Kaiser Family Foundation CEO: ‘Medicare For All’s Popularity May Have Peaked’

WASHINGTON – At Axios, Kaiser Family Foundation CEO Drew Altman writes that support for Medicare for All is “headed in the wrong direction” – meaning down – while “polling shows that support drops much further, and opposition rises, when people hear some of the most common arguments against Medicare for All.”

While 2020 presidential hopefuls continue to face tough questions about their support for new government-controlled health insurance systems, POLITICO has noted that polls show “growing opposition to ‘Medicare for All’” while a recent national poll by the Kaiser Family Foundation “probes Democrats’ views about the general approaches to expanding health coverage and lowering costs” and finds that “[m]ost Democrats and Democratic-leaning independents (55%) say they prefer a candidate who would build on the Affordable Care Act to achieve those goals.  Fewer (40%) prefer a candidate who would replace the ACA with a Medicare-for-all plan.” 

A separate poll released by Kaiser in July also found support for Medicare for All on the decline, as “a larger share of Democrats and Democratic-leaning independents would prefer lawmakers build on the existing ACA” and “the share of Democrats who now say they ‘strongly favor’ a national Medicare-for-all plan is down” 12 percentage points in the three months since Kaiser last asked the question.
 
And, as in past polling, Kaiser also found that “large shares” express uncertainty about what proposed new government-controlled health insurance systems would mean for them.  The American public’s confusion over one-size-fits-all proposals such as Medicare for All is not surprising.  “Such a sweeping overhaul of the country’s patchwork health insurance system hasn’t been attempted before,” The Washington Post reports, “and even though the 2020 contenders frequently mention it, they tend to shy away from details on exactly how the whole thing would work.”

Previous national polling data released by Kaiser in June revealed that “majorities of Americans are unaware of the kind of dramatic changes that [Medicare for all] would bring to the nation’s health care system.”  However, “[t]here’s one thing Americans understand about Medicare-for-all: It would mean higher taxes … Americans seem most familiar with the fact that Medicare-for-all would require massively higher taxes,” The Washington Post reports.  As Kaiser noted, “[t]he survey finds eight in 10 Americans (78%) are aware that taxes would increase for most people under such a plan.”

Yet another national poll conducted earlier this year by Kaiser revealed that support for Medicare for all “drops as low as -44 percentage points” when people find out it would “lead to delays in some people getting some medical tests and treatments,” and “is also negative if people hear it would threaten the current Medicare program (-28 percentage points), require most Americans to pay more in taxes (-23 percentage points), or eliminate private health insurance companies (-21 percentage points).”
 
And Voter Vitals – the Partnership’s quarterly tracking poll conducted nationwide and in 2020 battleground states – finds that a majority of Democratic voters are unwilling to pay any more in taxes for universal coverage and a supermajority of Democrats (69 percent) support building and improving on what we have today over new government insurance systems.

So it’s no surprise that “some Democratic lawmakers key to holding the House majority worry that the health-care pledges [by supporters of Medicare for All] … could hurt their re-election chances,” as The Wall Street Journal reports. 

… Democrats won back the House in the 2018 midterm elections with a message focused on saving Obamacare … House Democrats and candidates fighting to win competitive seats say health care is the top concern of voters, but that a Democratic presidential nominee who backs Medicare for All could create headaches.

… Kristen Hawn, a strategist who works with moderate Democrats, said candidates in competitive districts could lose if the health-care conversation is focused on Medicare for All.  “Making this election about whether you support Medicare for All is very damaging up and down the ballot,” said Ms. Hawn.  She said …  the centrists and independents that moderate Democrats rely on to win re-election aren’t ready to eliminate private health insurance.

… The majority of Democrats who won GOP-held seats last year haven’t signed on to the Medicare-for-All legislation in the House.  Rep. Ben McAdams, a Utah Democrat who won a GOP-held seat last year, says the policy“would maybe cause more challenges than it solves.”  Democratic Rep. Elaine Luria, who beat a GOP incumbent last year, said she recently voiced her opposition for Medicare for All in a town hall meeting in her coastal Virginia district.  She received a standing ovation.

In a story headlined “Why 2020 Democrats are backing off Medicare-for-all, in four charts,” The Washington Post explains that “[p]olls show why they’re doing this.  On the surface, the idea sounds as if it would appeal to voters.”  But when voters are made aware of the many negative consequences of such a system, including the elimination of private insurance and need for higher taxes, support drops.  

Of course, The Journal’s report is just the latest in a string of headlines that lay bare the political risks of embracing a one-size-fits-all government-controlled health insurance system:

• The Washington Post reports that “Democrats in swing districts are increasingly worried that the outspoken embrace of Medicare-for-all by Bernie Sanders and other top Democratic presidential hopefuls could hurt their chances of keeping the House in 2020.”

• The Hill reports that “[c]entrist Democrats who helped their party win back the House majority with victories in key swing districts last fall are sounding the alarm that the liberal push for ‘Medicare for all’ could haunt them as they try to defend their seats and keep control of the House.”

• “[A] majority of those [Democratic Members] who flipped their seats from red to blue focused on strengthening the 2010 health care law and protecting coverage for people with pre-existing medical conditions,” Roll Call reports, noting the significant “risks for any politician that proposes dramatic change and uncertainty in a system that is central to Americans’ well-being.” 

• “None of the people that were able to win in tough districts in 2018 ran on Medicare-for-all, and the reason is that they can’t,” Matt Bennett of the centrist Democratic group Third Way explains to CNN.  “People in those districts don’t support it.”

• As one Democratic strategist put it to The New York Times: “Most of the freshmen who helped take back the House got elected on: ‘We’re going to protect your health insurance even if you have a pre-existing condition,’ not ‘We’re going to take this whole system and throw it out the window.’”

• The Washington Post reports that by “veer[ing] left,” Democratic presidential hopefuls are “leaving behind [the party’s] successful midterm strategy.”

• And The New York Times reports that some Democratic governors are “anxious” and “alarmed that their party’s presidential candidates are embracing policies they see as unrealistic and politically risky.  And they are especially concerned about proposals that would eliminate private health insurance … Noting that many voters were already uneasy about losing their coverage, [Michigan Governor Gretchen] Whitmer said, ‘I don’t think feeding into that is a good idea.’”

Meanwhile – as headlines and studies warn – the risks to patients and hospitals under so-called “moderate” fallbacks to Medicare for All – like the public option – are similar, especially in rural America, as a study by Navigant for the Partnership for America’s Health Care Future, finds that the public option could put more than 1,000 rural U.S. hospitals in 46 states “at high risk of closure.”  These hospitals serve more than 60 million Americans, and as Kaiser Health News and NPR report, hospital closures can have “profound social, emotional and medical consequences,” while RevCycleIntelligence also reports, “[p]atient access to care suffers when a rural hospital closes its doors for good, and consequently, patient outcomes can deteriorate.”

A previous study found that “[f]or hospitals, the introduction of a public plan that reimburses providers using Medicare rates would compound financial stresses they are already facing, potentially impacting access to care and provider quality.”  Yet another study found that government insurance systems such as “buy-in” or “public option” could force hospitals to limit the care they provide, produce significant “layoffs” and “potentially force the closure of essential hospitals.”

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