What Kaiser Polling Tells Us

The Kaiser Family Foundation has once again come out with polling on people's perceptions of major health issues, including support for the Affordable Care Act. While polling is just a snapshot of where people are at one given moment (for example, see how support for the ACA has changed over time) it is useful for understanding what concerns people express about their personal healthcare. 

This matters because in our effort to explain the benefits of health reform and the need for further improvements to the health system, progressives need to understand how our solutions address people's concerns. Reforming the health system is still an important and powerful issue to push for, the Kaiser Family Foundation poll shows this, and with its help we can create the vision of a better world to push for. 

Here's what's interesting about this poll:

According to the poll, two of the top three concerns for people depend on their politics:

EVERYONE
1. Making sure that high-cost drugs for chronic conditions are affordable to those who need them
2. Government action to lower prescription drug prices
3. Protecting people from being charged high prices when they visit hospitals covered by their health plan but are seen by a doctor not covered by their plan

DEMOCRATS
1. Making sure that high-cost drugs for chronic conditions are affordable to those who need them
2. Requiring all states to expand their Medicaid program
3. Changing current eligibility rules so that financial help under the health care law to purchase health insurance is available to more people

INDEPENDENTS
1. Making sure that high-cost drugs for chronic conditions are affordable to those who need them
2. Protecting people from being charged high prices when they visit hospitals covered by their health plan but are seen by a doctor not covered by their plan
3. TIE: Making sure health plans have sufficient provider networks AND make prices available to patients.

REPUBLICANS
1. Making sure that high-cost drugs for chronic conditions are affordable to those who need them
2. Repealing the entire health care law
3. Repealing the individual mandate

It is interesting stuff. While as a whole the government drug question ranked high, no subgroup put it in it's top three. And besides the high cost of chronic care drugs, neither Democrat's top issues nor GOP's see independent support of even 50%. It will be important for us to show how our issues address those concerns of transparent prices and adequate networks that people are worried about. The advantage for progressives is that independents are already more open to Medicaid expansion (43%) and improving the eligibility rules for financial help to purchase coverage (44%) than repealing either the individual mandate (37%) or the entire law (37%). So we have a head start but it is important to show how they're connected. 

As far as what the poll says about perceptions of health cost:

  • 64% say it is somewhat challenging or very challenging to find out how much medical procedures cost
  • The insured are more worried about deductibles than premiums or co pays
  • More people think premiums are going up at least a little (46%) compared to those that think premiums are holding steady (37%).
  • More people, however, believe deductibles/co-pays are holding steady (53%) than going up even a little (39%)
  • Very few people think premiums (3%) or deductibles/co-pays (3%) are going down at all.

 

Also, the graphs that show how the insured and uninsured believe they would pay for a $500 or $1,500 medical cost is pretty scary. 

  • Less than half of insured people polled feel like they could pay a $500 medical bill at time of occurrence, and only one out of 4 could pay a $1,500 bill. And that's those with insurance.
  • In fact the same number, one out of four insured are not convinced they could pay for $1,500 bill at all!

 

This is where health concerns begin turning into economic and financial threats. Between 27%-39% of people - both insured and uninsured - are saying they'd have to borrow money, get a payday or bank loan, or put it on the credit card. And that's the case both for a $500 bill or a $1,500 one. This is important to remember because most Silver plans on the marketplace, even with cost sharing tax credits, can feature deductibles that high or higher. That is still a substantial improvement on previous plans before the Affordable Care Act, but it still represents a substantial cost for consumers that can't spent in other areas of the economy.

 

The cost of healthcare is a pressing issue, to be sure, and we've long argued this is an important next step in talking to people about reforming the medical sector. But it is important to remember that people's concerns on healthcare are varied, and that concerns of what hospitals they can use and the cost of prescription drugs are often the lens in which they look at health reform. 

- Kevin.kane@citizenactionwi.org

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