To: Interested Parties

From: Brad Woodhouse, Protect Our Care Campaign Director

Date: May 3, 2018

Re: Health Care Remains Top Issue Heading Into Midterms


Throughout the Trump presidency, one issue has consistently stood out as the top priority for voters, critical to how Americans will cast their ballots in the midterm elections: health care.

  • Health care is a top issue in nearly every  major issue-ranked poll in 2018;
  • Voters overwhelmingly trust Democrats over Republicans on health care; and
  • Voters resoundingly reject President Trump and Congressional Republicans’ repeal-and-sabotage campaign against the Affordable Care Act and Medicaid.

These polls, conducted by nonpartisan news outlets and by research firms from a wide array of ideological backgrounds, have shown consistent results despite asking differently-framed questions amid a turbulent political landscape. Clearly, health care is a dominant issue that will remain potent through the midterm elections, and the consistent partisan trust divide indicates that it should be a major focus for Democratic candidates in virtually every race in the country.

HEALTH CARE REMAINS A TOP ISSUE FOR AMERICAN VOTERS

Throughout 2018, poll after poll has surveyed which issues are top-of-mind for voters and nearly every time health care has been at the top of the list.

For example, a February CNN poll found that health care was voters’ top priority. Among its findings:

  • 83% of voters said health care was extremely important or very important, the highest among all issues.
  • 53% of voters said health care was extremely important, the highest among all issues – a 20% increase from August of 2010, a year when health care played a major factor in midterm elections.
  • 78% of independent voters said health care was important, tied with the economy as their top issue.
  • At least 70% of voters in every demographic category said health care was important – a trend that stretches across gender, age, income level, education level, ideology, and party affiliation.

These results were echoed by a March Pew Research Center survey, which found health care is the number-one pocketbook issue for Americans across all income brackets:

  • More than half of those surveyed said that health care affects their household’s financial situation “a lot,” the only issue which more than half of Americans rated a key economic issue.

  • Health care is “a top household financial issue” across all income levels, with 53% of those earning more than $100,000 and 52% of those earning $30,000 or less saying it has a large effect.

An April HuffPost/YouGov poll found that health care was a top issue for voters, with, 28% of those surveyed listing health care as their top the top issue, leaving the Huffington Post to conclude:

“Heading into the midterm elections, American voters are more likely to say they’re focused about health care than any other issue.”

A March Gallup survey asked Americans about the issues they are most worried about and, 78% of those surveyed named health care as a worry, more than any other issue, leading Newsweek to frame its coverage of the poll, “Health Care Is A Bigger Concern Than Terrorism”:

“Americans are more concerned about health care than they are about terrorism, according to a poll released on Monday. The Gallup survey rated health care as the top concern among Americans, with 55 percent of respondents noting they were “a great deal” concerned about the availability and affordability of health care. Twenty-three percent were “a fair amount” concerned about the topic. It is the fifth year running that health care has topped Gallup’s list of concerns for  Americans. It’s the 13th time overall that the issue has been a top concern. Democrats were more concerned about health care than Republicans, although 39 percent of Republicans still expressed concerns about the issue.”

A survey leaked in March from America First Policies using President Trump’s own pollsters found that health care was the top issue for voters, with 41% saying lowering health care costs should be Congress’ top priority. On the other side of the spectrum, a February poll from Priorities USA also found that independent voters continue to hold major concerns about President Trump’s war on health care:

“Donald Trump’s policies are adding to the economic burdens of average families by raising the cost of health care and driving up insurance premiums. And Trump has broken his promise to crack down on excessive drug prices. Instead, he has given the big drug companies huge tax breaks while allowing them to charge as much as they want, without any controls or negotiation. 60% of voters have major concerns, including 71% among independents.”

HEALTH CARE IS DRIVING DEMOCRATIC SUPPORT

Health care is not just a top concern for voters – it’s also a deciding factor for voters, and drives widespread support of Democrats.

On March 13, voters in Pennsylvania’s eighteenth district went to the polls and selected Conor Lamb over pro-repeal candidate Rick Saccone in a district which had gone for Donald Trump by nearly twenty points. A telephone exit poll of those who cast ballots found that:

  • Health care was a top issue for voters, with 52% listing it as important and only 19% deeming it not important. Among voters who said health care was the most important issue, Lamb beat Saccone 64-36, and among voters who said it was either the most important or a very important issue, Lamb beat Saccone 62-38.
  • On health care, voters said Lamb better reflected their views by 7 points, 45-38. Among independents, that gap widened to 16 points, with 50% saying Lamb’s health care views were more in line with theirs to only 34% for Saccone.
  • Voters were less likely to support Saccone because of the Republican health care agenda. Saccone’s support of the Republican health care agenda made 41% of voters less likely to vote for him and only 28% more likely to support him.

On April 24, Hiral Tipirneni nearly upset Republican Debbie Lasko in Arizona’s eighth district, a “closer-than-expected” result in a district Donald Trump carried by 21 points. A telephone exit poll of those who cast ballots similarly found that:

  • Health care was a top issue to voters, and these voters favored Tipirneni. Health care was ranked as a top issue for 58% of voters, with only 17% saying it was not that important or not important at all. Among these voters, Tipirneni beat Lesko 65-33.
  • On health care, voters said Tipirneni better reflected their views. Overall, voters said Tipirneni better reflected their views by 2 points, 45-43, over Lesko. Among independents, the gap widened to 30 points, 57-27 in favor of saying Tipirneni.
  • Voters were less likely to support Lesko because of the Republican health care agenda. Lesko’s support of the Republican health care agenda made 40% of voters less likely to vote for her and only 33% more likely to support her.

These were not special occurrences, either. A March 21 PPP poll among voters in battleground states found voters supporting pro-health care candidates and rejecting those favoring repeal:

  • In Arizona, health care is a top issue for 68% of voters, with 21% saying it is the most important issue. In a hypothetical Senate election, Democrat Kyrsten Sinema leads pro-repeal candidate Martha McSally 46-41
  • In Nevada, health care is a top issue for 65% of voters, with 27% saying it is the most important issue. In a hypothetical Senate election, Democrat Jacky Rosen leads pro-repeal Dean Heller 44-39.
  • In Pennsylvania, health care is a top issue for 71% of voters, with 25% saying it is the most important issue. In a hypothetical Senate election, Democrat Bob Casey leads pro-repeal candidate Lou Barletta 54-36.
  • In Tennessee, health care is a top issue for 71% of voters, with 31% saying it is the most important issue. In a hypothetical Senate election, Democrat Phil Bredesen leads pro-repeal candidate Marsha Blackburn 46-41.
  • In Wisconsin, health care is a top issue for 72% of voters, with 25% saying it is the most important issue. In a hypothetical Senate election, Democrat Tammy Baldwin leads pro-repeal candidates Leah Vukmir and Kevin Nicholson 51-39 and 51-38, respectively.

And in November, in what analysts deemed the election most seen as a bellwether for the rest of the country, exit polling from Virginia, where Democrats had their best performance in decades, found health care to be far-and-away the most important issue:

  • Asked whether health care, immigration, gun policy, taxes, or abortion was the most decisive issue, 39% of voters said health care was the issue which mattered most.
  • Among those who selected health care, 77% backed Democrat Ralph Northam.

VOTERS REJECT THE REPUBLICAN HEALTH CARE AGENDA

Ultimately, Americans don’t support or trust the GOP when it comes to health care.

A February PPP poll found Americans placing blame for rising health care costs on President Trump’s sabotage of the law. Among its findings:

  • Over half of voters know Republicans are sabotaging health care, with 51% stating that the Trump administration is actively taking steps that will raise people’s health care costs.
  • 60% of voters want to keep the ACA in place and make fixes as necessary, with just 34% favoring repeal.

This rang true in Pennsylvania’s eighteenth district, with polling showing not just support for Conor Lamb based on his health care stance, but also a rejection of Rick Saccone for his pro-repeal views:

  • Voters in this heavily-Republican district disapproved of the Republican efforts to repeal the Affordable Care Act by 14 points, 53% to 39%.
  • 59% of those surveyed said the Affordable Care Act should be kept in place with fixes made to it as necessary, while just 38% of those surveyed said the best path forward on health care was to repeal the ACA.
  • Among independent voters, the disparity is even wider, with 63% of independent voters opposing the GOP’s health care efforts and just 33% supporting them.

This was also the case in Arizona’s eighth district. Although Tipirneni was not able to pull off the upset, polling showed health care was a boost for her, and once again showed the ACA’s growing popularity:

  • Voters in this heavily Republican district disapproved of the Republican efforts to repeal the Affordable Care Act by 5 points (49% to 44%).
  • Only 41% of voters think the best path forward on health care is to repeal the Affordable Care Act, to 54% who think it should be kept in place with fixes made to it as necessary.

In fact, even the Trump-backed poll finds that voters don’t trust the GOP’s health care agenda. The America First Policies poll also found:

  • By 17 points, voters disapprove of Trump’s “handling of health care and health insurance” with only 38% approving (16% strongly) and 55% disapproving (44% strongly).
  • Among the 41% of voters who say lowering health care costs should be the top priority, 68% want Congress to either leave the Affordable Care Act as it is or work to fix it, with just 31% backing repeal.

And let’s not forget – in direct opposition of the Republican health care agenda, the popularity of the ACA continues to rise:

  • In the PPP poll, approval for the Affordable Care Act 12 was points above water, 47% approval to 35% disapproval, a dramatic reversal from trends before Trump took office.
  • In the PA-18 exit polling, a deeply-red district, 44% of voters supported for the ACA while just 42% opposed it.
  • And in the latest Kaiser tracking poll, 50% of voters expressed their support for the ACA to just 43% who disapproved, reflecting the long-term upward trend of support for the ACA that reached an all-time high in February at 54-42 approve/disapprove.

Ultimately, the message could not be more explicit: voters from all backgrounds and in states across the country are telling the GOP that enough is enough – it’s time for Republicans to end their war on health care and cease their repeal and sabotage agenda. As polls and election results have made clear, if Republicans continue their war on health care and Democrats call them on it, the opposition party will continue to widen its advantage in the midterm elections.