell me whether that will make things better or harder or have no effect for you. Many states will expand their Medicaid programs to help lower-income people afford health insurance. Tax credits and health care subsidies will enable people to buy health insurance at a discount. Your health insurance premiums cannot be more than 9.5 percent of your income. All new health plans must offer essential benefits for women, including maternity and reproductive health care. Starting in October 2013, individuals and small businesses will be able to purchase insurance on a state or national health care exchange. No copay will be required for birth control prescriptions. All businesses with over 50 employees must provide health insurance to their workers or the business will be fined. RAE RAE RAE RAE RAE RAE RAE Much better

27 27 Regressions show three categories of driving principles: benefits, expanded access to coverage, and keeping insurance companies in check Drivers of being better off under the Affordable Care Act R2 =.17 Odds Ratio Many states will expand their Medicaid programs to help lower-income people afford health insurance All new health plans must offer essential benefits for women, including maternity and reproductive health care. Insurance companies cannot be able to put lifetime limits on what they will pay for medical care All businesses with over 50 employees must provide health insurance to their workers or the business will be fined. Drivers of being better off under the Affordable Care Act R2 =.20 Starting in October 2013, individuals and small businesses will be able to purchase insurance on a state or national health care exchange. All insurance plans provided must provide a standard set of basic medical benefits, such as preventative care. Insurance companies must justify any rate increase of 10 percent or more to prevent sudden rate increases Odds Ratio Your health insurance premiums cannot be more than 9.5 percent of your income

28 28 People worry about impacts on employment and small businesses Now I'm going to read you a list of concerns some people have about the new health care law - The Affordable Care Act or Obamacare. After I read each one, please tell me whether you are very concerned about this, somewhat concerned, a little concerned, or not at all concerned. Workers will be laid off or forced go part time so that companies don't have to pay for their health insurance. RAE Very concerned Small businesses will go out of business because they won't be able to afford health insurance. RAE Premiums for health insurance will go up. RAE People who already can't afford insurance will have to purchase insurance or will be fined. RAE This is a major expansion of government power, which will increase our deficit and grow the size of government. RAE

29 29 Among married women, concerns about the effect on business I don t know if these small businesses are going to survive having to provide that insurance. And I m worried about jobs being lost or hours being cut because of the fact that, you know, they re having to provide the health insurance. Or people are going to say, Well, OK, you re a 40-hour employee now, but we re going to have to cut you back to 29 hours or something like that to not be a full-time employee. Or just saying, We ve got to reduce our workforce because of having to pay for health insurance. Small business owners who have more than 50 employees are going to say, I know you ve been working 55 hours, but we re taking you down to 34.5 or 29, or whatever it is that they re staying underneath the law. And that s going to affect peoples paychecks.

30 30 Unmarried women concerned about fines hitting those already on the edge You re going to get fined if you don t have insurance. These poor people, they don t have insurance because they can t afford it. I can t afford insurance as it is. It s not going to help me if I get fined and have to pay more money that I can t even afford. I don t like that there s fines for people who can t afford healthcare.

31 31 But remember, that mix of positive and negative information produced big shift to law making things better. All in all, do you think the health care reform law will make it better or harder for you, or will it not have much effect? Before information Net change: +11 After information Better Harder Better Harder Likely 2014 Voters

32 Big messaging around health care reform: Insurance companies will now have to act like insurance companies 32

33 33 Protections from insurance companies, and women s health strong messages combined with reassurance about improving Now I'm going to read you some things people are saying about Obamacare. After I read each one, please tell me whether it makes you much more supportive of Obamacare, somewhat more supportive, a little more supportive, no more supportive, or less supportive of Obamacare. (INSURANCE COMPANIES) The biggest change in this law is that insurance companies actually have to act like insurance companies and provide health coverage when you need it. They can't raise your rates or drop you when you get sick, get older, or have a baby, nor can they charge women more than men or set life-time limits that hurt you take away your coverage when you need it most. Insurance will now give you the peace of mind it should RAE Unm wom (WOMEN'S HEALTH) We have to make sure health care is affordable and good for small business. But the Affordable Care Act is important particularly for women. Women can't be charged more than men. Having a baby is no longer considered a pre-existing condition. All plans must cover preventive health services, mammograms and contraception. This coverage is long overdue and a big deal for women RAE Unm wom

34 34 Protections from insurance companies dropping sick people powerful in groups: that s the point Insurance is supposed to be there for you when you are sick. That s the whole purpose of having insurance. When you re sick and need it. It s the f****** point of health insurance. It d be like getting in a car accident and insurance drops you.

35 35 Unmarried women s strongest response ties health care to broader working women s agenda Now I'm going to read you some things people are saying about Obamacare. After I read each one, please tell me whether it makes you much more supportive of Obamacare, somewhat more supportive, a little more supportive, no more supportive, or less supportive of Obamacare. (WOMEN AGENDA) Working women struggle with pay that doesn't keep up with prices and managing the demands of work and children. We should make sure women get equal pay for equal work, raise the minimum wage, expand child care, make sure working parents can care for kids and finally, make sure they have affordable health insurance. Now, women will be sure of having health insurance and health services they can afford - and that is critical for working women RAE Unm wom (ALL HAVE INSURANCE) Finally, we will be a country where everybody has health insurance and access to the care they need. It was terrible we let the insurance companies call the shots for so long. We created Social Security and Medicare to help seniors. Finally, we are moving to a health care system that can work for everyone RAE Unm wom

36 And let s call it: The Affordable Care Act 36

37 37 Affordable Care Act more favorable terminology Now, I'd like to rate your feelings toward some people and organizations, with one hundred meaning a VERY WARM, FAVORABLE feeling; zero meaning a VERY COLD, UNFAVORABLE feeling; and fifty meaning not particularly warm or cold. Very warm (75-100) Very cool (0-25) Mean: 42.1 Net: -10 Mean: 44.0 Net: -8 Mean: 45.2 Net: The new health care reform law Obamacare The Affordable Care Act

38 38 Obamacare more favorable among minorities Now, I'd like to rate your feelings toward some people and organizations, with one hundred meaning a VERY WARM, FAVORABLE feeling; zero meaning a VERY COLD, UNFAVORABLE feeling; and fifty meaning not particularly warm or cold. Very warm (75-100) Very cool (0-25) African Americans Hispanics Unmarried women Mean: 79.2 Mean: 66.9 Mean: 51.7 Mean: 45.5 Mean: 59.9 Mean: 57.4 Net: +67 Net: +41 Net: +19 Net: -8 Net: +16 Net: Obamacare The Affordable Care Act Obamacare The Affordable Care Act Obamacare The Affordable Care Act

39 39 But Affordable Care Act does dramatically better among youth, swing groups Now, I'd like to rate your feelings toward some people and organizations, with one hundred meaning a VERY WARM, FAVORABLE feeling; zero meaning a VERY COLD, UNFAVORABLE feeling; and fifty meaning not particularly warm or cold. Very warm (75-100) Very cool (0-25) White non-college Millennials Suburban Mean: 33.1 Mean: 41.9 Mean: 47.3 Mean: 50.3 Mean: 43.1 Mean: 44.2 Net: -37 Net: -14 Net: -4 Net: +4 Net: -4 Net: Obamacare The Affordable Care Act Obamacare The Affordable Care Act Obamacare The Affordable Care Act

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