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Post Presidential Election: What should we expect for health care?

Post Presidential Election: What should we expect for health care?. Celinda Lake, President Lake Research Partners. Lessons from the 2008 Election. Voters are demanding change, but are also economically stressed. Key Points: The 2008 Election.

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Post Presidential Election: What should we expect for health care?

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  1. Post Presidential Election: What should we expect for health care? Celinda Lake, President Lake Research Partners

  2. Lessons from the 2008 Election Voters are demanding change, but are also economically stressed.

  3. Key Points: The 2008 Election • The 2008 election delivered a substantial mandate for real change. Barack Obama’s central argument in the closing days of the campaign was that it was time to turn to the page on the last 8 years and try something new. The margin of victory underscores that the voters are ready for change. • The results of the presidential and congressional elections completes the wave that started in 2006. Four years ago, voters wanted change, but felt cross-pressured by the 9/11 dynamic. In 2006, terrorism was not enough to offset weak job approval ratings for President Bush and the Congress. And in 2008 voters completed their repudiation of conservative Republican ideas. • Health care reform is a key element of the change that voters demand. Consistently over the past year and a half, voters have expressed concern over rising costs and limited access and expressed an appetite for a larger government role. • The economy dominated this election as a voting issue. All other issues took a back seat to the economic crisis. The health care issue was the top personal economic issue. • The weak state of the economy presents a challenge to health care reform, but also an opportunity. While many politicians will instinctively seek to pull back on spending, health care is one of the key components of voters’ economic anxiety. Health care reform can also help the economy, especially small businesses. Voters accept that the cost of doing nothing is too great.

  4. The vast majority of voters are insured. However, some key constituencies viewed health care as a voting issue. • Currently, 91% of voters report having some sort of insurance coverage, and 66% had coverage for every member of their families in the last 3 years.** • Core health care voters supporting progressive reforms include Democrats, Democratic women, and African-Americans. • Older women and seniors are the most attentive voters on this issue. They need to be reassured that reforms will not adversely affect the quality of their health care. *SEIU/AHC polling by Lake Research Partners, November 2006. ** LRP Poll for The Partnership to Fight Chronic Disease. October 4-9, 2008. 1500 Likely Voters (795 Women).

  5. Michigan went from a swing state in 2004 to Obama’s strongest Great Lakes state (besides Illinois) in 2008. Presidential Vote in Michigan 2004 2008

  6. Two Congressional seats switched parties in Michigan in 2008, the first time since 2002. Key Congressional Races in Michigan Michigan’s 7th CD Michigan’s 9th CD Won with 51% in 2006 Won with 52% in 2006

  7. Even before all races have been called, the Democrats have solidified the majorities they won in 2006. *Races in Alaska and Minnesota are still too close to call. Georgia’s Senate seat will be decided in a runoff. **4 House races are still too close to call.

  8. Two health care-related propositions passed in Michigan, but with a narrow margin allowing stem cell research. Ballot Initiatives in Michigan Prop. 1 (Medical Marijuana) Prop. 1 (Stem Cells)

  9. The economic-themed messages in support of stem cell research helped it win with a large margin among economically stressed voters. Stem Cell Vote by View on Economy Not So Good (35% of Voters) Poor (60% of Voters) CNN 2008 Exit Polls. 3,096 Interviews

  10. The economy dominated this election. Obama won by being the most trusted voice on the economy. He also appealed to voters specifically concerned about health care. Source: CNN 2008 Exit Polls. 17,836 Interviews

  11. Michigan voters mirrored the country overall on their top issue concerns for the 2008 election. Michigan Source: CNN 2008 Exit Polls. 3,096 Interviews

  12. Even before the Wall Street mess in September, a large majority of voters thought we were in a recession. Do you think we are in an economic recession, or not? Men: 54% recession Women: 64% recession White: 57% recession Black: 70% recession Hispanic: 60% recession GWU Battleground. August 10-14, 2008. 1,003 Likely Voters

  13. Nearly nine out of ten Michigan voters are worried about the economy—now the rest of the country is near Michigan’s pessimism. Worried about Economy (Michigan) 89% CNN 2008 Exit Polls. 3,096 Interviews

  14. In Michigan, employment worries have gone from a majority opinion to a near universal opinion. Job Situation in Your Area (Michigan) CNN 2008 Exit Polls. 3,096 Interviews

  15. Health care in an Economic Context In an economically stressed country, health care is one of the main sources of that stress.

  16. Key Points • Even after the financial collapse on Wall Street, health care remains one of the top economic concerns. When voters focus on the personal, health care is at the top of their economic concerns. • Despite the economic sensitivity that makes voters apprehensive about taxes and a strong anti-Washington sentiment—voters want health care reform even when they are told it will raise taxes or bring in more government. • Affordable quality health care and keeping their coverage are the two main priorities for voters on this issue. • Voters see health care in values terms as well, linking it to the overall attainment of the American Dream.

  17. Almost two-thirds of voters are worried about being able to afford health care. How worried are you about being able to afford health care? CNN 2008 Exit Polls. 17,836 Interviews

  18. Even after the collapse of Bear Stearns, Lehman Brothers and AIG, health care was the top personal economic concern in voters’ everyday lives. Now I’m going to read you some problems you and your family may face. Please listen carefully, then tell me which ONE of these you personally worry the most about? … Now from the same list, please tell me which ONE of these you personally worry about second most? LRP Poll for The Partnership to Fight Chronic Disease. October 4-9, 2008. 1500 Likely Voters Nationwide

  19. Men and women rate these issues similarly. Now I’m going to read you some problems you and your family may face. Please listen carefully, then tell me which ONE of these you personally worry the most about? … Now from the same list, please tell me which ONE of these you personally worry about second most? LRP Poll for The Partnership to Fight Chronic Disease. October 4-9, 2008. 1500 Likely Voters Nationwide

  20. Voters cite rising costs as the most worrying thing about health care today. And thinking specifically about health care, what are you personally worried about the MOST? … And what are you personally worried about the SECOND most? LRP Poll for The Partnership to Fight Chronic Disease. October 4-9, 2008. 1500 Likely Voters Nationwide

  21. For the past year leading up to the election, the public’s appetite for progressive reform remained strong—even if it meant raising taxes. Do you favor or oppose providing access to affordable, quality health care for all Americans even if it mean raising your taxes? Do you feel strongly or not strongly about that choice?* Oppose Favor 69% 28% September 20071 64% 27% February 20082 October 20083 31% 64% * Asked of half of sample. 1 LRP Poll for the Herndon Alliance, September 15-27, 2007. 1000 Likely Voters. 2 LRP Poll for Health Care for America NOW!. February 16-21, 2008. 800 Likely Voters. 3 LRP Poll for The Partnership to Fight Chronic Disease. October 4-9, 2008. 1500 Likely Voters (795 Women).

  22. Similarly, voters have consistently been more than willing to accept a strong federal government role in making sure all Americans have access to affordable, quality health care. Do you favor or oppose providing access to affordable, quality health care for all Americans even if it mean a major role for the federal government? Do you feel strongly or not strongly about that choice?* Oppose Favor 28% 66% September 20071 February 20082 23% 69% October 20083 30% 64% * Asked of half of sample. 1 LRP Poll for the Herndon Alliance, September 15-27, 2007. 1000 Likely Voters. 2 LRP Poll for Health Care for America NOW!. February 16-21, 2008. 800 Likely Voters. 3 LRP Poll for The Partnership to Fight Chronic Disease. October 4-9, 2008. 1500 Likely Voters (795 Women).

  23. Both Obama and McCain voters believe that reducing the cost of health care is the top priority for reform. However, Obama voters are much more likely to be concerned about access as well. Source: Kaiser Family Foundation Poll. N=1622 Registered Voters. 9/2008.

  24. The fundamental disagreement between the two camps comes in who is most responsible for making sure that Americans have access to quality, affordable health care. Who should have the most responsibility for making sure Americans receive health insurance coverage? Source: Kaiser Family Foundation Poll. N=1622 Registered Voters. 9/2008.

  25. Two thirds of all voters were worried about health care costs, and these voters broke hard for Obama. Worried About Health care (66%) Not Worried about Health care (33%) Source: CNN 2008 Exit Polls. 17,836 Interviews

  26. Protecting current benefits and guaranteeing access to quality, affordable care are seen as the most important step that can be taken to help make the American Dream more attainable. Now thinking overall about the goal of making the American Dream more attainable. I am going to read some steps that could be taken to help make the American Dream more attainable. For each one, please rate how effective that step would be in making the American Dream more attainable. Use a scale from 0 to 10, where 10 means this step would be very effective, and 0 means the step would not be effective at all, and 5 is neutral. You can choose any number between 0 and 10. LRP poll for CTW, November 1-4, 2008, 900 non-supervisory workers nationwide

  27. Moving Forward Taking advantage of opportunities to win real reform in 2009.

  28. The Strategic Situation • Based on focus groups and survey findings, advocates of health care for all Americans are in a position for a successful push for health care reform in 2009. • Voters are feeling more urgency about national health care reform and the need to fix the system but are also sensitive to the urgency of dealing with the economic crisis. • Women continue to be a key constituency – women bring up health care as a top concern unprompted in focus group discussions, while men mention the economy or the war in Iraq before mentioning health care. • The gender gap in intensity presents a challenge and an opportunity in launching and sustaining a campaign.

  29. The Strategic Situation • Voters have negative feelings about the health insurance industry, and a narrative that ties the industry’s huge profits with denying people coverage elicits anger that can be channeled into support for reform and discredit of attacks. • This anger can also be used to discredit the health insurance industry as the source of attacks on reform. • Both men and women want the government to regulate and “police” the health insurance and drug industries, and do not view regulatory reforms as competing with fixing the economy.

  30. Voters strongly identify the health insurance industry with negative traits of putting profits ahead of people and being greedy, uncaring, and bureaucratic. LRP Poll for Health Care for America NOW!. February 16-21, 2008. 800 Likely Voters.

  31. In polling for Health Care for America NOW! we tested a Guaranteed Affordable Choice framework for reform. Americans would be guaranteed to have a choice of health plans they can afford, either from a private insurer, or from a public plan. Everyone would pay on a sliding scale based on income. To maintain quality and allow fair cost comparisons, health insurance companies and the public plan would be required to provide at least a standard, comprehensive package of benefits including preventive care and all needed medical care. Employers and individuals could choose to keep their current health plans. The public plan would be paid for through a modest payroll tax on employees and employers and by rolling back tax breaks for those who make over $200,000 a year. Small businesses would pay a lower rate. No insurer could deny coverage or charge higher premiums to people with pre-existing conditions.

  32. Nearly two-thirds of voters rate the progressive plan a six or higher on a scale from zero to ten. 34% 65% LRP Poll for Health Care for America NOW!. February 16-21, 2008. 800 Likely Voters.

  33. Among all voters, banning the practice of denying coverage due to “pre-existing conditions” is the highest scoring feature of progressive reform, especially among women. Now, I'm going to read you the individual components that are in the health care proposal I just read you. For each one, please rate how favorable you are toward that item on a scale of 0 to 5, where 5 means it is a very convincing reason to support the initiative, and 0 means it is a not at all convincing reason to support the initiative. If you are not sure, please say so. • Among Women • Very Convincing • 65% • Total Convincing • 80% • Mean Score • 4.2 LRP Poll for the Herndon Alliance, September 15-27, 2007. 1000 Likely Voters.

  34. When asked head-to-head, voters prefer Guaranteed Affordable Choice over health savings accounts, tax credits, or a single payer plan by about three-to-one. 67% 20% 65% 20% 64% 22% Even among the health care base, intense support for single-payer is far lower than for GAC. LRP Poll for the Herndon Alliance, September 15-27, 2007. 1000 Likely Voters.

  35. Text of GAC, HSA, Tax Credits, and Single Payer plan. Guaranteed Affordable Choice language: An approach that would guarantee affordable health insurance coverage for every American with a choice of private or public plans that cover all necessary medical services, paid for by employers and individuals on a sliding scale. Health Savings Account language: A Health Savings Account program that would provide tax-deductible savings accounts to all Americans if they purchase a private insurance plan with at least a thousand dollar deductible. Tax Credits language: An approach that would provide tax credits that will reimburse individuals and families for 25 to 50 percent of the cost of their private health insurance policies. Single Payer language: A single government-financed health insurance plan for all Americans financed by tax dollars that would pay private health care providers for a comprehensive set of medical services.

  36. Words that Work LRP conducted focus groups in 7/06 in partnership with AE on behalf of the Herndon Alliance

  37. Words that Work LRP conducted focus groups in 7/06 in partnership with AE on behalf of the Herndon Alliance

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