What are the top healthcare concerns for voters? Surprise bills, ACA's future, poll shows

According to the most recent Kaiser Family Foundation (KFF) Health Tracking Poll, many Americans are worried about the future of the Affordable Care Act (ACA) protections for people with preexisting conditions.

As many as 68% of respondents say they do not want to see the Supreme Court overturn their preexisting condition protections, and 54% are also in favor of keeping the entire healthcare law as is.

The concern is split almost equally between Democrats and Republicans, with most respondents saying it’s “very important” that ACA provisions remain in the law, even if these protections may lead to increased insurance costs for all. Voters are divided, however, on who should bear those costs; about 43% believe the burden should be on the insurance company alone, and 47% believe insurance companies and providers should share the cost.

Other healthcare issues on the minds of Americans include prescription drug costs, 68%; protections for preexisting conditions, 64%; and surprise medical bills, 50%. Other concerns consumers have for Congress, although not in the top three, include a "Medicare-for-All" plan, 31%, and repealing and replacing the ACA, 27%.

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These top priorities mirror those laid out in the January KFF Health Tracking Poll released earlier in the year.

Though protections for people with preexisting conditions enjoy bipartisan support, there's a split on the ACA's role in preserving those protections. While a majority of Republicans want the Supreme Court to overturn the ACA, less than half (44%) say they want to see the ACA’s protections for people with preexisting conditions overturned.

The landmark healthcare law has faced significant legal pushback. In December of last year, a Texas judge issued a ruling that invalidated the ACA because its individual mandate was repealed. And just last month the Trump administration filed a statement that supports the judge’s ruling that the ACA is invalid.

The poll also spotlights consumer anxiety about surprise billing. The Texas Hospital Association (THA) put out a press release in support for consumer protections.

“Texas hospitals have consistently supported protecting patients from surprise medical bills for out-of-network health care services,” said Ted Shaw, THA president and CEO. “Receiving an unexpected bill, and the shock, distress and anxiety that it can cause undermine a patient’s recovery and road back to good health.”

Currently, patients who receive bills for out-of-network care can request mediation with the Texas Department of Insurance, the association said. While Texas hospitals support a change in the current system, they do not want to throw out mediation and replace it with binding arbitration for health plans and providers—possibly leading to increased insurance costs.

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In addition, Kaiser Family Foundation's poll found that 56% of voters favor a Medicare-for-All plan, and 50% think highly of the ACA. Another 38% hold unfavorable views of a Medicare-for-All plan or the ACA. By party, three-fourths of Democrats support the 2010 ACA, and 77% of Republicans have an unfavorable view.

Looking at both sides of the aisle, 52% of Republicans say replacing the ACA is a top priority, and 47% of Democrats say implementing Medicare for All is a top priority.

And support is growing from Democrats. The most recent poll shows 58% call Medicare for All very positive, up from 49% in 2017. And there has been a growing number—from 42% to 51%—of Republicans who have a very negative reaction to it.

The poll also weighed how support varies depending on the terminology used to describe the plan. For example, 63% said they viewed "universal coverage" and "Medicare for All" positively. However, support dropped to 59% when it was described as a "national health plan," 49% for a "single-payer health insurance system" and 46% for "socialized medicine."

Most Democrats report wanting Congress to increase spending on Medicare (65%) and Medicaid (61%). And Republicans are more divided, with about 58% wanting spending on Medicare to remain the same and 52% wanting Medicaid to remain the same, according to the poll.