Latest American Majority Project health care research focuses on voter priorities for change

Our latest research focuses on voter priorities for change in the American health care system.

For topline results, full slide deck and analysis from our polling partners, The Winston Group, see links below.

About the Research

  • Focus Groups on Swing Voters conducted by the American Majority Project in cooperation with the Center for Healthy America at the America First Policy Institute. April 19, 20, 27, and 28, 2022.
  • National Poll and analysis conducted by The Winston Group, on behalf of The American Majority Project and America First Policy Institute. Poll: 1,000 Registered Voters May 24-25, 2022.

Key Takeaways

We found high dissatisfaction with the U.S. health care system and a desire for a major overhaul – though one done in a step-by-step process over time.

  • Desire for overhaul was driven by dissatisfaction with the state of health care among Republicans and Independents.
  • Older voters were more negative about the state of health care than younger voters. This indicates that the older people are and the more they engage with the health care system, the more negative they are.
  • The preference for a step by step overhaul was similar across parties.
    • Health Care in America: Right Track / Wrong Track
      • All: 31-50
      • Democrats: 51-32
      • Independents: 18-58
      • Republicans: 21-63
      • Millennial/Gen Z: 39-42
      • Gen X: 29-56
      • Baby Boomers: 27-51
    • Would you say the American health care system needs…A major overhaul / A few targeted fixes
      • All: 49-43
      • Democrats: 42-51
      • Independents: 54-34
      • Republicans: 54-42
    • Would you say the American health care system needs…A major overhaul done in a step by step process over time / A major overhaul done quickly / A few targeted fixes
      • All: 37-25-31
      • Democrats: 37-24-34
      • Independents: 38-25-26
      • Republicans: 37-26-32
Perception of American health care
Desire for major change

Voters tend to view the federal government – rather than state and local government – as having the most power and responsibility to drive change, though their trust in government is low.

  • A plurality view the federal government as having the most power and responsibility to improve America’s health care system (43% and 37%, respectively).
  • However, there is a large dropoff when it comes to who Americans trust the most, with only 20% of Americans choosing the federal government.
  • Unlike on the question of power and responsibility, there is a large partisan divide in those voters choosing the federal government as the entity they trust the most to make improvements to America’s health care system:
    • Democrats: 28%
    • Independents: 17%
    • Republicans: 13%
  • This may be because Americans show a preference for national standards in health care due.
  • 55 percent of Americans prefer that health care laws and regulations be set at the national level “to provide consistency and standards across the country” versus 35% who prefer the local level “to account for specific local circumstances and values.”
  • The numbers are similar when the rationale for local standards is to “allow for experimentation that identifies what works and what doesn’t. (55-35 vs 54-36).
  • As expected, there is a significant partisan divide, though even Republicans show plurality support for national standards.
    • Democrats: 63-29 and 60-31.
    • Independents: 52-33 and 50-33.
    • Republicans: 50-42 and 49-43.
Desire for national consistency

Americans see health care as a moral issue and believe everyone should be treated equally regardless of ability to pay.

  • 68% of Americans agree with the statement “When it comes to getting the health care they need, people should only have to pay what they can afford.” 21% disagree and 11% don’t know.
  • The desire for “equal treatment and respect” given to patients was the highest scoring indicator for whether the health care system is working.

Americans see health insurance as their “pass” to getting good health care.

  • 79% agree with the statement “Getting good health care requires having good health insurance.” 17% disagree.
  • 68% agree with the statement “Patients with health insurance are treated better by health care providers than those without insurance.” 23% disagreed.
Desire for equal treatment
Role of insurance

More choices in health insurance is broadly popular (particularly among younger Americans) but the intensity is low. Americans want more choices but have much higher priorities in terms of the changes they would like to see, and what they find important.

  • 63% agree with the statement “I wish I had more health insurance choices”. 30% disagree.
    • Millennials/Gen Z: 74-20
    • Gen X: 74-18
    • Baby Boomers +: 46-46
More choices - health insurance

More choices for treatment is similarly broadly popular, especially among younger Americans. However, the intensity is much higher within the context of making health insurance work better, rather than more providers in geographic areas.

  • 63% agree with the statement “I wish I had more health care treatment choices.” 30% disagree.
    • Millennials/Gen Z: 74-19
    • Gen X: 73-20
    • Baby Boomers+: 45-46
  • In fact, 4 of the top 5 top scoring changes voters would like to see in the health system involve the way insurance works, including more providers in networks and steps to address prior authorization frustrations. (see full list at bottom)
More choices - treatment

We also explored concepts of patient responsibilities to purchase health insurance and live a healthy lifestyle, with strong results for Medicaid recipients being required to work and more modest support for time limits.

  • 59% agreed with the statement “Everyone who can afford health insurance should be required to purchase it.” 33% disagreed.
  • 69% agreed with the statement “If a person who can afford health insurance but chooses not to purchase it gets sick or injured, they should be 100% responsible for the cost of treatment.” 23% disagree.
Patient responsibilities - insurance
  • 83% agreed with the statement, “We have a responsibility to ourselves to live a healthy lifestyle to reduce the amount we have to spend personally on health care. 11% disagreed.
  • 75% agree with the statement, “We have a responsibility to our fellow Americans to live a healthy lifestyle to lower overall health care spending, which will lower health insurance premiums.” 18% disagreed.
Patient responsibilities - healthy lifestyle
  • 74% of Americans agreed with the statement “Able bodied adults receiving taxpayer funded Medicaid benefits have a special responsibility to maintain a healthy lifestyle to keep their health expenses low.” 19% disagreed.
    • Democrats: 74-19
    • Independents: 63-26
    • Republicans: 80-13
    • On Medicaid: 62-30
  • 68% of Americans agreed with the statement “Able bodied adults receiving taxpayer funded Medicaid benefits should be required to work, be actively looking for work, or go to school to qualify.” 24% disagreed.
    • Democrats: 66-26
    • Independents: 62-27
    • Republicans: 74-19
    • On Medicaid: 48-41
  • 61% of Americans agreed with the statement, “There should be a time limit to able bodied adults receiving taxpayer funded Medicaid benefits.” 29% disagreed.
    • Democrats: 58-32
    • Independents: 53-34
    • Republicans: 69-23
    • On Medicaid: 46-45
Patient responsibilities - Medicaid

Voters do not believe that health care in America is working.

  • Fifty percent disagreed with the statement “The American health care system is working”, and when presented with the negative of that statement, “The American health care system is NOT working,” 65% agreed.

Voters were presented with a list of ways to judge whether the health care system was working, and asked to vote 1-9 based on how important they found each, with 1 being not at all important and 9 being extremely important.

Voters were also presented with a list of changes to the health care system, and asked to vote 1-9 on how much each would improve things, with 1 being not at all improve and 9 being greatly improve.

Results falling one standard deviation above the mean are marked in green, indicating they are higher priority. Results falling one standard deviation below the mean are marked in orange, indicating they are lower priority.