KFF Health Tracking Poll February 2024: Voters on Two Key Health Care Issues: Affordability and ACA

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Key Takeaways

  • Inflation and well being care affordability proceed to be the highest problems citizens need the 2024 presidential applicants to discuss at the marketing campaign path, and whilst nationwide information has not too long ago emphasized an making improvements to nationwide financial system along expanded client spending, maximum citizens (67%) price the nationwide financial system as “now not so excellent” or “deficient.” Electorate’ evaluation of the financial system is in large part influenced by way of their perceptions of their very own prices, as majorities describe the financial system negatively because of the price of on a regular basis bills (64%), inflation (63%), the price of housing (57%), or the price of well being care (48%). About part of all citizens say the financial system is “now not so excellent” or “deficient” because of the state of the federal funds deficit and nationwide debt (52%), and few say monetary signs such because the unemployment price (24%) or the state of the inventory marketplace (20%) issue into their evaluation in a big means.
  • Surprising scientific expenses and well being care prices most sensible the listing of bills that adults, irrespective of partisanship, say they concern about affording, with 3 in 4 adults announcing they’re “very” or “moderately fearful” about having the ability to have enough money sudden scientific expenses (74%) or the price of well being care products and services (73%) for themselves and their circle of relatives. Simply over part (55%) document being concerned about having the ability to have enough money prescription drug prices, and about part of insured adults (48%) say they’re fearful about having the ability to have enough money their per thirty days medical health insurance top rate.
  • Electorate are divided alongside celebration strains over which candidate they suspect has the easier option to the way forward for the Inexpensive Care Act, with partisans overwhelmingly opting for their celebration’s candidate. 9 in ten Democratic citizens (90%) say Biden has the easier way and 9 in ten Republican citizens (91%) say Trump does. Despite the fact that the majority of Republicans say Trump has a greater option to the ACA, few (30%) Republican citizens assume Trump has a well being care plan to interchange it. On the identical time, lots of the public does now not affiliate President Biden with taking part in a big function within the passage of the ACA, which was once signed into regulation when he was once Vice President. One in 5 (21%) say he had a big function within the regulation’s passage, together with a bigger proportion of Democrats ages 50 and older (42%).
  • The Inexpensive Care Act remains to be extra common than it was once previous to Republican makes an attempt to repeal it in 2017, with six in ten (59%) expressing a good view, although partisans are divided on what they need to see completed with the regulation. About 3 in 4 Democrats need the following Presidential Management and Congress to enlarge what the regulation does (77%), whilst about two-thirds of Republicans both need the regulation to be scaled again (23%) or repealed fully (39%). A majority of independents need the regulation to be expanded (48%) or saved as is (18%).
  • Probably the most persistently common provisions of the Inexpensive Care Act is its protections for other folks with pre-existing stipulations. Maximum adults throughout partisans say it is important to that the sides of the regulation that save you medical health insurance corporations from denying protection because of any individual’s scientific historical past (67%) and that save you medical health insurance corporations from charging in poor health other folks upper premiums (65%) stay regulation. Alternatively, few – between 3 and 4 in ten for each and every side – are conscious that those are provisions of the ACA.
  • Wisdom a few of the public is low in regards to the Inexpensive Care Act’s affect on decreasing the velocity of uninsured within the U.S. and the all-time high rate of enrollees all the way through the hot open enrollment duration. One-third (35%) of adults – emerging to about part (48%) of Democrats – appropriately say that because the ACA was once handed in 2010, the uninsured price within the U.S. has reduced. A identical proportion (34%) appropriately say that extra other folks signed up on this enrollment duration than previously.

Well being Care Affordability as a Balloting Factor

Electorate need to Listen from Applicants on Inflation, The Affordability of Well being Care and The Long run of Executive Well being Care Systems

Heading into the election, the problems that citizens are maximum to listen to applicants discuss are associated with the financial system and well being care prices. No less than 8 in ten citizens say it’s “crucial” for the 2024 presidential applicants to discuss inflation (83%) and the affordability of well being care (85%) – fairly unchanged from November 2023. Following inflation and well being care affordability, about seven in ten citizens say it’s “crucial” to listen to presidential applicants discuss the way forward for Medicare (73%), the way forward for democracy (72%), and immigration (69%).

The way forward for the Inexpensive Care Act, a topic that was once once a key health care issue for Republican citizens, is ranked as a “crucial” factor for better stocks of Democratic citizens (71%) than Republican citizens (36%). In December 2023, former President Donald Trump reignited the problem by way of announcing that he plans to replace the 2010 well being care regulation. Alternatively, identical minorities of Republicans now and before these statements say the problem is “crucial” to them.

With inflation and well being care affordability final a few of the maximum vital problems citizens need to listen the presidential applicants discuss heading into the 2024 election, two-thirds of citizens (67%) describe the nationwide financial system as both “now not so excellent” or “deficient.” Republican citizens are greater than two times as most probably as Democrats to price the financial system negatively (88% v. 37%) and 7 in ten unbiased citizens (72%) price the financial system negatively.

Huge stocks of citizens who price the financial system negatively cite value problems, together with well being care prices, as a big reason why for doing so. A majority of citizens price the financial system negatively and say a “main reason why” for doing so is the price of on a regular basis bills (64%), inflation (63%), or the price of housing (57%). About part of citizens describe the financial system as “now not so excellent” or “deficient” and say the state of the federal funds deficit and nationwide debt (52%) or well being care prices (48%) are a “main reason why” for his or her unfavorable perspectives. A long way fewer citizens cite signs such because the unemployment price (24%) or the state of the inventory marketplace (20%) as a “main reason why” they price the financial system negatively.

Amongst those that price the financial system negatively, Democratic citizens are much more likely than Republican citizens to quote the price of well being care and the velocity of unemployment as “main reason why” for doing so, whilst Republican citizens are much more likely to quote the state of the federal funds deficit and nationwide debt.

Well being Care Bills Most sensible Record of Monetary Worries

Along citizens’ overwhelmingly unfavorable perspectives of the financial system, massive stocks of the general public say they concern about having the ability to have enough money elementary dwelling bills with well being care value issues topping the listing. About 3 in 4 adults say they’re both “very” or “moderately fearful” about having the ability to have enough money sudden scientific expenses (74%) or the price of well being care products and services (73%) for themselves and their households. Simply over part of adults (55%) say they’re “very fearful” about having the ability to have enough money prescription drug prices, and about part of insured adults say they’re “very” or “moderately fearful” about having the ability to have enough money their per thirty days medical health insurance top rate (48%).

Past well being care value issues, a majority of the general public experiences being concerned about having the ability to have enough money fuel or different transportation prices (65%), their per thirty days utilities like electrical energy and warmth (64%), meals (62%), paying down debt (61%), or their hire or loan (58%). About 4 in ten folks (43%) say they’re fearful about having the ability to have enough money kid handle themselves and their circle of relatives.

Surprising scientific expenses and the price of well being care products and services are the highest monetary worries throughout partisans. No less than seven in ten Democrats and Republicans say they’re “very” or “moderately fearful” about having the ability to have enough money the price of well being care products and services (72% and 75%, respectively) or sudden scientific expenses (71% and 78%, respectively) for themselves and their circle of relatives.

Biden vs. Trump on Addressing Prime Well being Care Prices

With well being care affordability topping the listing of problems citizens need to listen about and main the listing of monetary worries, the most recent KFF Monitoring Ballot suggests neither President Biden nor former President Trump has a transparent merit in this factor, however Republicans give Trump upper marks in this factor than Democrats give Biden.

Reflecting the present dynamic of the 2024 election total, citizens are divided alongside partisan strains on which candidate did extra after they had been president to deal with well being care prices. Maximum Democrats (90%) say Biden has completed extra to deal with well being care prices and maximum Republicans (91%) say Trump did extra all the way through his time as president. Independents are break up, with identical stocks announcing each and every did extra to deal with well being care prices.

Whilst partisans say their celebration’s candidate did extra to deal with well being care prices, Trump receives upper ranges of pride at the factor from citizens total and Republican citizens than Biden does from citizens total and Democratic citizens. One in seven (14%) citizens total say Biden has completed greater than Trump and has completed sufficient to deal with well being care prices, whilst one in 4 (26%) say Trump has completed greater than Biden and that he did sufficient in this factor. A majority of citizens say neither president did sufficient, together with about one in 3 who say President Biden did greater than Trump however now not sufficient (36%) and about one in 5 who say former President Trump did greater than Biden however now not sufficient (22%). Trump is also reaping the advantages of the retrospective perspectives of citizens, while complaint of Biden is also extra reflective of citizens’ basic dissatisfaction with the present state of the nationwide financial system.

This additionally holds true when inspecting partisan attitudes, with Democratic citizens being much less happy with Biden’s efficiency than Republican citizens are with Trump on well being care prices: About one in 3 (33%) Democratic citizens say Biden has completed sufficient to deal with well being care prices whilst six in ten (59%) Republican citizens say Trump has completed sufficient. Few unbiased citizens are happy with both candidate’s addressing of well being care prices, as one in ten (9%) say President Biden has completed sufficient and 14% say former President Trump has completed sufficient. That is in-line with Democrats’ total loss of enthusiasm of President Biden and powerful beef up for Trump amongst Republicans as each and every celebration’s respective presidential candidate right now.

Possibly reflecting more youthful citizens’ total decrease enthusiasm for President Biden, one in 4 (24%) more youthful Democratic citizens say Biden has completed sufficient with regards to addressing well being care prices, in comparison to 4 in ten (40%) Democratic citizens ages 50 and older who say the similar.

Republican citizens, alternatively, by way of age are aligned, with identical stocks throughout age teams announcing Trump has completed sufficient to deal with well being care prices. Trump is also reaping the advantages of the retrospective perspectives of a in large part Republican base, while Democrats’ evaluations of President Biden might replicate citizens’ basic dissatisfaction with the present state of the financial system.

The Inexpensive Care Act as a Balloting Factor

In November of remaining 12 months, former President Trump reignited the dialog of changing the Inexpensive Care Act if elected president, a topic that was once once a key health care issue for Republicans. As soon as a extra contentious factor, the well being care regulation enacted beneath the Obama Management in 2010 has persistently garnered more support than opposition since 2018.

Alternatively, perspectives of the Inexpensive Care Act stay partisan with just about 9 in ten (87%) Democrats and about part (55%) of independents conserving sure perspectives of the regulation whilst two-thirds (67%) of Republicans view the regulation unfavorably. One-third (33%) of Republicans view the regulation favorably, a proportion that has greater because the regulation was once enacted. See here for full trend on perspectives of the ACA by way of partisanship.

Development at the ACA has been a point of interest of President Biden’s well being care schedule, whilst former President Trump has not too long ago mentioned his need to take a look at once more to repeal and substitute the regulation. Part of the general public say they wish to see the following president and Congress enlarge what the ACA does. A smaller proportion desires to stay the regulation as it’s (16%) and a few 1/3 need to both reduce what the regulation does (14%) or repeal it fully (18%). Partisans fluctuate on those approaches, with about 3 in 4 Democrats short of the 2024 incoming management and Congress to enlarge what the regulation does (77%), whilst two-thirds of Republicans need the regulation to be scaled again (23%) or repealed fully (39%). A majority of independents need the regulation to be expanded (48%) or saved as it’s (18%). Perspectives against what to do with the well being care regulation have remained largely unchanged since 2020.

Perspectives of the ACA is also pushed by way of interactions with the regulation and perceptions about what it has completed for get admission to to medical health insurance. About 4 in ten (39%), together with identical stocks throughout family source of revenue, say the Inexpensive Care Act has made it more uncomplicated for other folks like them to get medical health insurance, whilst about one quarter (23%) say it has made it tougher and about one-third (37%) say it has had no affect on other folks like them to get medical health insurance. Very similar to different exams of the 2010 well being care regulation, this belief varies by way of partisanship, as Democrats are about 3 times as most probably as Republicans (60% v. 22%) to mention the ACA has helped other folks like them get insurance coverage. Greater than 4 in ten independents (44%) say the ACA has had no affect at the talent of other folks like them to get medical health insurance.

An identical stocks of adults beneath and over age 65 – the age of eligibility for Medicare, a central authority medical health insurance program – say the ACA has made it more uncomplicated for other folks like them to get medical health insurance (40% amongst adults ages 18 to 64 vs. 36% amongst adults ages 65 and older), although more youthful adults are much more likely to mention the ACA has made it tougher for them to get admission to well being care (25% v. 17%) and no more more likely to say it has had “no affect” on other folks like them (34% v. 45%).

The passing of the Inexpensive Care Act beneath the Obama Management was once certainly one of Biden’s achievements as Vice President, and its enlargement was a cornerstone for his 2020 presidential marketing campaign and management, however many citizens don’t affiliate Biden with the ACA. About part of adults affiliate President Biden with the passing of the Inexpensive Care Act, with one in 5 announcing he had a big function (21%) and about 3 in ten (28%) announcing he had a “minor function” within the passing of the law. Few (14%) say he had no function, and about 4 in ten (38%) aren’t certain. About one 1/3 (32%) of Democrats say that Biden had a “main function” within the passing of the ACA, together with better stocks of Democrats ages 50 and older (42%) than more youthful Democrats (23%). About one in 5 (22%) Republicans say that Biden had a big function, together with identical stocks throughout age teams. About one 1/3 of partisans say they don’t seem to be certain about Biden’s function within the ACA.

Biden vs. Trump at the Inexpensive Care Act

Electorate are break up alongside celebration strains of their exams of the possible 2024 presidential applicants’ approaches to the ACA, with about 9 in ten Democratic citizens announcing they suspect President Biden has the easier option to figuring out the way forward for the ACA, and identical stocks of Republicans announcing the similar of Trump. Impartial citizens are break up, with part (50%) announcing Biden has the easier way and about part (47%) announcing Trump has the easier way. Neither President Biden nor former President Trump has the brink amongst citizens total with regards to approaches to figuring out the way forward for the Inexpensive Care Act.

Whilst Republican citizens assume President Trump has a greater option to figuring out the way forward for the ACA, many say they both don’t assume he has a well being care plan to interchange the 2010 regulation or are undecided. A majority of citizens, together with seven in ten Republican citizens, say they don’t assume President Trump has a well being care plan to interchange the ACA (42%) or that they don’t seem to be certain if he has a plan (43%). Trump’s supporters, or MAGA Republican citizens, are perhaps to mention Mr. Trump does have a plan, with one-third (35%) announcing this in comparison to one in seven (16%) non-MAGA Republicans.

Pre-Current Prerequisites Protections

As a part of the ACA, non-public medical health insurance corporations are prohibited from denying protection in keeping with an individual’s scientific historical past and are prohibited from charging the ones with pre-existing stipulations extra protection. Those protections were consistently popular among the public, and about two-thirds of adults say it’s “crucial” that provisions prohibiting insurance coverage corporations from denying protection as a result of an individual’s scientific historical past (67%) and prohibiting insurance coverage corporations from charging in poor health other folks extra (65%) stay regulation.

Pre-existing situation provisions are common throughout celebration strains. As an example, about 8 in ten (79%) Democrats and two-thirds (66%) of independents say it’s “crucial” to them that the availability prohibiting medical health insurance corporations from denying protection as a result of one’s scientific historical past stays intact. A slight majority (54%) of Republicans say that is “crucial” to them, and an extra 1/3 (35%) say it’s “moderately vital.” In a similar fashion, part (51%) of Republicans and majorities of Democrats (79%) and independents (65%) say it’s “crucial” that insurance coverage corporations are prohibited from charging in poor health other folks extra.

Despite the fact that the way forward for the Inexpensive Care Act has reentered the inside track cycle with Trump’s reigniting of repeal efforts, consciousness of the regulation’s provisions is low. About 3 in ten (31%) adults are conscious that the ACA prohibits non-public medical health insurance corporations from charging in poor health other folks upper premiums, whilst about seven in ten say they don’t seem to be certain or incorrectly say it does now not, although Democrats (37%) are much more likely than Republicans (29%) to appropriately say it does. Six in ten adults both say they don’t seem to be certain or have no idea if the ACA prohibits non-public medical health insurance corporations from denying protection for a pre-existing situation, together with identical stocks throughout partisans.

Wisdom of the regulation’s provisions has dropped over the past 14 years. At its peak, seven in ten U.S. adults had been acutely aware of the ACA’s protections for other folks with pre-existing stipulations on the regulation’s inception in 2010. Since 2017, fewer than part of U.S. adults were conscious, whilst the recognition of those provisions stays top.

The ACA Market

Since 2010, with the enactment of the Inexpensive Care Act Marketplaces and enlargement of Medicaid, the share of uninsured non-elderly adults within the U.S. has dropped from 18% to about 10%. About one in 3 (35%) are acutely aware of this lower – emerging to part (48%) of Democrats – whilst about 3 in ten adults say the uninsured price has greater (32%) or remained the similar (31%) since 2010. Republicans (39%) are much more likely than Democrats to mention the uninsured price has stayed the similar.

All over the open enrollment duration on the finish of 2023, a document breaking collection of people decided on medical health insurance plans throughout the ACA Market, or healthcare.gov, continuing a trend of will increase in enrollment since 2020’s open enrollment duration. Alternatively, this truth isn’t well known a few of the public: one in 3 (34%) U.S. adults appropriately say extra other folks bought their very own medical health insurance throughout the Inexpensive Care Act Market all the way through this enrollment duration than in previous years, whilst about one in 5 (23%) say fewer other folks signed up, and 4 in ten (40%) say about the similar collection of enrollees signed up. There are sharp partisan divides on wisdom of the most recent enrollment duration, as part of Democrats appropriately say extra other folks signed up, in comparison to one in 4 Republicans who say the similar.

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