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NEACH Summit

November 9, 2015

Marlborough, MA

Moving Forward On The ACA

KATHY MELLEY COMMUNICATIONS DIRECTOR

AGENDA

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1. Where We Started

2. Findings

3. Takeaways

4. New Messaging

• The purpose of this study was to learn where voters currently are on the

Affordable Care Act and understand what they want for the future of the law.

• We started with focus groups, sponsored by Community Catalyst, with

voters who are conflicted about the law. We purposely wanted to hear from

voters who are more conservative and who lean against the law.

• We followed with a survey, which was jointly sponsored by Community

Catalyst and SEIU. The survey was of likely voters in five battleground

states: Florida, Nevada, Ohio, Pennsylvania, and Virginia.

Where We Started

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Methods

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Battleground Survey FL, NV, OH, PA, and VA

Focus Groups

August 2015

Six focus groups with voters who are

“conflicted” about the ACA (most were

Republican and Independent voters):

• Philadelphia 8/11/15

• Charlotte 8/12/15

• Milwaukee 8/13/15

September 2015

N=1,005 adults 18 and older who are likely voters.

5 states: FL (n=202); NV (n=201); OH (n=200); PA

(n=201), and VA (n=201).

“Likely voters” are individuals who say they are likely

to vote in the 2016 elections, and have shown a

history of voting in the 2008 and 2012 elections.

15-minute survey.

Telephone survey (50% landline/50% cell phone).

Margin of error is + 3.1 percentage points.

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Where They Start

• ACA does not affect me…

• Except we are paying for it.

• The ACA is not working – it did not make health care more

affordable.

• But there are things about the law they like – no more exclusions

for pre-existing conditions, etc.

• Limited awareness of King v Burwell – not a big deal.

• Still, most feel it’s too late to repeal the ACA – too many people

are affected.

• Leads them to conclude……

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…the health care law is here to stay!

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Poll Findings

Two-thirds (64%) agree the ACA is probably here

to stay.

58% Say “stop wasting time.” Fifty-eight percent of voters agree

strongly (46%) or somewhat (12%)

that “Congress should stop wasting

time trying to repeal the Affordable

Care Act” – 39% disagree. (Dems

84% agree/13% disagree; Indeps

55% agree/42% disagree; Reps

32% agree/66% disagree).

Democrats: 83% agree/14% disagree

Independents: 63% agree/33% disagree

Republicans: 45% agree/50% disagree

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Improve vs. Repeal

Improve the law, don’t repeal it.

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Q: Here are two statements about the Affordable Care Act. Please

choose the one you agree with most.

N=1,005

40% 58% Vs.

Is it working? Voters are torn: 46% agree the

law is working but 49% do not

agree it is working. This is likely

driving their support for

improving the law.

Keep/Improve

Repeal

D-84%

I-54%

R-31% D-13%

I-44%

R-67%

71% Agree strongly (48%) or

somewhat (23%) that

“Congress should work to

improve the ACA” – 26%

disagree. (Dems 88%

agree/8% disagree;

Indeps 67% agree/31%

disagree; Reps 54%

agree/43% disagree).

40%

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The Ongoing Debate

Frustrated by the debate.

What is one word that describes how you feel about the ongoing

political debate about the Affordable Care Act?

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TOTAL

Very

Important

Somewhat

Important

No more pre-existing conditions. People with pre-existing conditions

no longer have to worry about being denied insurance because of their

health.

93%

74%

19%

More preventive care. Some states are reporting that more people are

now getting preventive services like physical exams and breast cancer

screenings.

93% 73% 20%

You now have an option. Now if you lose a job, become pregnant, get

married, or have another life-changing event, you can get health

insurance right away without waiting.

90% 69% 21%

Benefits to women. More women now have maternity coverage and

are able to get cancer screenings, annual check-ups, and birth control

with no copayments.

87% 64% 23%

More people insured. More than sixteen million uninsured people

have now been able to get heath insurance. 83% 60% 23%

Less uncompensated care. Studies are starting to show that fewer

uninsured people are using hospital ERs for their care. 81% 52% 29%

Children covered until 26. Parents now have the option of keeping

their children on their health insurance until age 26. 76% 52% 24%

Agreement on Outcomes of the Law Q: Please tell me if you think each is an important or not important outcome of the law.

N=1,005

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Agreement on Changes to the Law

Q: I am going to read some ideas to improve the Affordable Care Act. Regardless of how you feel

about the law, please indicate whether you support or oppose the idea. N=1,005

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Agreement on Changes to the Law

Q: I am going to read some ideas to improve the Affordable Care Act. Regardless of how you feel

about the law, please indicate whether you support or oppose the idea. N=1,005

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Key Takeaways

Two-thirds of likely voters in battleground states believe the ACA is here to stay.

The majority supports improving the law over repealing it.

They prefer a 2016 candidate who wants to keep/improve the law over a candidate who wants to repeal it.

The prolonged debate over the law is frustrating them.

Likely voters agree there are a number of important outcomes from the law.

They support many ideas to improve the law. In particular, they want more transparency in healthcare pricing and limits on insurance companies’ ability to overcharge consumers.

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Messaging

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Message Frame

Value to tap into: Frustration over the on-going debate over ACA

Value Message: We have wasted enough time, energy and taxpayer money

fighting over repealing the ACA. It’s here to stay.

• Congress voted on it.

• Supreme Court upheld it.

• Voters believe that “Congress should stop wasting time trying to repeal it”

(poll).

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Message Frame

Barrier to remove: I don’t believe the law is working (don’t want to join

an effort that will force them to celebrate ACA as a huge success).

Barrier Message: While there are some good outcomes to the law such as

coverage for people with pre-existing conditions, there are a lot of things about

the ACA that must be improved. The top priority moving forward should be

finding ways to lower people’s healthcare costs.

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Message Frame

Ask: Let’s move forward and find ways to improve the ACA so it lowers health care costs.

• Expand tax credits to small businesses to help them offer health insurance to their employees.

• Prevent insurance companies from charging high co-payments for medications and treatments that are necessary for people with serious illnesses.

• Give Medicare more power to negotiate prices for prescription drugs to lower costs.

• Give state insurance commissioners more authority to push back on insurance companies that want to hike up insurance premiums.

Vision: Together, we can move forward to bring health care costs down for everyone.

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Best Messengers

• A local hospital CEO

• A director of a local health clinic

• A local small business owner

• A large local employer

• Someone who has marketplace coverage

• A local nurse, doctor, and frontline healthcare worker

• Researchers at a state university

• Someone from the American Cancer Society/American Heart Association

While some want to hear from their governor, most

do not trust local and national politicians on this

issue.

Thank You