NATIONAL: COST DRIVES OPINION ON HEALTH CARE

Please attribute this information to: Monmouth University Poll West Long Branch, NJ 07764 www.monmouth.edu/polling Follow on Twitter: @MonmouthPoll Released: Tuesday, 7, Contact: PATRICK MURRAY 732-979-6769 (cell); 732-263-5858 (office) pdmurray@monmouth.edu Follow on Twitter: @PollsterPatrick NATIONAL: COST DRIVES OPINION ON HEALTH CARE Public divided on how changes to ACA would affect pocketbook West Long Branch, NJ A national Monmouth University Poll conducted right before Congressional Republicans unveiled their health care plan this week found that 1-in-3 Americans believe any such reform would drive up their costs compared with 1-in-5 who anticipate their costs going down. Most Americans prefer to keep the Affordable Care Act in place with improvements, while still retaining the ACA s individual mandate. The bottom line for most Americans will be how any changes to the ACA will impact their own health care costs. Before House Republicans revealed their new health care legislation, most Americans (5) said they would prefer to keep the Affordable Care Act and work to improve it, with another saying they want to keep the ACA entirely intact. Just 4-in-10 want to see the ACA repealed, either with a replacement put in place (3) or repealed entirely without a replacement (). The poll finds majority support for retaining the ACA regardless of how individuals get health care coverage such as through an employer (5 prefer to keep the law), a privately purchased plan (5), or publicly funded coverage (6). There may be a pitched battle over the Republican plan since it is not clear how similar or different it may be from the ACA. Two-thirds (6) of those who want to repeal Barack Obama s signature policy say it is very important to them that Congress follow through on this GOP promise. On the other hand, a similar 6 of those who want to keep the law say it is very important to them that the ACA remains basically intact. People on opposite sides of this issue are strongly attached to their position on the ACA. Early reviews of the Republican draft plan suggest that it might not do enough to either retain or repeal it, which may leave all sides disappointed, said Patrick Murray, director of the independent Monmouth University Polling Institute in West Long Branch, New Jersey. 1

Monmouth University Polling Institute 03/07/17 Before details of the GOP plan emerged, one-third (3) of the public suspected that a repeal and replace effort would cause their own health care costs to go up, expected their costs would go down, and 3 expected no change to their costs. Those with private insurance (3) or with no coverage at all (3) are slightly more likely than those with employer-provided plans () and public coverage () to anticipate cost savings from any repeal and replace effort. The poll also found that the vast majority of Americans (8) support offering tax credits to help low and moderate income families purchase private insurance, while the Republican proposal seems to have shifted to an age-based rather than an income-based credit. Additionally, a majority (5) also support a mandate requiring that every person carries health insurance, which is an ACA provision that the new legislation eliminates. It looks like the new Republican bill is a mixed bag in terms of the public s expectations for what worked with the ACA. Ultimately, most Americans will judge this plan in terms of its anticipated impact on their own household budgets, said Murray. Just over half (5) of Americans report that their health care costs have gone up in the past two years including who say they have gone up a lot and who say they have gone up somewhat. Another 4 say their costs have not changed and just report their health care costs have gone down. More than two-thirds (6) of those with private insurance report their costs have gone up in the past two years. This compares with 5 of those with employer-provided plans and 3 of those with publicly funded coverage, such as Medicare, Medicaid or military plans, who say the same. One-third (3) of Americans blame the Affordable Care Act for contributing to the rise in their families health care costs. Another say that the ACA actually helped lower their own costs and 4 say the ACA did not have an impact on their own health care costs either way. Among those who purchase insurance in the private market including through ACA exchanges 4 say their health care costs have gone up because of the ACA, say they have gone down and 2 say their costs have remained the same. A January Monmouth University Poll found that health care costs had jumped to the top spot among day-to-day issues that concern American families which in turn spurred this deeper dive into the topic. Nearly half of Americans (4) say it is difficult for them to pay health care deductibles and other out-of-pocket expenses compared with 4 who say this is easy for them. The public is divided on the ease of paying health insurance premiums 4 say this is difficult for them and 4 say it is easy. Paying for health care is a lot more problematic for American families than paying for other household expenses such as grocery bills (3 say this is difficult and 6 say this is easy) and mortgage or rent payments (3 difficult and 4 easy). Paying for health care is even more difficult than paying tax bills (4 say paying taxes is difficult and 4 say this is easy for them). 2

Monmouth University Polling Institute 03/07/17 Among those who get insurance through an employer representing about half of the country about 4-in-10 say meeting their health care costs is difficult (3 for premiums and 4 for out-ofpocket expenses). Among those who purchase private insurance about one-tenth of Americans the majority say they have difficulty meeting those costs (6 for premiums and 6 for out-of-pocket expenses). Monmouth is committed to looking beyond the political headlines to examine how these policies affect people where they live, said Murray, adding, Satisfaction levels can prove to be more predictive than typical political metrics like presidential job ratings and favorability. If people are struggling, they will look for change. One-in-five () Americans report that there has been a time in the past two years when they had to choose between paying for health care or other household expenses like rent or mortgage, including 3 with private insurance plans, with employer plans, with public plans, and nearly half (4) of those with no insurance coverage at all. Furthermore, 3-in-10 (3) Americans report that someone in their household did not go for needed care in the past two years because of the expense involved including 4 of those with private plans, with employer plans, with public plans, and fully 6 of those without insurance. Earlier this year, we found that paying for health care is the top issue of families across the country, surpassing jobs and other expenses as the concern most likely to keep Americans up at night. Whether the public feel that their own costs are under control will be a much more telling metric than whether they support or oppose any particular provision in the new health care bill, said Murray. The Monmouth University Poll was conducted by telephone from 2 to 5, with 801 adults in the United States. The results in this release have a margin of error of +/- 3.5 percent. The poll was conducted by the Monmouth University Polling Institute in West Long Branch, NJ. 3

Monmouth University Polling Institute 03/07/17 QUESTIONS AND RESULTS (* Some columns may not add to 10 due to rounding.) [Q1-15 previously released.] [Q16-23 held for future release.] w I d like to ask you about some concerns closer to home. I m going to read you some typical household expenses. For each, please tell me if it is very easy, somewhat easy, somewhat difficult, or very difficult for you to pay for it? If you do not have this expense, just let me know. [QUESTIONS 24-28 WERE ROTATED] 24. Mortgage or rent payment 1 (VOL) Don t know 25. Grocery bills 3 (VOL) Don t know 26. Health insurance premiums (VOL) Don t know 27. Health care deductibles and out of pocket expenses 2 (VOL) Don t know 4

Monmouth University Polling Institute 03/07/17 28. Paying taxes 2 (VOL) Don t know 29. Have your health care costs gone up, gone down, or stayed about the same over the past two years? [If GONE UP: Have they gone up by a lot or somewhat?] Gone up a lot Gone up somewhat Gone down Stayed about the same 4 (VOL) Don t know 30. Has there been a time over the past two years that you had to choose between paying for health insurance or medical care and paying for things like rent or mortgage, or has this not happened?, has happened has not happened 7 (VOL) Don t know 31. In the past two years, have you or anyone in your household not gone for needed health care because you felt you could not afford it, or has this not happened?, has happened 3 has not happened 6 (VOL) Don t know 32. Do you feel the Affordable Care Act of 2010, which is sometimes called Obamacare, has had an impact on your family s health care costs, or has it not really had an impact? [If YES: Has it made your own costs go up or go down?], made costs go up 3, made costs go down t really had an impact 4 (VOL) Don t know 5

Monmouth University Polling Institute 03/07/17 33. What would you like to see Congress do when it comes to the Affordable Care Act They should keep the law as it is. They should keep the law in place and work to improve it. They should repeal the law and replace it with an alternative. They should repeal the law and not replace it? [CHOICES WERE ROTATED] Keep law as it is Keep law and work to improve it 5 Repeal law and replace it 3 Repeal law and NOT replace (VOL) Don t know 34. [BASED ON RESPONSE TO Q33:] How important is it to you that the current health care law [is/is not] repealed very important, somewhat important, or not too important? Very important 6 Somewhat important t too important (VOL) Don t know (VOL) opinion on ACA 35. If the Affordable Care Act was repealed and replaced by Congress, do you think your own health care costs would go up, go down, or stay about the same? Go up 3 Go down Stay the same 3 (VOL) Depends (VOL) Don t know 36. If the Affordable Care Act was repealed and replaced by Congress, do you think you would have more choice, less choice, or about the same amount of choice in deciding how you get health care? More choice 2 Less choice About the same amount of choice 4 (VOL) Depends (VOL) Don t know 37. Do you support or oppose requiring everyone to carry health insurance? Support 5 Oppose 4 (VOL) Don t know 6

Monmouth University Polling Institute 03/07/17 38. Do you support or oppose providing tax credits to help low and moderate income families purchase health insurance if they cannot get coverage through their jobs? Support 8 Oppose (VOL) Don t know [Q39-53 held for future release.] METHODOLOGY The Monmouth University Poll was sponsored and conducted by the Monmouth University Polling Institute from 2 to 5, with a national random sample of 801 adults age 18 and older, in English. This includes 401 contacted by a live interviewer on a landline telephone and 400 contacted by a live interviewer on a cell phone. Telephone numbers were selected through random digit dialing and landline respondents were selected with a modified Troldahl-Carter youngest adult household screen. Monmouth is responsible for all aspects of the survey design, data weighting and analysis. Final sample is weighted for region, age, education, gender and race based on US Census information. Data collection support provided by Braun Research (field) and SSI (RDD sample). For results based on this sample, one can say with 9 confidence that the error attributable to sampling has a maximum margin of plus or minus 3.5 percentage points (unadjusted for sample design). Sampling error can be larger for subgroups (see table below). In addition to sampling error, one should bear in mind that question wording and practical difficulties in conducting surveys can introduce error or bias into the findings of opinion polls. DEMOGRAPHICS (weighted) Self-Reported Republican 4 Independent 3 ocrat 4 Male 5 Female 3 18-34 3 35-54 3 55+ 6 White 1 Black Hispanic Asian/Other Health Insurance 4 Through employer 1 Private plan Public coverage Through parents, other 1 insurance 7

Monmouth University Polling Institute 03/07/17 MARGIN OF ERROR unweighted sample moe (+/-) 801 3. INSURANCE 422 4. COVERAGE Private 80 11. Public 202 6. 54 13. REGISTERED VOTER 722 3. SELF-REPORTED 79 11. Republican 199 7. Independent 340 5. ocrat 246 6. IDEOLOGY Liberal 190 7. Moderate 327 5. Conservative 262 6. Male 408 4. Female 393 5. AGE 18-34 199 7. 35-54 251 6. 55+ 347 5. White non- Hispanic 583 4. Other 191 7. UATE degree 390 5. 4 year degree 401 4. 252 6. $50 to <100K 245 6. 248 6. 2016 VOTE BY 270 6. Swing 180 7. Clinton 351 5. 8

24/C1A. Easy or difficult to pay for: Mortgage or rent payment 1 3 1 1 3 3 3 1 2 3 2 24/C1A. Easy or difficult to pay for: Mortgage or rent payment 1 3 2 2 2 2 2 3 1 1 2 1 3 24/C1A. Easy or difficult to pay for: Mortgage or rent payment degree 4 yr degree 3 1 1 3 3 1 1 24/C1A. Easy or difficult to pay for: Mortgage or rent payment Swing 1 Clinton 1 Page 1

25/C1B. Easy or difficult to pay for: Grocery bills 3 3 3 2 3 3 1 3 3 3 3 3 3 3 3 25/C1B. Easy or difficult to pay for: Grocery bills 2 3 2 3 4 3 3 2 2 3 2 3 3 3 3 3 2 25/C1B. Easy or difficult to pay for: Grocery bills 3 3 3 3 1 degree 4 yr degree 3 3 4 3 2 4 2 4 3 1 3 3 1 25/C1B. Easy or difficult to pay for: Grocery bills Swing 3 2 Clinton 3 Page 2

26/C1C. Easy or difficult to pay for: Health insurance premiums 2 3 4 3 2 1 2 1 1 2 26/C1C. Easy or difficult to pay for: Health insurance premiums 2 2 2 2 2 2 3 2 2 1 26/C1C. Easy or difficult to pay for: Health insurance premiums 2 1 degree 4 yr degree 3 2 1 3 2 3 3 2 1 26/C1C. Easy or difficult to pay for: Health insurance premiums Swing Clinton Page 3

27/C1D. Easy or difficult to pay for: Health care deductibles and out of pocket expenses 2 3 2 1 3 2 3 1 27/C1D. Easy or difficult to pay for: Health care deductibles and out of pocket expenses 1 3 2 2 2 2 3 27/C1D. Easy or difficult to pay for: Health care deductibles and out of pocket expenses 1 degree 4 yr degree 1 1 2 3 1 3 2 3 27/C1D. Easy or difficult to pay for: Health care deductibles and out of pocket expenses Swing 1 Clinton Page 4

28/C1E. Easy or difficult to pay for: Paying taxes 2 3 3 3 2 2 2 3 2 3 1 28/C1E. Easy or difficult to pay for: Paying taxes 3 1 2 3 2 3 1 1 2 3 2 1 1 1 1 1 28/C1E. Easy or difficult to pay for: Paying taxes 2 1 degree 4 yr degree 2 3 1 3 3 1 2 3 1 1 28/C1E. Easy or difficult to pay for: Paying taxes Swing 1 1 Clinton Page 5

29/C2. Have your health care costs gone up, gone down, or stayed about the same over the past two years? IF "GONE UP" ASK: Have they gone up by a lot or somewhat? Gone up a lot Gone up somewhat Gone down Stayed about the same 4 2 3 3 4 5 4 1 3 1 2 4 4 3 3 2 3 3 29/C2. Have your health care costs gone up, gone down, or stayed about the same over the past two years? IF "GONE UP" ASK: Have they gone up by a lot or somewhat? Gone up a lot Gone up somewhat Gone down Stayed about the same 5 2 3 2 2 4 4 3 2 3 2 2 4 4 4 3 4 29/C2. Have your health care costs gone up, gone down, or stayed about the same over the past two years? IF "GONE UP" ASK: Have they gone up by a lot or somewhat? Gone up a lot Gone up somewhat Gone down Stayed about the same 2 3 4 degree 4 yr degree 2 2 4 3 4 3 3 3 3 3 3 29/C2. Have your health care costs gone up, gone down, or stayed about the same over the past two years? IF "GONE UP" ASK: Have they gone up by a lot or somewhat? Gone up a lot Gone up somewhat Gone down Stayed about the same Swing 4 Clinton 4 Page 6

30/C3. Has there been a time over the past two years that you had to choose between paying for health insurance or medical care and paying for things like rent or mortgage, or has this not happened?, has happened, has not happened (VOL) Dont know _ Refused 7 8 3 6 8 4 5 3 8 6 8 7 30/C3. Has there been a time over the past two years that you had to choose between paying for health insurance or medical care and paying for things like rent or mortgage, or has this not happened?, has happened, has not happened (VOL) Dont know _ Refused 8 8 7 7 1 7 7 7 7 9 30/C3. Has there been a time over the past two years that you had to choose between paying for health insurance or medical care and paying for things like rent or mortgage, or has this not happened?, has happened, has not happened (VOL) Dont know _ Refused 3 8 6 degree 4 yr degree 7 8 3 6 8 9 8 30/C3. Has there been a time over the past two years that you had to choose between paying for health insurance or medical care and paying for things like rent or mortgage, or has this not happened?, has happened, has not happened (VOL) Dont know _ Refused Swing 8 Clinton 7 Page 7

31/C4. In the past two years, have you or anyone in your household not gone for needed health care because you felt you could not afford it, or has this not happened?, has happened, has not happened 3 6 7 4 6 7 6 3 4 7 5 3 7 6 31/C4. In the past two years, have you or anyone in your household not gone for needed health care because you felt you could not afford it, or has this not happened?, has happened, has not happened 7 3 3 7 6 6 3 3 3 2 7 6 6 6 7 31/C4. In the past two years, have you or anyone in your household not gone for needed health care because you felt you could not afford it, or has this not happened?, has happened, has not happened 3 7 6 degree 4 yr degree 3 6 7 3 6 3 6 8 3 6 31/C4. In the past two years, have you or anyone in your household not gone for needed health care because you felt you could not afford it, or has this not happened?, has happened, has not happened Swing 3 6 Clinton 7 Page 8

32/C5. Do you feel the Affordable Care Act of 2010, which is sometimes called Obamacare, has had an impact on your familys health care costs, or has it not really had an impact? IF "YES" ASK: Has it made your own costs go up or go down?, made costs go up, made costs go down t really had an impact 3 4 3 5 4 2 2 5 4 4 3 3 1 4 4 5 3 1 3 4 32/C5. Do you feel the Affordable Care Act of 2010, which is sometimes called Obamacare, has had an impact on your familys health care costs, or has it not really had an impact? IF "YES" ASK: Has it made your own costs go up or go down?, made costs go up, made costs go down t really had an impact 2 5 3 5 5 4 4 4 3 3 4 3 2 1 4 4 4 4 5 32/C5. Do you feel the Affordable Care Act of 2010, which is sometimes called Obamacare, has had an impact on your familys health care costs, or has it not really had an impact? IF "YES" ASK: Has it made your own costs go up or go down?, made costs go up, made costs go down t really had an impact 4 2 4 4 degree 4 yr degree 3 3 1 4 4 3 4 4 1 4 4 4 4 4 32/C5. Do you feel the Affordable Care Act of 2010, which is sometimes called Obamacare, has had an impact on your familys health care costs, or has it not really had an impact? IF "YES" ASK: Has it made your own costs go up or go down?, made costs go up, made costs go down t really had an impact Swing 3 1 4 Clinton 3 4 Page 9

33/C6. What would you like to see Congress do when it comes to the Affordable Care Act? READ LIST They should keep the law as it is. They should keep the law in place and work to improve it. They should repeal the law and replace it with an alternative. They should repeal the law and not replace it. 5 3 5 3 5 3 1 5 2 3 4 5 3 5 1 5 5 3 33/C6. What would you like to see Congress do when it comes to the Affordable Care Act? READ LIST They should keep the law as it is. They should keep the law in place and work to improve it. They should repeal the law and replace it with an alternative. They should repeal the law and not replace it. 7 8 5 2 2 5 1 4 3 5 2 5 1 4 3 4 3 degree 4 yr degree 33/C6. What would you like to see Congress do when it comes to the Affordable Care Act? READ LIST They should keep the law as it is. They should keep the law in place and work to improve it. They should repeal the law and replace it with an alternative. They should repeal the law and not replace it. 4 3 6 4 3 5 3 5 4 3 4 3 1 Page 10

33/C6. What would you like to see Congress do when it comes to the Affordable Care Act? READ LIST They should keep the law as it is. They should keep the law in place and work to improve it. They should repeal the law and replace it with an alternative. They should repeal the law and not replace it. Swing Clinton 4 5 5 3 2 2 1 34/C7. How important is it to you that the current health care law [is not/is] repealed? Very important Somewhat important t too important 6 6 6 1 5 6 6 4 5 5 2 [VOL] Dont know\ref opinion on ACA [C6] 34/C7. How important is it to you that the current health care law [is not/is] repealed? Very important Somewhat important t too important 6 7 1 5 6 6 6 5 6 6 [VOL] Dont know\ref opinion on ACA [C6] degree 4 yr degree 34/C7. How important is it to you that the current health care law [is not/is] repealed? Very important Somewhat important t too important 6 5 5 6 5 2 6 6 1 6 [VOL] Dont know\ref opinion on ACA [C6] Page 11

34/C7. How important is it to you that the current health care law [is not/is] repealed? Very important Somewhat important t too important [VOL] Dont know\ref opinion on ACA [C6] Swing Clinton 5 6 1 35/C8. If the Affordable Care Act was repealed and replaced by Congress, do you think your own health care costs would go up, go down, or stay about the same? Go up Go down Stay about the same (VOL) Depends 3 3 3 4 3 3 3 2 4 3 3 3 3 3 3 1 3 3 4 3 35/C8. If the Affordable Care Act was repealed and replaced by Congress, do you think your own health care costs would go up, go down, or stay about the same? Go up Go down Stay about the same (VOL) Depends 5 3 5 3 3 3 4 3 3 3 3 3 3 3 3 3 3 4 35/C8. If the Affordable Care Act was repealed and replaced by Congress, do you think your own health care costs would go up, go down, or stay about the same? Go up Go down Stay about the same (VOL) Depends 4 4 3 degree 4 yr degree 3 3 2 3 4 3 3 3 3 4 4 Page 12

35/C8. If the Affordable Care Act was repealed and replaced by Congress, do you think your own health care costs would go up, go down, or stay about the same? Go up Go down Stay about the same (VOL) Depends Swing Clinton 3 3 3 3 36/C9. If the Affordable Care Act was repealed and replaced by Congress, do you think you would have more choice, less choice, or about the same amount of choice in deciding how you get health care? More choice Less choice About the same amount of choice (VOL) Depends 2 4 2 4 3 2 3 4 3 3 2 4 3 1 4 4 4 36/C9. If the Affordable Care Act was repealed and replaced by Congress, do you think you would have more choice, less choice, or about the same amount of choice in deciding how you get health care? More choice Less choice About the same amount of choice (VOL) Depends 1 3 4 1 4 4 4 4 4 3 2 3 3 2 4 4 4 4 4 36/C9. If the Affordable Care Act was repealed and replaced by Congress, do you think you would have more choice, less choice, or about the same amount of choice in deciding how you get health care? More choice Less choice About the same amount of choice (VOL) Depends 3 3 4 3 degree 4 yr degree 4 4 4 3 2 4 5 Page 13

36/C9. If the Affordable Care Act was repealed and replaced by Congress, do you think you would have more choice, less choice, or about the same amount of choice in deciding how you get health care? More choice Less choice About the same amount of choice (VOL) Depends Swing Clinton 3 4 4 4 37/C10. Do you support or oppose requiring everyone to carry health insurance? Support Oppose 5 4 5 4 5 5 4 3 6 5 4 4 4 3 4 5 4 37/C10. Do you support or oppose requiring everyone to carry health insurance? Support Oppose 7 7 5 4 4 5 5 5 5 5 5 4 3 4 4 4 37/C10. Do you support or oppose requiring everyone to carry health insurance? Support Oppose 4 6 4 3 degree 4 yr degree 5 5 4 4 5 4 4 5 5 3 4 5 37/C10. Do you support or oppose requiring everyone to carry health insurance? Support Oppose Swing 4 4 Clinton 6 3 Page 14

38/C11. Do you support or oppose providing tax credits to help low and moderate income families purchase health insurance if they cannot get coverage through their jobs? Support Oppose 8 8 1 7 8 2 7 8 8 8 8 1 38/C11. Do you support or oppose providing tax credits to help low and moderate income families purchase health insurance if they cannot get coverage through their jobs? Support Oppose 8 1 8 8 8 1 8 8 8 8 8 1 38/C11. Do you support or oppose providing tax credits to help low and moderate income families purchase health insurance if they cannot get coverage through their jobs? Support Oppose 8 8 1 degree 4 yr degree 8 8 8 8 8 8 38/C11. Do you support or oppose providing tax credits to help low and moderate income families purchase health insurance if they cannot get coverage through their jobs? Support Oppose Swing 8 Clinton 8 Page 15