Attitudes on “Medicare for All”

1. Attitudes on “Medicare for All” 12 State Survey (N=1,211) 6 Focus Groups Across 3 States

2. States in Sample Alabama Arizona Colorado Florida Georgia Iowa Kentucky Maine Michigan North Carolina Ohio Wisconsin

3. Focus Group Locations Milwaukee, WI Phoenix, AZ Tampa, FL

4. How satisfied would you say you are with your own healthcare insurance – extremely satisfied, very satisfied, somewhat satisfied, or not at all satisfied? 87% 11% Q1

5. Which of the following views on the country’s healthcare system comes closest to your own – Our healthcare system is a confusing, expensive mess and we need to start over with a new government system that will provide universal coverage and make healthcare a guaranteed right for every American. While our healthcare system has problems, we should focus on improving what’s working and fix what’s broken, rather than starting from scratch and making massive changes.

6. Now I would like to read you a list of issues related to healthcare and health insurance. Please tell me, for each one, using a scale from 0 to 10, where 0 means it is "not at all important" and 10 means it is "extremely important," how important each of these issues is to you personally. • Reducing healthcare costs • More affordable healthcare costs • Having personal control over your healthcare and health insurance • Having personal choice over your healthcare and health insurance • Being able to keep your current health insurance plan if you want to • Making sure that every American has health insurance coverage and access to healthcare

7. Now I would like to read you a list of several health insurance plans. For each one, please tell me whether you have a favorable or an unfavorable impression of that plan. If you do not recognize the policy, just say so.

8. Now I would like to read you a list of several key government policies which have been mentioned in the news recently. For each one, please tell me whether you have a favorable or an unfavorable impression of that policy. If you do not recognize the policy, just say so.

9. Would you favor or oppose having a Medicare for All system, in which all Americans would get their health insurance from a single government plan? 49% 44%

10. Being as specific as you can, what are the one or two most important reasons why you would oppose having a Medicare for All national health plan? (If “Oppose” in Q21, Asked of N= 589 Respondents, or 48.7% of Sample)

11. Under a Medicare for All program, do you think that the healthcare that you and your family receive would -- get better, stay the same, or get worse – than it is now under your current plan? Q1

12. Message Testing MFA “Opponent” Messages

13. Medicare for All – Messages Against • Under Medicare for All, politicians and bureaucrats, not doctors, will call the shots on your health care. 17% 74% Independent experts estimate that Medicare for All would be so expensive that even doubling the current tax rate on every individual and corporation in the country would not be enough to pay for it. 19% 73% Other countries like Canada and the United Kingdom that have government-run healthcare like Medicare for All have to ration healthcare and suffer from horrible wait times.  There are four point three million patients on the wait list for treatment in the United Kingdom, and Canadian patients have to wait as long as a year for procedures… 74% 17% • Contrary to the name, Medicare for All would actually eliminate Medicare.  Seniors who currently rely on Medicare would lose the coverage they paid for all their lives and be forced into a massive plan with everyone else. 71% 21% • With Medicare for All, many Americans will pay more, wait longer for healthcare, and get worse care than they receive now. 18% 73%

14. Medicare for All – Messages Against It’s predicted that Medicare for All would cause a chronic shortage of doctors and hospital overcrowding would be epidemic. 73% 19% The Medicare for All proposal could cost an additional $32 trillion dollars and require more than doubling federal income taxes on every American in order to pay for it. 70% 20% Medicare for All could cause drug innovation to come to a standstill and there would be long delays before the newest drugs for cancer and other dangerous diseases would become available to patients. 72% 18% • The Medicare for All proposal would make employer-sponsored health insurance illegal. It would be totally eliminating private insurance for 180 million Americans. For people who like their employer-sponsored insurance – they wouldn’t be allowed to keep it. 70% 22% • Medicare for All, like other government-run health systems, will restrict patients’ access to the medicines they need. 72% 20% • Medicare for All would eliminate the current Medicare, Medicaid, TRICARE, and Children’s Health Insurance plans that seniors, military members and veterans, and children rely on. 69% 20%

15. Medicare for All – Messages Against • Medicare for All would cut payments to doctors and hospitals by roughly 40 percent -driving doctors out of medicine and hospitals out of business. 18% 71% Whatever too-good-to-be-true promises about Medicare for All are being made now, when it turns out we can’t afford it the politicians and bureaucrats will start rationing care to hold down costs. 17% 71% Medicare for All will include government price controls that will lead to less research and development of new drugs. There will be fewer new drugs for patients who need them. 72% 17% Under the Medicare for All proposal, 71 percent of workers and families who currently have private insurance would pay more for their health insurance than they do now. 70% 20% • A government-run healthcare system like Medicare for All is likely to waste huge amounts of taxpayer dollars through fraud and abuse—totaling as much as $400 billion dollars a year in improper payments. 68% 21% • The so-called Medicare for All proposal would not be Medicare. In fact, it would mean the elimination of Medicare. It would be government-run healthcare – forcing every American into a one-size fits-all healthcare plan, whether they want it or not. 65% 26%

16. Medicare for All – Key Messages Roundup Three points are key to defeating Medicare For All: Costs Both personal cost through tax hikes as well as overall cost to the economy. Cost is the key message to drive opposition to Medicare For All and related proposals. Choice/Control These words are often used interchangeably. Choice means choice of doctors, plans, and procedures. When government takes control, people feel they will lose control—and choice. Note: when people are given a “choice” (e.g. to “buy in” to Medicare), this concern drops off. Quality of Care/Wait Times Longer wait times for doctor’s visits and medical procedures are an effective and believable consequence of Medicare For All. People understand that wait times would increase, and the quality of care they receive would decline as a result.

17. Examples Are Helpful / “Scary” 17 March, 2018 After years of austerity, Britain’s National Health Service is under enormous strain, with severe shortages of beds and medical staff, all of which is producing waiting times for nonemergency procedures to stretch over months, and sometimes beyond a year. 11 February, 2019 In Canada, the median time for specialty treatment after a patient was referred by a primary care doctor in 2018 was 20 weeks. On average, patients waited nine weeks to see a specialist, then waited an additional 11 weeks to receive treatment.

18. Would you favor or oppose having a national health plan, sometimes referred to as Medicare for All, in which all Americans would get their health insurance from a single government plan?

19. Moving Forward Key Points Once Medicare for All is defined and discredited, there is greater skepticism about fallback proposals like Medicare For America and Medicare Buy-In. People are already dubious about politicians creating more disruption in their health care. The best messengers are those they trust: nurses, doctors and other health care consumers like them. Targets Key groups that respond to these messages are: • Moderate women with employer-sponsored healthcare • Seniors who are concerned about their Medicare being degraded • Union Households that like their negotiated employer-provided healthcare