Field Poll: Support for new health care law, Prop. 45

The major findings from Part 2 of the 2014 TCWF-Field Health Policy Survey conducted among 1,535 California registered voters about changes in the state’s health care system following implementation of the Affordable Care Act (ACA) include the following:

• Over one in three voters under the age of 65 (36%) have personally visited the Covered California website and 9% say they obtained their health coverage there.

• While a majority (56%) of voters who visited the Covered California web site were satisfied with their experience there, 42% were dissatisfied. Voter evaluations of the web site are colored largely by a voter’s party affiliation and overall opinion of the ACA. For example, 63% of registered Democrats and 71% of voters supportive of the ACA say they were satisfied with their experience at the web site. By contrast, 39% of Republicans and just 28% of voters opposed to the ACA who visited the site were satisfied. Interest in visiting the web site in the future is similarly partisan and is tied to a voter’s party affiliation and overall opinion of the ACA.

• Nearly two in three voters (62%) say that the state’s Medi-Cal program is important to themselves or their families. This is up from 58% who reported this in 2013 and 51% who said this in 2011. The proportion of voters who consider Medi-Cal to be “very important” has also increased from 29% in 2011 to 40% in the current survey. Two in three voters (65%) also believe Medi-Cal has been successful in meeting its program objectives, while just 16% feel it
has not.

• Large majorities of voters support a number of proposals aimed at improving the state’s health care system. These include: encouraging insurance companies to reward doctors and hospitals more for the quality of care they provide than the number of patients they serve (82%), encouraging insurance companies to reduce costs by allowing physician assistants and nurse practitioners to play a bigger role in providing care to patients (81%), and expanding state funding of not-for-profit health insurance co-ops (78%). Another 62% favor allowing insurance
companies to offer a lower cost, high deductible plan option through Covered California.

• Opinions are more divided in regard to the proposal to expand Medi-Cal to provide preventive health services to undocumented immigrants. Slightly more than half (51%) support the idea, but 45% are opposed. Views about this are highly partisan and divide voters along racial/ethnic lines.

• There is strong early support for Proposition 45, the “Approval of Healthcare Insurance Rate Changes” initiative that will appear on the November 2014 statewide election ballot. Greater than two in three likely voters (69%) say they would vote YES after being read a summary of its official ballot description, while just 16% are initially opposed. Another 15% are undecided.

• Somewhat smaller majorities of likely voters say they’re inclined to vote YES on Prop. 46, the “Drug and Alcohol Testing of Doctors; Medical Negligence Lawsuits” initiative (58%) and Prop. 47, the “Criminal Sentencing/Misdemeanor Penalties” initiative (57%). “It is heartening to see that California voters increasingly observe the important role the Medi-Cal program plays in the health care safety net,” said Judy Belk, president and CEO of The California Wellness Foundation. “Expanding access to Medi-Cal for hundreds of thousands of Californians has been a key element of the Affordable Care Act in our state and has helped them access health care that was out-of-reach for many before this important reform.”

More than one in three voters under age 65 have personally visited the Covered California website and 9% obtained their health coverage there. Greater than one in three California voters under age 65 (36%) say they personally visited the Covered California web site to see what kinds of health insurance were being offered there. Of these, 9% say they obtained their health insurance coverage there.

Most likely to have visited the site were those currently uninsured (50%) or report having had a lapse in their insurance coverage during the past two years (47%). The under age 65 segments least likely to have visited the site were non-English speakers (23%), those with no more than a high school education (24%), voters who have been continuously insured over the past two years (28%), and Asian Americans or Pacific Islanders (28%).

Evaluations of the Covered California web site and interest in visiting it in the future are colored by voters’ political affiliations and their opinions of the ACA When voters who visited the Covered California web site are asked to evaluate their experience at the site, 56% say they were satisfied, while 42% were dissatisfied. However, evaluations are directly related to voters’ party affiliation and overall opinion of the ACA. Large majorities of registered Democrats (63%) and ACA supporters (71%) say they were satisfied with their experience at the site.

On the other hand, just 39% of Republicans and only 28% of ACA opponents who visited the site say they were satisfied. When voters are asked whether they are interested in visiting the web site in the future, 46% of voters under age 65 express some interest, while 51% do not. Interest is again highly partisan and tied to a voter’s overall opinion of the ACA. More than twice as many Democrats (56%) as Republicans (25%) say they are interested in visiting the site in the future. Similarly, while 61% of those who support the ACA express an interest in visiting the site in the future, just one in four (24%) of the law’s opponents say this. Increasing proportions consider the state’s Medi-Cal program important to themselves and their families

The current survey finds that nearly two in three voters (62%) say that Medi-Cal, the state program that provides health insurance and long-term care to California’s low-income adults and children, is important to themselves or their families. This is up from 58% who reported this last year and 51% who said this in 2011.

The proportion that consider Medi-Cal to be “very important” has also grown. In 2011 just 29% of voters reported Medi-Cal to be very important to themselves and their families. Last year this increased to 38%, while now it stands at 40%.

Most voters (65%) also believe the state’s Medi-Cal program has been successful in meeting its goals. This compares to just 16% who feel the Medi-Cal program has not been successful in meeting its goals, down from 20% who felt this way last year and 24% in 2011.

Support for a number of proposals aimed at improving the state’s health care system Voters were asked their opinions of five proposals aimed at improving the state’s health care system. Three proposals are favored overwhelmingly. They include:

• Encouraging insurance companies to reward doctors and hospitals more for the quality of care than the number of patients they serve. (82% favor vs. 12% oppose)

• Encouraging insurance companies to reduce health care costs by allowing physician assistants and nurse practitioners to play a bigger role in providing care to patients. (81% favor vs. 14% oppose)

• Expanding state funding of not-for-profit health insurance co-ops. (78% favor vs. 15% oppose) A fourth proposal, to allow insurance companies to offer a new lower cost, high deductible coverage option through the Covered California insurance marketplace is also supported by a two-to-one margin (62% favor vs. 29% oppose). On the other hand, a fifth proposal, expanding Medi-Cal to provide preventive health services to undocumented immigrants, divides the voting public. At present, 51% of voters favor the idea, but 45% are opposed. Views about this are highly partisan and divided along racial/ethnic lines. While Democrats support expanding Medi-Cal to include undocumented immigrants greater than two to one (68% to 28%), Republicans are opposed more than three to one (74% to 23%). In addition, larger proportions of Latinos (73%), African Americans (62%) and Asian Americans/Pacific Islanders (57%) are supportive, compared to white non-Hispanics (41%).

There is strong early support for Proposition 45, the “Approval of Healthcare Insurance Rate Changes” initiative.

After being read a summary of Prop. 45’s official ballot description, 69% of likely voters say they would vote YES, while 16% say they would vote NO. Another 15% are undecided. Support crosses party lines, and currently includes about three in four Democrats (75%) and non-partisans (73%), and 58% of Republicans. Somewhat smaller majorities of likely voters are also backing Propositions 46 and 47 on the general election ballot. Proposition 46, the “Drug and Alcohol Testing of Doctors; Medical Negligence Lawsuits” initiative, is currently supported by 58% and opposed by 30%, with 12% undecided. Yes voters outnumber No voters on Proposition 47, the “Criminal Sentencing/Misdemeanor Penalties” initiative, 57% to 24%, with 19% undecided.
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Ed’s Note: A total of 1,167 of the interviews were conducted in English and 368 in non-English languages. Interviewing was conducted June 26 – July 19, 2014 from Field Research Corporation’s central location call center.