More Than Half of Americans Favor State Insurance Exchanges; Lawmakers Split Along Party Lines

More than half of Americans believe that the creation of state-based health insurance exchanges should be a main healthcare priority, contrary to lawmakers who are split along partisan lines on the exchanges, according to a survey released by the Kaiser Family Foundation, the Robert Wood Johnson Foundation and the Harvard School of Public Health.

Fifty-five percent of the public, which includes majorities of Republicans and Democrats, say that establishing the exchanges is a “top priority” for their governor and legislature. So far, 18 states and the District of Columbia have declared that they will create their own state-based exchanges, seven other states have opted to establish exchanges in partnership with the federal government and 25 others, some driven by resistance to the ACA, appear set to default to a federally run exchange.

Similarly, while some Republican governors are opposed to optional expansion of Medicaid under the ACA, 52 percent of Americans say their state should expand its Medicaid program. Two-thirds of Republicans say they prefer to keep their state Medicaid program as is, and 75 percent of Democrats are seeking a state expansion.

In other key findings, results show that:

  • Fifty-two percent of Americans — including 78 percent of Republicans — agree that opponents of the ACA should continue trying to change it, while 40 percent feel that opponents should accept it now that it’s law.
  • Sixty-five percent of Americans say that Washington should act quickly to bring down the deficit, but a minority are in favor of major reductions in federal spending on healthcare.
  • Fifty-eight percent of Americans oppose any spending cuts to Medicare and 46 percent oppose any cuts to Medicaid.
  • Only two specific proposals to trim Medicare drew majority support from the public: requiring drug companies to give the federal government a better deal on medications for low-income people on Medicare, and requiring high income seniors to pay higher Medicare premiums. Proposals to raise the Medicare age to 67, and raising all seniors’ Medicare premiums, drew opposition.

Americans were also asked to identify from a list of 15 federal program areas in health and healthcare, excluding Medicare, Medicaid and the ACA, which ones they considered to be top priorities for federal spending; the tops five were:

  • Funding for veterans’ healthcare (60 percent);
  • Funding for health problems resulting from natural or man-made disasters (59 percent);
  • Increasing research to find new cures and treatments for major disease threats (58 percent);
  • Preventing the spread of infectious diseases, including providing vaccinations (52 percent);
  • Preventing chronic illnesses, such as heart disease, cancer, and diabetes (51 percent).

Asked about the diseases or health conditions that pose the greatest threats to the American public, the public’s top concerns are cancer (56 percent) and heart disease (35 percent), as has been true for several years. But since 2007, there has been a substantial increase in the proportion of the public that see diabetes (30 percent in 2013, compared to 14 percent in 2007) and obesity (26 percent in 2013, compared to 6 percent in 2007) as posing one of the two greatest threats.

Source: Robert Wood Johnson Foundation, January 24, 2013

Health Insurance Exchanges: Preparing for the Brave New Marketplace Ahead

Health Insurance Exchanges: Preparing for the Brave New Marketplace Ahead provides information on the hurdles state lawmakers and stakeholders are facing in developing models and establishing exchanges, through insights from industry consultants, state lawmakers and regulators, scholars and other key industry observers.

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