hispanic attitudes on healthcare law

8/3/2019 Hispanic Attitudes on Healthcare law

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Herndon Alliance / Protect Your CareHealthcare Poll of Hispanic Voters

December 12, 2011


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Survey among N=600 Likely Hispanic Voters

480 land line completes / 120 cell phone completes

Conducted November 29 December 5, 2011

Sampling error + 4.0% at 95% confidence interval

Methodology


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Summary

A strong majority (55%) of Hispanic voters currently support the

Affordable Care Act (ACA) and 68% oppose repealing it.

Even more encouraging than their current support for the ACA isthe tremendous opportunity Hispanic voters offer to increasesupport for the new law. After they hear positive informationabout the ACA, support among Hispanic voters rises by 16points, over three times the increase that we see among votersoverall.

Hispanic voters are also much hungrier for information aboutthe law, as 66% say they need more information about it,compared to just 44% who say the same among voters overall.


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Summary

Making sure we are communicating anybenefits of the ACA toHispanic voters is much more important than getting tied down on

whichbenefits we are communicating, as each of the fourteen benefitsof the law that we tested were very popular. And some of the benefitsthat didnt test quite as high as others came out on top when they were

fleshed out as messages.

That said, benefits relating to the uninsured should be used primarilywith more downscale groups and Spanish speaking audiences. It isalso not critical to highlight benefits specifically related to the Hispaniccommunity, as it does not have a significant impact on support.

We see major gains across all demographics among Hispanic voters,but our best targets are younger, non-college women and those whospeak Spanish as much or more than they speak English.

Hispanic voters, including seniors and independents, strongly opposethe changes to Medicare and employer-based healthcare being

proposed by Republicans in Congress.


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Political Environment


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The economy is overwhelmingly the top issue for Hispanic voters, regardless of age,gender, or partisanship, with 57% identifying it as their top issue and 79% selecting it asone of their top two. Education and healthcare are a distant second, with immigrationseen as the least important of those tested. There is a major divide by language on

immigration, as it is tied for second most important among Spanish speakers (38% toptwo), but just 11% of English speakers make it one of their top two issues.

Most Important Issue

0 20 40 60 80 100

Immigration

The budget deficit

Healthcare

Education

The economy and jobs

8

9

11

13

57

20

28

34

33

79

1st choice 2nd choice


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57 55

2127

17 18

0

20

40

60

80

100

Party ID Generic congressional ballot

Dem

Rep

Ind/Pers

Hispanic voters remain a firmly Democratic voting bloc. In 2008, exit polls foundthat they identified with Democrats over Republicans by a more than 30-pointmargin, and that Democratic advantage has persisted. Hispanic voters currentlygive Democrats a 36-point edge in party identification and a 28-point lead in thegeneric Congressional ballot.

Partisanship of Hispanic Voters


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57

77

44

17

41

21

54

81

0

20

40

60

80

100

Overall Dem Ind Rep

Positive Negative

As a result of their firm Democratic leanings, Hispanic voters give PresidentObama a strong job approval rating of 57%. It is worth noting that amongindependent Hispanic voters, the Presidents job approval is at exactly the same

level (44%) as it was with independents overall in our last healthcare poll in May.

Obama Job Rating: Overall and by Party

+16+56 -10 -64

Net

Positive


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Hispanic voters trust President Obama more than Congressional Republicans onevery issue tested by at least a 20-point margin. The Presidents biggest advantage

is on protecting the middle class (34 points). He also leads by about 30 points onMedicare and Healthcare in general, and by 21 points on Medicaid.

33

33

33

30

29

28

54

55

55

59

59

62

0 20 40 60 80

Medicaid

Immigration

The economy and jobs

Healthcare

Medicare

Protecting the middle class

Obama GOP in Congress

Party Trust on the Issues: Obama vs. GOP in CongressNet

Hispanics

+34

+30

+29

+22

+22

NetOverall(May)

+15

+8

+7

+4

+21

N/A

N/A


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Support for ACA


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A majority of 55% of Hispanic voters currently support the new healthcarelaw, 13 points higher than the percentage supporting it among votersoverall. The level of strong opposition to the law among Hispanic voters

(19%) is also less than half of what it is among voters overall (39%).Support for ACA: Hispanic Voters vs. Voters Overall (May)

+26 -8

Net

Support

28 231939

0

20

40

60

80Strongly support

Somewhat support

Strongly oppose

Somewhat oppose

5042

29

55

Hispanic Voters Voters Overall(May)


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55

70

48

2329

14

35

62

0

20

40

60

80

Overall Dem Ind Rep

Support Oppose

Among Hispanic Democrats, 70% support the new law, which is actually 6 pointsbelow the percentage of overall Democrats who support it. But unlikeindependents overall (who oppose the law by a 16-point margin) Hispanic

independents supportit by a 13-point margin (48% support / 35% oppose).

Support for ACA: Overall and by Party

+26 +56 +13 -39Net

Support


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57 54

64

51 52 54

3226

21

34 3228

0

20

40

60

80

100

Men Women 18-34 35-49 50-64 65+

Support Oppose

+20 +26

As is the case with voters overall, there is no gender gap amongHispanics when it comes to support for the ACA. Other than the laws

elevated support among Hispanics under 35, support is fairly consistent

across age groups as well, with a majority in each age group supporting it.Support for ACA: By Gender and Age

+25 +28 +43 +17Net

Support


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49

5951

5663

36

23

3628

16

0

20

40

60

80

100

College Non-college Englishonly/mostly

Both equally Spanishonly/mostly

Support Oppose

The major demographic distinctions on ACA support among Hispanic voters occuralong the lines of education and language. In a reversal from voters overall, non-college Hispanics are much more supportive of the law than those with a collegedegree. Support is also higher among Spanish speakers than it is among English

speakers.

Support for ACA: Education and Language Spoken

+13 +36 +15 +47

Net

Support +28


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When we asked Hispanic voters what word or two came tomind when they thought about the new law, most of the

responses were positive.Impressions of Law: Open-Ended Responses


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66

4431

54

0

20

40

60

80

100

Hispanic voters Voters Overall (May)

I need to know more about the new healthcare law before I can take a firm position on it

I know enough about the new healthcare law to have a firm position on it

While Hispanic voters are more supportive of the new law than voters overall, theyhave much less information about it and their opinions are softer. While voters overallsay they already know enoughabout the law by a 10-point margin (44% need to knowmore / 54% know enough), Hispanic voters say they need to know moreby a 35-pointmargin (66% need to know more / 31% know enough). Among Hispanic Democratsand independents, the share saying they need to know more rises to 70%.

Knowledge of Law: Hispanic Voters vs. Voters Overall (May)

+35 -10Net NeedMore Info


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26

12

34

5668

83

55

40

0

20

40

6080

100

All Dem Ind Rep

The new healthcare law is deeply flawed, and Congress should repeal the entire law and start over again

The new healthcare law is not perfect, but we should give it a chance to work and make changes asneeded

+42 +71 +21 -16Net Dont

Repeal

Hispanic voters also are staunchly opposed to repeal, preferring to givethe law a chance to work and make necessary changes by a 42-point

margin. The opposition to repeal is also strong among independentHispanics they oppose it by a 21 point margin.

Support for Repeal: Overall and by Party


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Messaging


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We know that Hispanics are hungry for information on the law, so it is encouraging to see that they are

extremely supportive of its provisions once they learn about them. Each of the fourteen provisions of thelaw made at least two-thirds of Hispanic voters more likely to support it. The three benefits thatgenerated the strongest support were increasing funding for community health centers, cracking downon waste in Medicare, and making preventive care free. However, these benefits tested only marginally

higher than most others, making it clear that it is far more important to communicate some benefits toHispanic voters than to get caught up focusing on which ones.

Support for ACA Provisions 1st Tier: All and Key Audiences% MUCH More likely

All Shift tosupport

Ind

Increases funding for community health centers to improve healthcarein communities that need it most

62 62 64

Cracks down on waste, fraud and abuse in Medicare 59 64 62

Makes preventive care free by eliminating co-pays for annual check-ups, mammograms and other cancer screenings

58 57 43

Provides tax credits to small businesses to make healthcare coveragefor their employees more affordable

56 60 56

Cracks down on waste, fraud and abuse in Medicaid 55 55 58

Requires that members of Congress get their healthcare coverage fromthe same plans as tens of millions of Americans

54 55 56

Provides financial assistance to uninsured families earning under

eighty-eight thousand dollars so that they can get affordable healthcare

53 60 50


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Though the benefits below didnt rate quite as high as the previous seven, the differences are minor

and they are still very popular with Hispanic voters. Although ending denials for pre-existing conditionsgenerated the lowest support of the provisions tested, it was still strong. And since it is a focal point ofthe top-testing message later in the survey, we shouldnt shy away from using pre-X with Hispanics. Itis also worth noting that preventive care tests 8 points higher without the reference to birth control

Support for ACA Provisions 2nd Tier: All and Key Audiences% MUCH More likely

All Shift tosupport

Ind

Provides healthcare coverage to thirty-two million uninsuredAmericans, including nine million Latino-Americans

51 58 48

Provides healthcare coverage to thirty-two million uninsuredAmericans

51 51 53

Allows children to stay on their parents health insurance until theage of twenty-six

51 59 45

Makes preventive care free by eliminating co-pays for annual

check-ups, mammograms and other cancer screenings, andprovides birth control at no cost

50 49 44

Reduces minority health disparities by investing in communityhealth centers, language training and the recruitment of minorityhealth professionals

49 50 45

Cracks down on excessive premium hikes by insurance companies 49 51 46

Ends the practice of denying coverage for pre-existing conditions 46 47 39


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While all the benefits we tested were well-received by both English and Spanish speakers,there are some distinctions to keep in mind. Increasing funding for community health centersis very popular with both groups, but while benefits to the uninsured are major selling pointsfor bi-lingual and Spanish speakers, benefits such as cracking down on waste, the member of

Congress requirement and tax credits for small businesses had greater resonance amongEnglish speakers.

Support for ACA Provisions: Most Popular by Language Spoken% MUCH More likely

Mostly/Only English Both Equally or Mostly/Only Spanish

Cracks down on waste, fraud and abuse in

Medicare / Medicaid

60 Increases funding for community health

centers to improve healthcare incommunities that need it most

70

Requires that members of Congress get theirhealthcare coverage from the same plans astens of millions of Americans

58 Makes preventive care free by eliminatingco-pays for annual check-ups,mammograms and other cancerscreenings

64

Increases funding for community healthcenters to improve healthcare incommunities that need it most

55 Provides financial assistance to uninsuredfamilies earning under eighty-eightthousand dollars so that they can getaffordable healthcare

59

Provides tax credits to small businesses tomake healthcare coverage for theiremployees more affordable

53 Provides healthcare coverage to thirty-twomillion uninsured Americans, including ninemillion Latino-Americans

58


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After these voters heard about all the provisions, we asked them to name the one theythought was most important. The two provisions that came out on top were providingcoverage to the uninsured (22%) and making healthcare more affordable for those earningunder eighty-eight thousand dollars a year (17%). These two provisions were also the

most cited by those who shifted to support and by independents.

Most Important Provision: Open-Ended ResponsesTop Five

4

4

10

19

17

8

7

6

22

21

6

5

7

17

22

0 5 10 15 20 25 30

Cracks down on waste inMedicare/Medicaid

Ends denials for pre-existingconditions

Kids can stay on parentsplan

More affordable for under88K

Provides coverage touninsured

Overall Shift to support Ind


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Word Cloud of Open-Ended Responses on Most Important Provision


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After hearing about the provisions, support for the law among Hispanicvoters rose 16 points, from 55% to 71%. Strong support increased by nearlyas much, rising from 28% to 41%. This demonstrates that we cansignificantly increase support for the law with straight information and dont

need flowery rhetoric.Increase in Support for ACA Post Provisions

2841

19 150

20

40

60

80

Strongly support

Somewhat support

Strongly oppose

Somewhat oppose

21

55

71

29

+26 +50Net

Support

Initial Post Provisions


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55

71

4247

29

21

5045

0

20

40

60

80

Initial Post Positives Initial Post Positives

Support Oppose

This 16-point increase in support demonstrates the tremendous opportunity thatHispanic voters offer to supporters of the ACA. This increase was over threetimes as large as the 5-point increase in support among voters overall that we

saw in our May poll, after a similar exercise touting the benefits of the ACA.Impact of Positive Information on Support for ACA: Hispanics vs. Voters Overall

+26 +50 -8 +2Net

Support

Hispanic Voters Voters Overall (May)


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All HISPANIC VOTERS +16

Non-College women under 50 +24

Non-College women +22

35 to 49 year olds +22

Women under 50 +21

No health insurance +21

Spanish equally/mostly/only +20

Unmarried women +20

Groups With Biggest Increases in Support for ACA


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The top-testing messages among Hispanic voters focus on making healthcare more secure (byhighlighting pre-existing conditions and the member of congress requirement), expanding preventivecare and reducing costs. All messages are very effective with both Hispanic voters overall and keyswing groups. The pre-existing/Congress message was also the strongest in our May poll of all

voters, and among Hispanic independents, it tests 10 points higher than the 2

nd

best message.Messages in Favor of ACA 1st Tier: Overall and Key Audiences% MUCH More Likely to Support ACA

All Shift tosupport

Ind

[SECURE/CONGRESS] The new healthcare law will make healthcare coveragemore secure by ensuring that working families cannot be denied coverage due to

a pre-existing condition, or lose their coverage when someone gets sick. It willalso require that members of Congress get their healthcare coverage from thesame plans as millions of Americans. If it is good enough for Congress, then it willbe good enough for working Americans.

67 70 71

[PREVENTIVE CARE] The new healthcare law requires that all new insuranceplans must cover key prevention services, like annual-checkups, contraception,mammograms and other cancer screenings with no co-pay. This will save

thousands of lives every year and bring down costs because it is far better todetect health problems early or prevent them entirely. Covering preventive care,including check-ups and cancer screenings, is important to good healthcare.

66 66 58

[REDUCE COSTS] The new healthcare law will reduce costs for families bycracking down on insurance companies unfair premium hikes, creating newcompetitive healthcare markets that will increase competition among insurancecompanies, and by eliminating co-pays for preventive care, including annual

check-ups and cancer screenings. These changes will make quality healthcaremore affordable for working families.

64 67 61


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The other three messages on job creation and providing coverage to the uninsured alsotested well, underscoring the point that this it is more important to be communicating benefits toHispanic voters than to get tied down on which ones to communicate. Also important: it isnt

necessary to highlight benefits specific to the Latino community to increase support.

Messages in Favor of ACA 2nd Tier: Overall and Key Audiences% MUCH More Likely to Support ACA

All Shift tosupport

Ind

[CREATE JOBS] The new healthcare law will help to create jobs by reducinghealthcare costs for small businesses. It gives tax credits to small businesses to

make it easier for them to provide healthcare to their employees and allows themto band together to pay the same rates for healthcare that big corporations pay. Byreducing their healthcare costs, small businesses will be able to invest more intheir companies and create jobs.

60 71 51

[COVER UNINSURED W/O LATINO] The new healthcare law will help families byproviding healthcare coverage to thirty-two million uninsured Americans.Uninsured families earning under eighty-eight thousand dollars will get financial

assistance so that they can get affordable healthcare. And because E-R visits forthe uninsured increase costs for everyone, covering them will also help reducecosts for those families who already have insurance.

59 63 51

[COVER UNINSURED W/ LATINO] The new healthcare law will help the Latinocommunity by providing healthcare coverage to nine million uninsured Latino-Americans. Uninsured families earning under eighty-eight thousand dollars will getfinancial assistance so that they can get affordable healthcare. And because E-R

visits for the uninsured increase costs for everyone, covering them will also helpreduce costs for those in the Latino community who already have insurance.

50 56 37


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Opposition to GOP Healthcare Changes


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Hispanic voters are staunchly opposed to Republicans proposed changes to Medicare and

the nations employer-based healthcare system. Even when the plan is described in balancedlanguage, noting that it would not impact those 55 or over, 61% of Hispanic voters oppose it,with 40% strongly opposed. Strong opposition is even higher among seniors and a strongmajority of Hispanic independents also oppose it.

GOP Budget Proposal After Description of Medicare Changes

The healthcare plan recently proposed by Republicans in Congress would keep the healthcarecoverage and traditional Medicare benefits the same for anyone who is now fifty-five or OVER. But foranyone UNDER 55, Medicare would be replaced by a voucher system. The plan would also eliminatetax breaks that encourage companies to provide healthcare to their employees and instead givevouchers to individuals to buy their own insurance. For Americans UNDER 55, this would mean thatmost healthcare plans from employers and all traditional Medicare benefits would be replaced withvouchers from the government that would be used to buy private health insurance coverage.

12 14 9

40 47 35

0

20

40

60

80

Strongly support Somewhat support Strongly oppose Somewhat oppose

30

-32 -31Net

Support

Hispanic Voters Seniors Independents

-26

29 28

61 5659


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Conclusion

Hispanic voters firmly support ACA and strongly oppose repeal.

They offer a tremendous opportunity for ACA allies to expand supportfor the law.

Most important to communicate some benefits, dont get bogged down

on whichbenefits, though those pertaining to the uninsured should bereserved for more downscale groups and Spanish speakers. Also notcritical to highlight benefits specific to the Hispanic community.

Best targets are younger, non-college women and those who speakSpanish as much or more than they speak English.

Hispanic voters strongly oppose the changes to Medicare andemployer-based healthcare being proposed by Republicans inCongress.

hispanic attitudes on healthcare law

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