Medicare

Poll: Americans Open to Medicare Choice, Not Medicare-for-All

Fresh poll results indicate a majority of Americans think a choice between private health insurance and Medicare is a good idea, but a Medicare-for-All plan is a bad idea.

Fresh poll results indicate a majority of Americans think a choice between private health insurance and Medicare is a good idea, but a Medicare-for-All plan is a bad idea.

A majority of Americans like the idea of choosing between private health insurance or Medicare, but disfavor eliminating private health insurance under a Medicare-for-All plan, according to a new NPR/Marist Poll.

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Seventy percent of poll respondents said a choice between coverage under private health insurance or Medicare is a “good idea.” Only 25 percent view that choice as a “bad idea.” Democrats are the most supportive at 90 percent, with 70 percent of independents in agreement. Republicans are split with 46 percent liking the idea and 48 percent viewing it is a bad idea.

There was little difference in viewpoints between men and women, between respondents from different regions in the country or between big city and small city dwellers.

There were slight differences based on education and age. Millennials (79%) were the most favorable toward the idea and older Americans (64%) were the least favorable.

Fifty-four percent of poll respondents consider Medicare-for-All a “bad idea,” while only 41 percent view it as a “good idea.” As you would expect, people identifying themselves as “progressive” (68%) were the most supportive and Republicans (14%) and Trump supporters (15%) were the least enamored.

For 2020 Democratic presidential candidates, a troubling finding was that only 40 percent of self-described moderates and 39 percent of independents regard Medicare-for-All as a good idea. It is unpopular in all regions of the country and in big cities, suburban areas and rural areas.

Millennials (53%) and people with household incomes below $50,000 (49%) are the most supportive respondents for Medicare-for-All. 

The poll touched on a number of other issues. Here is a quick summary:

  • 89% of respondents regard background checks for gun purchases at gun shows is a good idea.

  • 67% favor government regulation of prescription drug prices.

  • 64% favor a pathway of citizenship for immigrants in the United States illegally.

  • 63% favor legalizing marijuana nationally.

  • 63% favor a Green New Deal to address climate change.

  • 62% favor a so-called wealth tax on higher-income individuals.

  • 57% favor a ban on the sale of semi-automatic assault guns.

  • 56% favor a $15 per hour minimum wage.

  • 53% favor the United States rejoining the Paris Climate Agreement.

  • 53% favor free tuition at colleges and universities.

  • 50% favor a carbon tax on coal, oil and natural gas.

  • 51% oppose repeal of Obamacare.

  • 50% oppose eliminating the electoral college.

  • 58% oppose abolishing the death penalty.

  • 62% oppose a national health insurance program for illegal immigrants.

  • 66% oppose decriminalizing illegal border crossings.

  • 62% oppose reparations for slavery.

  • 66% oppose a universal basic income of $1,000 per month for all US adults.

The Marist Poll was conducted from July 15-17 with 1,346 adults using a random sample of landline and mobile phone users. Of the adult respondents, 1,175 said they were registered voters. Thirty-eight percent of the registered voters were independents, 33 percent were Democrats and 27 percent Republicans. Fifty-two percent were women and 48 percent men. Minority participation was consistent with US population demographics.

 

Older Voters to Continue to Set US Political Agenda

Longer lifespans have many ramifications for housing, health care and mobility. They also have ramifications on US elections as the number of older adults continues to grow, packing even more clout on influencing political agendas by both Republicans and Democrats and perhaps deciding who will face off in the 2020 presidential election against Donald Trump.

Longer lifespans have many ramifications for housing, health care and mobility. They also have ramifications on US elections as the number of older adults continues to grow, packing even more clout on influencing political agendas by both Republicans and Democrats and perhaps deciding who will face off in the 2020 presidential election against Donald Trump.

The graying of America isn’t news, but the ramifications of a larger, older population on US elections may be underappreciated and undervalued in political campaign strategies, including for the 2020 presidential election.

Michael Hobbes, writing for Huffpost, says, “The US electorate is the oldest it’s ever been and will keep getting older for at least four more decades. Voters over retirement age will continue to dominate US politics until at least 2060.”

Not only are there more older people in America, Hobbes says there are more older registered voters who actually vote. Older voters take a different set of issues and perspectives to the ballot box than younger generations. And older voters are whiter and wealthier than younger cohorts.

“Older voters have unique characteristics and specific interests that transcend the Democratic-Republican divide,” Hobbes says. “From their economic circumstances to their demographic makeup, the concerns of older voters are only going to become more prominent as the baby boom generation enters retirement.” 

That’s why, he adds, politicians don’t like to cross older voters on issues such as Medicare and Social Security. In less obvious ways, they also recognize older Americans are largely white, traditional in their social views, more comfortable with the status quo and wealthier than the generations that follow them.

Washington Governor Jay Inslee is one of seven declared or soon-to-declare candidates running for president who is 65 years or older. President Trump is 72. Based on current polls, if Joe Biden enters the race as expected, he will be the Democratic frontrunner. Biden is 76. His closest challenger is Bernie Sanders who is 77.

Washington Governor Jay Inslee is one of seven declared or soon-to-declare candidates running for president who is 65 years or older. President Trump is 72. Based on current polls, if Joe Biden enters the race as expected, he will be the Democratic frontrunner. Biden is 76. His closest challenger is Bernie Sanders who is 77.

These tensions are evident in the mix of Democratic presidential candidates that stretch from young, fresh faces touting universal health care, free college tuition and transformational climate change policies to older, more seasoned pols who talk about preserving Social Security and Medicare and pursuing progressive legislation at a more measured pace. 

Young progressives point to the energy and new voters they are bringing to the Democratic Party. But in raw numbers, eligible voters who are 65 or older already outnumber Millennials and the gap is projected to grow larger over the next four presidential election years. That could heavily influence whether a fresh, younger face or a familiar, older face wins the Democratic nomination after the gauntlet of primary elections. Almost half of the declared or likely candidates for president in 2020 are 65 or older. 

Older voters have historically been more Republican than Democratic. Even though that is changing overall and especially in highly blue states, older adults as an age group are more moderate in their viewpoints. They tend to see themselves as the people who will have to pay for whatever policies are enacted. That reticence is almost hard-wired into the political process, according to Hobbes, and affects both Democratic and Republican policymaking. 

“To a great extent, older voters are still setting the agenda,” says Andrea Campbell, a Massachusetts Institute of Technology political scientist. “They’re incredibly important to both parties’ coalitions. Politicians remain reluctant to run afoul of older voters.”

As AARP bluntly said in its April 30, 2018 bulletin, “If candidates want to win, they better pay attention to the issues that matter to Americans 50-plus.”

 

Survey Shows Medicaid is Popular, If Sometimes Confusing

A national survey found Medicaid, despite its lower profile than Medicare, is popular and widely recognized for providing health care access to some of America’s most vulnerable citizens from low-income families to elderly adults ibn long-term care facilities.

A national survey found Medicaid, despite its lower profile than Medicare, is popular and widely recognized for providing health care access to some of America’s most vulnerable citizens from low-income families to elderly adults ibn long-term care facilities.

A national survey commissioned by Providence St. Joseph Health shows a strong majority of respondents know about and value Medicaid, which provides health insurance to low-income Americans and pays for long-term care and in-home care for elderly and disabled persons.

Medicaid was signed into law along with Medicare in 1965. Medicaid remained largely in the political shadows until its expansion became a key part of the Affordable Care Act’s goal of moving closer to universal health insurance coverage in America.

The Providence St. Joseph Health survey found 87 percent of respondents were aware of Medicaid, though some were confused about what it covers. More than half of respondents said they, a friend or a loved one were covered by Medicaid. Seventy-seven percent of respondents said Medicaid is very important to maintain broad access to health care.

Today, one in five Americans is covered by Medicaid, making it the nation’s largest health insurance plan. Medicaid covers nearly half of all babies born in America and 60 percent of elderly persons in nursing homes. Medicaid also provides health benefits to military veterans and people dealing with opioid addiction and mental health issues.

“In other words, these are our children, parents, grandparents, neighbors, friends and colleagues,” Providence St. Joseph health wrote in a blog about the survey. “To make matters even more confusing, many Americans may be covered by Medicaid and not even realize it because the program goes by different names in different states.” The Oregon Health Plan is the name for Oregon’s Medicaid program. In Washington, Medicaid is called Apple Health.

GOP congressional efforts to reduce the federal budget deficit have zeroed in on Medicaid and particularly federal funds that go to states to pay for expanding eligibility to Medicaid. The Trump administration is pushing to impose work requirements on Medicaid recipients capable of working, though critics say this could penalize low-income workers with jobs that have uncertain schedules and  irregular hours.

There have been Medicaid-related controversies at the state level. Oregon removed nearly 55,000 Medicaid recipients who were enrolled, but later were found ineligible under the expanded program. Oregon also determined that coordinated care organizations (CCOs) were overpaid $41 million in Medicaid benefits. Fifteen CCOs were created statewide to coordinate the delivery of services to 1 million Oregonians.  

“Medicaid has served as a vital safety net since it was signed into law in 1965, along with Medicare, as part of the Social Security Act,” according to Providence St. Joseph Health. “There’s plenty of room to improve the program, and Providence St. Joseph Health is pursuing innovative ways to provide the best care in the right setting for this population. At the same time, it’s important for everyone to know what this program does and who it covers, because it affects so many of us.”

[NOTE: Providence Health & Services and Providence St. Joseph Health are long-time CFM clients.]

 

Business Leaders Predict Health Care Cost Hikes

An online survey conducted this week of 300 Oregon business decision makers found a majority had an unfavorable opinion of the federal Affordable Care Act, believing it will increase private health insurance premiums.

Despite that, almost 37 percent of the decision makers say their organization plans to maintain their existing private health insurance plans for employees and another 39 percent are adopting a wait-and-see attitude.

Federal health care insurance reform, referred to by critics as Obamacare, has been a mainstay issue in the presidential election that will wrap up November 6. President Barack Obama calls federal health reform essential to the economic security of the nation, while his GOP challenger Mitt Romney calls the act an unnecessary and costly intrusion into the national economy and people's lives.

One of the claims made in the presidential debate has been the effect of the Affordable Care Act on businesses that now provide health insurance to their employees. Republican vice presidential nominee Paul Ryan asserted the act would lead businesses to drop coverage. Obama and his supporters insist nothing in the act forces businesses or their employees to change health plans.

CFM and Oregon Business posed a series of questions on October 23 and 24, 2012 to business leaders who subscribe to Oregon Business magazine and participate in its monthly business leader survey, Input. Only 9 percent of the 300 respondents said their business would drop current coverage and let employees shop for health insurance on their own. Even fewer — 4 percent — said they would limit employee hours so they didn't qualify for coverage and thus excuse the business from paying a penalty for not covering them.

Nearly half — 46 percent — said they disagreed with claims that a goal of the Affordable Care Act is to "move workers off of employer-provided health insurance plans."

Business dissatisfaction with federal health care reform seems tied to fears it will increase health care insurance premiums and costs for small businesses. Almost 63 percent of respondents said the Affordable Care Act would increase health care costs for small businesses.

The Political Consumer

Before each party's national convention, The Washington Post created a pair of graphs showing the consumer habits of Democrats and Republicans. Click on image to view larger version.Political point of view extends far beyond whether you support gay marriage or across-the-board tax cuts. That point of view apparently influences other parts of life, including consumption habits.

The Washington Post has developed a pair of visual graphs depicting Democratic and Republican consumers, relying on a Scarborough Research survey that sampled 200,000 U.S. adults.

Some of the findings are obvious enough — a lot more Republicans watch Fox News and eat at Chik-fil-A than Democrats; more Democrats contribute to environmental groups and shop at Kmart than Republicans. After that the findings get interesting and maybe even odd.

Click on image to view larger version. Image was created by The Washington Post.For example, more Democrats than Republicans buy organic products, while more Republicans are likely to eat at a steakhouse than Democrats. Almost three times more Republicans hunt compared to Democrats and Democratic Twitter users outnumber Republicans.

Twice as many Democrats than Republicans are very interested in the NBA. Three times as many Republicans than Democrats own a powerboat.

Almost equal numbers of Democrats and Republicans are covered by Medicare and do yoga. Republican dog owners outnumber their Democratic pup lovers, but more Democrats than Republicans frequent casinos.

One key piece of information from the survey — don't bug Republicans on college football Saturdays and don't interrupt Democrats during the Grammy Awards.

Read the graphs for more interesting comparisons and contrasts.