CHA News Article

Report Shows Increase in California Voter Support for ACA
Voters also support proposals aimed at improving state’s health care system

A Field Poll report released this week shows that following its first year of implementation in California, the Affordable Care Act (ACA) is now receiving greater support from California voters than at any time since its introduction in 2010. Conducted as a two-part survey, part one of the survey examines voter opinions about changes in the state’s health care system following implementation of the ACA. Part two examines voter visits to and views of the Covered California health insurance exchange website, the expansion of the state’s Medi-Cal system under the ACA and proposals aimed at improving the state’s health care system, including the proposal to extend Medi-Cal to the state’s undocumented immigrants. The poll — made possible by a grant from the California Wellness Foundation — was conducted June 26-July 19 among 1,535 California registered voters in seven languages and dialects.

Major findings from part one of the survey include:

  • By a two-to-one margin (60 percent to 30 percent) voters think the state of California has been successful in implementing the ACA. This contrasts with their much more divided assessment of the way the federal government has implemented the law (49 percent successful vs. 46 percent not successful).
  • Many more voters say the state has been successful than feel it has been unsuccessful in achieving six of seven goals that California set out to achieve when it began implementing the law. This includes encouraging uninsured residents to get coverage, expanding Medi-Cal, providing consumers with more insurance choices, obtaining the federal funds needed to implement the law, providing better consumer protections and establishing a one-stop place where consumers can go to shop for health insurance online.
  • The one area where more voters think the state has not been successful in its implementation of the law relates to limiting the rate increases that insurance companies charge their customers. Statewide, 46 percent feel California has been unsuccessful in meeting this goal, while 37 percent think it has been successful. Another 17 percent aren’t sure. Related to this is the finding that 46 percent of voters say they have difficulty paying the costs of their health care, including 17 percent who say it’s very difficult. However, the proportion reporting that their health care costs are very difficult to afford declined four points from 21 percent who said this last year.
  • The poll also finds two-thirds of California voters (66 percent) in support of the ACA’s requirement that private health insurance plans cover the full cost of birth control. In addition, most (56 percent) disagree with the recent U.S. Supreme Court ruling allowing certain employers, whose owners object to birth control on religious grounds, to be exempt from this requirement.
  • These generally positive evaluations of the ACA and its implementation in California appear to be impacting voters’ overall views of the way the state’s health care system is performing. Currently, 56 percent say they are satisfied with the way the state’s health care system is working, while 34 percent are dissatisfied — a significant improvement from prior TCWF-Field Health Policy Surveys.

Major findings from part two of the survey include:

  • More than one in three voters under the age of 65 (36 percent) have personally visited the Covered California website, and 9 percent say they obtained their health coverage there.
  • While a majority (56 percent) of voters who visited the Covered California website were satisfied with their experience there, 42 percent were dissatisfied. Voter evaluations of the website are colored largely by a voter’s party affiliation and overall opinion of the ACA. For example, 63 percent of registered Democrats and 71 percent of voters supportive of the ACA say they were satisfied with their experience at the website. By contrast, 39 percent of Republicans and just 28 percent of voters opposed to the ACA who visited the website were satisfied. Interest in visiting the website in the future is similarly partisan and is tied to a voter’s party affiliation and overall opinion of the ACA.
  • Nearly two in three voters (62 percent) say that the state’s Medi-Cal program is important to themselves and their families, up from 58 percent who reported this in 2013 and 51 percent who said this in 2011. The proportion of voters who consider Medi-Cal to be “very important” has also increased from 29 percent in 2011 to 40 percent in the current survey. Two in three voters (65 percent) also believe Medi-Cal has been successful in meeting its program objectives, while just 16 percent feel it has not.
  • Large majorities of voters support a number of proposals aimed at improving the state’s health care system. These include: encouraging insurance companies to reward doctors and hospitals more for the quality of care they provide than the number of patients they serve (82 percent); encouraging insurance companies to reduce costs by allowing physician assistants and nurse practitioners to play a bigger role in providing care to patients (81 percent); and expanding state funding of not-for-profit health insurance co-ops (78 percent).
  • Opinions are more divided about the proposal to expand Medi-Cal to provide preventive health services to undocumented immigrants. Slightly more than half (51 percent) support the idea, but 45 percent are opposed. Views about this are highly partisan and divide voters across racial/ethnic lines.