What Do Likely Voters Think About Their Health Care?

In next week’s Super Tuesday primaries, voters in 14 states and American Samoa will cast their ballots for the Democratic and Republican presidential nominees. Health care has emerged as one of the top issues in the 2020 election, at times dominating the Democratic presidential debates.

NBC News and the Commonwealth Fund recently took the health care pulse of U.S. adults. Between January 28 and February 16, the survey firm SSRS polled 2,303 people age 18 and older, including 1,594 likely voters. We asked about their concerns regarding health care and their confidence in President Trump or the Democratic presidential candidates to help fix what’s ailing the U.S. health system. Here’s what the poll found about the views of Americans who say they’re likely to vote this November.

Findings

Nearly one-quarter of likely voters said they are very or moderately worried about their ability to afford their health care in the next 12 months. Those most worried were Democrats, voters leaning Democratic, Hispanics, and people earning less than $50,000 a year. But nearly one of five Republicans also said they’re very or moderately worried about paying for their care.

When we asked people about specific health care costs, their worries grew. About three in 10 likely voters said they are very or moderately worried about the amount they will have to pay over the next 12 months for their health insurance premiums and deductibles, out-of-pocket costs for prescription drugs and other health care, and long-term care, such as home care or a nursing home stay. One-third or more of Democrats, those leaning Democratic, people with incomes under $50,000, and blacks and Hispanics were concerned. One of four Republicans and voters who lean Republican also expressed concern about being able to pay for these health care expenses.

Many patients have reported getting surprise bills for health care they thought was covered by their insurance policy, with some bills totaling in the hundreds of thousands of dollars. Congress is currently considering legislation to protect Americans from such bills. Over one-quarter of likely voters reported they are worried about receiving an unexpected or surprise medical bill in the next 12 months. More than one-third of Democrats, people leaning Democratic, blacks, Hispanics, and people earning less than $50,000 were concerned. About one of five Republicans and voters who lean Republican also said they were concerned about unexpected medical bills.

For many people, worries about paying for health care are rooted in experience. One in five likely voters told us that they had difficulty paying medical bills, or were unable to pay them, in the past two years. Of those reporting medical bill problems, many said they had resorted to extreme measures to pay bills, including dipping into retirement funds or selling personal items like jewelry or furniture.

Other respondents said they avoided getting care altogether because of costs, with many saying a health problem worsened as a result. More than one in five likely voters said either their health problem or one experienced by a family member had gotten worse in the past 12 months after they delayed getting care or medications because of the cost. The groups reporting this at the highest rates were adults ages 18 to 34, people with incomes under $50,000, and Hispanics.

Regardless of who is elected president in November, large majorities of likely voters think he or she should make it a top priority to reduce the amount people pay for health care. Nearly four-fifths of likely voters think that reducing what people pay for health insurance (including premiums and deductibles) and what they pay out of pocket for prescription drugs and other health care should all be high priorities. While Democrats and people leaning Democratic were significantly more likely to say this compared to Republicans and people leaning Republican, the majority who are Republican and Republican-leaning think these initiatives should be a high priority.

We also asked people whether what they had heard so far from the Democratic candidates or from President Trump gave them confidence that either would take action as president next year to make health care more affordable.

More than half of likely voters said they are very or somewhat confident that if a Democrat became the next president, he or she would work to make health care more affordable for them. On this same question, just over four of 10 likely voters said they are very or somewhat confident in President Trump if he is reelected. The difference in confidence in the Democratic nominee versus President Trump was widest among blacks, young adults, Hispanics, and women.

Not surprisingly, Democrats and Republicans had much greater confidence that a president from their own party would make their health care more affordable.  

NBC News and the Commonwealth Fund will be polling likely U.S. voters throughout this election season about their thoughts on health care and the presidential candidates. Stay tuned to see how their views evolve.

How We Conducted This Study

The NBC News/Commonwealth Fund Health Care Poll was conducted by SSRS from January 28 through February 16, 2020. The survey consisted of telephone interviews conducted among a random, nationally representative sample of 2,303 adults, age 18 and older, living in the United States, and included an oversample of African Americans and Hispanics. Overall, 686 interviews were completed via landline and 1,617 were conducted via mobile phone. For this analysis, the sample population was limited to adults who reported they would definitely vote in the 2020 presidential election (“likely voter”). The final sample size among likely voters was 1,594.

This is the first poll in a series to track public sentiment on a range of health care issues during the 2020 presidential election season. Data were collected through the SSRS Omnibus. The SSRS Omnibus uses a fully-replicated, stratified, single-stage, random-digit-dialing (RDD) sample of telephone households, and randomly generated cell phones.

Each SSRS Omnibus insert was weighted to provide nationally representative and projectable estimates of the adult population 18 years of age and older. The weighting process took into account the disproportionate probabilities of household and respondent selection because of the number of separate telephone landlines and cell phones answered by respondents and their households, as well as the probability associated with the random selection of an individual household member. The sample was poststratified and balanced by key demographics such as age, race, sex, region, and education. The sample was also weighted to reflect the distribution of phone usage in the general population, meaning the proportion of those who are cell phone only, landline only, and mixed users. The weighting procedures adjusted for the oversampling of African American and Hispanic respondents.

The margin of error is +/– 2.4 percentage points at the 95 percent confidence level. The landline portion of the survey achieved a 5.4 percent response rate and the cellular phone component achieved a 3.1 percent response rate. The overall response rate was 3.8 percent.

Contributors

Sara R. Collins, Munira Z. Gunja, Chris Hollander, Jen Wilson, Naomi Leibowitz, David Blumenthal, Elizabeth Fowler, Eric Schneider, Michelle Doty, Rachel Nuzum, Lovisa Gustafsson, Gabriella Aboulafia, Jesse Baumgartner, Barry Scholl, Bethanne Fox, Paul Frame, and Audrey McIntosh