Healthcare remains a top concern for American voters ahead of the November U.S. elections, ranking above the economy, immigration, taxes, gun control and other issues, according to a new poll.
The survey from the Bipartisan Policy Center and Morning Consult found that 56% of responders said healthcare would be the most important issue they consider when voting.
"The data shows that this is clearly important to voters across the political spectrum," said Caroline Bye, managing director of Morning Consult.
The survey showed that healthcare is likely to be "a defining issue" overall in the 2020 elections, though the results varied by political affiliation, Bye noted during a Jan. 8 forum in Washington hosted by the Bipartisan Policy Center.
While 66% of Democrats and 54% of independents said healthcare was their most important issue for the 2020 elections, 46% of Republicans put it as their top concern, according to the poll of 1,988 national voters, which was conducted in December 2019.
For Republicans in the poll, the economy ranked highest, followed by immigration and then healthcare.
Of the healthcare issues tested, voters ranked out-of-pocket costs their greatest concern, followed by the high costs of prescription drugs — 64% and 57%, respectively.
"It's always been healthcare costs," Mollyann Brodie, executive director of public opinion and survey research at the nonpartisan, nonprofit Kaiser Family Foundation, said at the Jan. 8 forum. "It is the one thing that has been so consistent," said Brodie, who has been involved in polling for about 25 years.
The survey found that 28% of responders said they strongly supported the idea of letting the U.S. federal government negotiate directly with drugmakers on prices of prescription drugs, while 31% said they somewhat supported that approach. Only 10% strongly opposed the idea, while another 10% said they somewhat opposed it.
A bill adopted in December 2019 by the Democratic-controlled House would permit the federal government to negotiate the prices of the most expensive prescription drugs on behalf of the Medicare program and the commercial insurance market.
Quality and improvement
The quality of healthcare Americans receive ranked third among the survey responders' greatest concerns.
Overall, 44% said quality of care was the most significant healthcare issue to them.
At 39%, improving the current healthcare system received the most overall support in the poll, versus 23% who said the Affordable Care Act should be repealed and replaced. Only 22% said they supported moving the U.S. to a single-payer system, such as Medicare for All promoted by Sens. Bernie Sanders, I-Vt., and Elizabeth Warren, D-Mass., who are both seeking the Democratic nomination for president.
"People are very risk-averse about changing their healthcare arrangements," Brodie said. "They may not like it or love it, but they know it and they have made it work for them."
The threat by Republicans to repeal and replace the ACA in 2017, which would have ended the law's protections for patients with preexisting medical conditions, drove voters in the 2018 elections to put Democrats back in charge of the House, she said.
The ongoing lawsuit challenging the constitutionality of the ACA, brought by a group of Republican state attorneys general and the Trump administration, remains a question about how voters will react in the 2020 election, Brodie said.
In a Dec. 18, 2019, ruling, the U.S. Court of Appeals for the 5th Circuit in New Orleans declared the ACA's individual mandate unconstitutional. The 5th Circuit returned the case to the lower district court in Texas to decide if other provisions in the 2010 healthcare law could survive without the individual mandate.
On Jan. 3, the cadre of Democratic state attorneys general who are defending the ACA in the lawsuit and the Democratic-controlled U.S. House of Representatives asked the Supreme Court to decide the fate of the ACA before the 2020 elections.
The Republican plaintiffs in the case have until 4 p.m. ET on Jan. 10 to respond to the high court on the Democrats' request for the expedited review.
If the Supreme Court decides against expediting the case, the ACA could be left in limbo for years while the lawsuit runs its course through the district and appeals court processes again.
That result would fundamentally change the current conversation for the 2020 presidential and congressional elections, particularly for Democrats — shifting it away from Medicare for All back to protecting the ACA, Brodie said.
A majority of the responders — 63% — were strongly opposed to reducing Medicare benefits as a way to maintain funding for healthcare.
"No matter your party, Americans voters don't want politicians to reduce Medicare benefits as a way to maintain funding for healthcare programs in the U.S.," Morning Consult's Bye said.
Illicit drugs, opioids, vaping
The survey also found that Americans continued to be concerned about illicit drugs and opioids, particularly in rural areas.
About half of the survey responders said illicit drugs and opioids were the most common public health concern in their local community, followed by mental and behavioral health issue.
Smoking and vaping ranked third on the public health issues voters were most concerned about, according to the survey.