Public Ranks Drug Costs and Sufficient Provider Networks Ahead of Affordable Care Act Changes as Health Care Priorities for Next President and Congress to Address

As the 2016 campaign nears its end, the latest Kaiser Health Tracking Poll examines the public’s view on health care priorities for the next president and Congress. Overall, Americans rank addressing high prescription drug costs and ensuring adequate provider networks in insurance plans among their top health care priorities.

Health care itself is not playing a major role in the election, as the poll finds the candidates’ characteristics, the economy and jobs, and foreign policy ranking are the top factors behind voters’ decision. The poll looks beyond the election to assess the public’s top health care priorities once the results are known.

Making sure that high-cost drugs for chronic conditions are affordable to those who need them is viewed as a “top priority” by three quarters (74%) of the public, including large majorities of Democrats, Republicans and independents. In addition, nearly two-thirds (63%) of the public say government action to lower prescription drug prices is a top priority. Other top priorities include making sure health plans have sufficient doctor and hospital networks (57%) and protecting people from high charges when they visit an in-network hospital but are seen by an out-of-network doctor (54%).

Fewer cite various changes to the Affordable Care Act as top priorities for the next president and Congress, such as helping people with moderate incomes pay high out-of-pocket costs for medical care (44%), repealing the law entirely (37%), and repealing specific provisions requiring nearly all Americans to have health insurance or pay a fine (38%) and requiring employers with 50 or more workers to pay a fine if they don’t offer health insurance to their workers (29%). Among Republicans, however, repealing the Affordable Care Act entirely remains a top issue, ranking second among health care priorities.

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The poll also examines the public’s views of a public health insurance option to compete with private plans in the Affordable Care Act’s marketplaces, an idea being floated as some private insurers have decided to stop selling plans in many areas. While most Americans initially say they favor creating a public health insurance option to compete with private plans, how such a proposal is described and labeled significantly impacts level of support.

For example, when half of the sample are asked whether they favor or oppose creating a public health insurance option, 70 percent express a favorable view while one-fourth (24%) oppose. When the other half are asked whether they favor or oppose creating a government-administered public health insurance option, about half (53%) say they favor such a plan while 41 percent oppose.

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In addition, some people’s opinion about a public option can shift when presented with arguments being made by those on the other side.  For instance, one-fifth (21%) shifts their opinion from favor to oppose after hearing the argument often made by opponents that doctors and hospitals would be paid less, and 27 percent shifts to oppose after hearing that the government plan would have an unfair advantage over private insurers.

On the other side, about one in ten changes their stance from oppose to favor after hearing that the public option could help drive down costs through increased competition (13%), provide more choices to people getting insurance through the marketplaces (11%), or could be the only insurance option for people in areas where private insurers may not offer marketplace plans (11%).

When asked specifically about the future of the Affordable Care Act, the public remains divided. About one-third (32%) want the next president and Congress to repeal the entire law, and a similar share (31%) want Washington to expand what the health care law does. One in five (18%) want to see the law implemented as is, while 9 percent want to see it scaled back. There are huge partisan divisions on this question, with large majorities of Republicans and voters supporting Donald Trump wanting the entire law repealed or scaled back, and large majorities of Democrats and voters supporting Hillary Clinton wanting it expanded or implemented as is.

With the Affordable Care Act’s fourth open enrollment period for marketplace coverage beginning Nov. 1, the tracking poll examines the public’s view on the 2010 health care law, including which groups they think are better and worse off as a result of this legislation, and what sources they go to for information about the law.

The public overall this month is evenly divided on the Affordable Care Act, with 45 percent reporting both a favorable and an unfavorable view. These views are largely stable, with few people changing their minds when presented with the other side’s arguments.

Overall, two-thirds (64%) of Americans say at least some of the news coverage they’ve seen about the health care law has been about politics and controversies. About half (51%) of Americans say at least some of the coverage has been about the number of people who are getting health insurance, higher than the share that says at least some has been about the number of people losing insurance (38%). Slightly less than half (47%) say at least some of the coverage has been about the cost of premiums in plans purchased through the law. To view all of the poll’s ACA-related findings, see the corresponding Data Note.

Designed and analyzed by public opinion researchers at the Kaiser Family Foundation, the poll was conducted from October 12-18 among a nationally representative random digit dial telephone sample of 1,205 adults. Interviews were conducted in English and Spanish by landline (424) and cell phone (781). The margin of sampling error is plus or minus 3 percentage points for the full sample. For results based on subgroups, the margin of sampling error may be higher.

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