As Health Care Costs Remain on Top of Voters’ Minds, Americans
Cite Unexpected Medical Bills as Their Top Problem, Ahead of Premiums,
Deductibles and Drugs
Published:
Sep 05, 2018
Public Not Confident in President Trump’s Calls on Drug Companies
to Lower Prices
As a federal court
considers a challenge to the Affordable Care Act’s constitutionality, the
public, including most Republicans, wants protections for people with
pre-existing conditions preserved, the latest Kaiser Family Foundation
tracking poll finds.
Large majorities of
Americans say it is “very important” to retain the ACA provisions that prevent
insurance companies from denying coverage based on a person’s medical history
(75%) and from charging sick people more (72%). This includes majorities of Democrats, independents
and Republicans, as well as majorities of those with and without people with
pre-existing conditions in their households.
The ACA’s pre-existing
condition protections have emerged as a hot topic in some key Congressional
races in part because of a pending legal challenge filed by 20 state attorneys
general. The Trump Administration has opted not to defend the law’s
pre-existing condition protections in the case, and a federal district court in
Fort Worth, Texas is scheduled to hear arguments on the challenge today. Republican
Senators also introduced a bill to address the issue if the ACA were
overturned, though some analysts say its protections fall short.
Four in 10 Americans
(41%) say they are “very worried” that they or a family member will lose
coverage if the Supreme Court overturns the ACA’s pre-existing condition
protections. In addition, half (52%) are “very worried” they or a family
member will have to pay more for coverage.
Americans
Cite Unexpected Medical Bills as Their Top Health Cost Concern
The public overall also sees health costs as a major problem –
with six in 10 (58%) saying they are “very concerned” about increases in what
people pay for health care.
When given a list of possible worries, unexpected medical bills
tops the list that includes other health care costs such as premiums,
deductibles and even drug costs. Two-thirds (67%) say they are at least
“somewhat” worried about affording an unexpected medical bill – more than say
the same about their deductibles (53%), drug costs (44%) or premiums (42%).
Unexpected medical bills also ranked higher than other pocketbook
concerns such as gasoline or transportation costs (46%), monthly utility bills
(43%) and rent or mortgage (41%).
Overall, 39 percent of
insured adults ages 18-64 say that in the past year they have received an
unexpected medical bill – either from a doctor, hospital, or lab that they
thought was covered and their health plan either didn’t cover the bill at all
or covered less than they expected. For 10 percent of insured adults ages
18-64, the surprise bill was related to care received from an out-of-network
provider.
Half (50%) of those
who had an unexpected medical bill say the amount they were expected to pay was
less than $500 overall. Smaller shares say the amount was between $500 and $999
(16%), between $1,000 and $1,999 (12%); or $2,000 or more (13%).
Partisans Split on Effectiveness of Trump Administration’s Efforts
to Lower Drug Prices
President Trump
recently has publicly criticized several drug companies and called on them to
lower the cost of their prescription drugs. A majority (55%) of the public say
that this strategy of publicly calling on drug companies to lower their costs
will not be too effective or at all effective. Fewer (42%) say it will be very
or somewhat effective.
There are large
partisan differences. Three-fourths of Democrats (74%) say this strategy will not be effective, while two-thirds of
Republicans (67%) say it will be effective. More independents say
it will not be
effective than will be effective
(57% v. 41%).
In addition, 38
percent of Americans say they are either “very” or “somewhat” confident that
President Trump and his administration will be able to deliver on his promise
that Americans will pay less for prescription drugs than they pay now. This
number remains virtually unchanged since March 2018, before the administration
released its “American Patients First” plan aimed at lowering drug prices.
The public debate over
drug prices appears to having an impact on the public’s views of drug
companies. When asked about the reasons behind rising health care costs, an
increasing share of the public blames prescription drug companies. Eight in ten
(78%) say drug companies making too much money is a “major reason” why people’s
health care costs have been rising, up from 62 percent in 2014.
Other top causes in
the public’s mind include fraud and waste in the health care system (71%),
hospitals charging too much (71%), and insurance companies making too much
money (70%). About six in 10 (62%) say a major reason for rising costs is due
to the expense of new drugs, treatments, and medical technologies.
Fewer, but still about
half, say doctors charging too much (49%), an aging population (47%), and
medical malpractice lawsuits (45%) are “major reasons” for rising costs. Less
than half blame people getting more services than they really need (41%), the
Affordable Care Act (39%), the Trump administration’s recent actions on health
care (38%), or people not shopping for lower-priced services (28%).
Across Parties, Costs Top Voters’ Health Care Concerns Heading
into the Midterm Elections
The poll finds
corruption in Washington, health care and the economy and jobs are what voters
want to hear candidates discuss on the campaign trail ahead of November’s
midterm election. Fielded after of the indictment of Michael Cohen and initial
trial of Paul Manafort, this is the first time the KFF poll included corruption
in Washington, D.C. in the list of possible campaign topics, and the issue
jumped to the top of the list.
Three in 10 of voters
(30%) say Washington corruption is the “most important” topic for candidates to
discuss, with health care (27%) and the economy and jobs (25%) close by. In
June, when Washington corruption wasn’t offered as an option, health care and
the economy topped the list of topics voters want to hear candidates discuss.
Battleground voters –
those living in states and districts that the Cook Political Report rates as
having the most competitive House, Senate and gubernatorial races – rank
campaign topics similarly, with corruption (32%), the economy and jobs (27%)
and health care (26%) topping their list of “most important” topics.
When voters are asked
what health care issue they most want to hear the candidates discuss, a
quarter (27%) mention health care costs – three times the share that mention
any other health care issue, such as increasing access (9%), universal coverage
(8%), Medicare or senior concerns (7%), or prescription drug costs (7%). Health
care costs are the top health care issue mentioned by Democratic voters (29%),
independent voters (29%), and Republican voters (25%).
Half of Public Views the ACA Favorably This Month
This month marks the
90th time that KFF has asked about the
public’s perception of the Affordable Care Act on a poll since April 2010. This
month, half (50%) of the public holds a favorable view of the law, while 40
percent hold an unfavorable view. Similar shares of Republicans hold
unfavorable views (78%) as Democrats hold favorable views (77%). Half (50%) of
independents holds favorable views toward the ACA, while 39 percent hold
unfavorable views.
Methodology
Designed and analyzed
by public opinion researchers at the Kaiser Family Foundation, the poll was
conducted from August 23-28, 2018 among a nationally representative random
digit dial telephone sample of 1,201 adults. Interviews were conducted in
English and Spanish by landline (301) and cell phone (900). 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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