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KFF: Healthcare Affordability is an Election Issue


The economy and healthcare costs are the issues voters want to hear about going into the 2024 presidential election, finds a survey by KFF.

Healthcare costs top the list of peoples’ financial worries. More than half of the people surveyed by KFF worry about paying for their prescription drugs, and almost 3 in 4 people said they worry about unexpected healthcare costs more than everyday expenses. The recent survey found that 86% say they are worried about the cost of healthcare services and 83% said they are worried about medical bills. Many also worry about financial debt; 70% of adults are very or somewhat worried a medical or dental bill will put them into debt.

KFF also found that 19% of adults say they have difficulty affording their bills each month and 37 say they are just able to afford their bills each month. The people who say they are struggling financially are disproportionately made up of Black adults, Hispanic adults, and women.

The survey also found that healthcare costs are a top issue for voters and have impacted their views on the economy. Overall, 67% of voters view the economy negatively. But 88% of Republican voters and 72% of Independent voters are more likely to hold negative views on the economy.

Voters who have trouble affording their monthly bills are more likely than those who can afford their bills with money left over to say it is very important for the 2024 presidential candidates to talk about economic and healthcare related issues such as inflation, affordability of healthcare, prescription drug costs, the future of Medicaid, and student loan debt.

The Affordable Care Act (ACA) remains popular generally, with 59% of those surveyed saying they viewed the law favorably. But 67% of Republican voters view the ACA unfavorably.

The survey also finds gaps in people’s knowledge about the law. For example, between 3 and 4 in 10 of those surveyed are aware of the provision that protects people with pre-existing conditions. Additionally, many are unaware that the uninsured rate has gone down since the ACA’s enactment. Since 2010, access to insurance through the Affordable Care Act Marketplaces, as well as the expansion of Medicaid, has led to a decrease in the uninsured non-elderly adults in the United States from 18% to about 10%.

“During the open enrollment period at the end of 2023, a record breaking number of individuals selected health insurance plans through the ACA Marketplace, or healthcare.gov, continuing a trend of increases in enrollment since 2020’s open enrollment period,” KFF wrote. “However, this fact is not widely known among the public.”

The KFF survey was conducted from Jan. 30, 2024, to Feb. 7, 2024, online and by telephone with 1,309 U.S. adults, including 1,055 registered voters.

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