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The Public’s Health Care Agenda for the 113th Congress

Meanwhile, Americans tilt negative on the idea of increasing Medicare payroll taxes (43 percent versus 55 percent oppose), and are strongly against the idea of raising premiums for all beneficiaries (85 percent oppose, including 61 percent that strongly oppose), at least when framed as ways to reduce the deficit.

Raising the Age of Eligibility. Two other proposals currently divide the public nearly in half: raising the age of Medicare eligibility (48 percent support, 51 percent oppose), and reducing payments to hospitals and other providers (46 percent versus 51 percent). The survey suggests that public opinion on changing the age of eligibility – a proposal that has received a fair amount of attention in recent months – is still moveable to a degree. When those who favor raising Medicare’s eligibility age were provided a counterargument, that the proposal would increase costs for employers and those people not yet eligible for Medicare and might leave some uninsured, just over half of them (representing 24 percent of the public overall) said they would be more likely to oppose the age change. On the flip side, when those who oppose the idea of increasing the eligibility age were told that the proposal would save the federal government money and help preserve the program, 15 percent of the public now felt more favorable to the proposal.

FIGURE 10: ARGUMENTS CAN SWAY PUBLIC OPINION ON RAISING THE ELIGIBILITY AGE Would you favor or oppose raising the age of eligibility for Medicare from 65 to 67 for future retirees as a way to reduce the federal deficit? Favor Oppose 48% 51% After those in favor heard that “this proposal would increase costs for employers and people not yet eligible for Medicare, and may leave those that can’t afford coverage uninsured” Favor More likely to oppose Oppose 20% 24% 51% After those opposed heard that “this proposal would save the federal government money and help preserve Medicare for the long term” Favor More likely to favor Oppose 48% 15% 35% There one group of Americans where a clear majority would be willing to see the future Medicare retirement age rise to 67: those who have already safely passed the current eligibility age of 65. Among today’s seniors, most say they favor the idea of increasing the age for future beneficiaries. At the same time, however, seniors are much less likely to favor the idea of cutting Medicare payments to hospitals and other health care providers that are treating them.

FIGURE 11: MOST SENIORS FAVOR INCREASING THE MEDICARE ELIGIBILITY AGE 18-64 65+ Gradually raising the age of eligibility for Medicare Favor 43% 64% Oppose Reducing payments to hospitals/other providers for treating Medicare patients Favor 48% 35% Oppose Views on Public Health Spending Priorities In addition to questions about the federal government’s insurance programs (Medicare, Medicaid, and the Affordable Care Act), the survey also asked people about their priorities for health spending in 15 additional program areas, given the substantial federal budget deficit. Five of these areas were cited by a majority of the public as being “one of the top priorities” for federal spending: funding for veterans’ health care (60 percent), preparing for and responding to health problems or injuries resulting from natural disasters or terrorist attacks (59 percent), increasing research to find new cures and treatments for major disease threats (58 percent), preventing the spread of infectious diseases, including providing vaccinations (52 percent), and preventing chronic illnesses, such as heart disease, cancer, and diabetes (51 percent). When asked if federal spending on improving health and preventing illness saves the nation money in the long run, two-thirds of the public (67 percent) says it does. Not surprisingly, those who hold this belief are significantly more likely to prioritize spending on things like vaccinations and screening tests, as well as providing funds to state public health departments and hospitals that treat the uninsured.

FIGURE 12: PUBLIC HEALTH SPENDING PRIORITIES Given the national budget deficit, what should be a priority for federal spending this year? One of the Top Priorities Funding for veterans’ health care 60% Preparing for – and responding to – health problems or injuries resulting from natural disasters or terrorist attacks Increasing research to find new cures and treatments for major disease threats Preventing the spread of infectious diseases, including providing vaccinations Preventing chronic illnesses, such as heart disease, cancer and diabetes Ensuring the safety and effectiveness of prescription drugs Providing screening tests for major health problems Detecting and preventing foodborne illnesses Preventing the spread of HIV/AIDS Funding support to hospitals so they can provide free or subsidized care to people without health insurance Ensuring workplace safety Funding to state public health departments Reducing smoking and tobacco use Reducing obesity by promoting healthy lifestyles Preventing injuries, such as burns, poisoning and falls The Government’s Role in Health Care Policy: The Big Picture Asked to say in their own words what they thought the federal government should focus on to improve the American health care system, the public was fairly divided, focusing on three familiar themes in the ongoing public debate: making health care more affordable (25 percent), making it more accessible (21 percent), and staying out of the way (19 percent).

FIGURE 13: IN THEIR OWN WORDS… “If the federal government could do one thing to improve the nation’s health care system in the next few years, what do you think it should be?” Make health care more affordable, lower costs 25% “Facilitate lower health care costs” “Make it more affordable for people to get health care” “Reduce hospital costs” “Make sure every patient is able to afford their needed medication” “Make insurance more affordable” “Make it affordable for people who don’t have that much” “The cost needs to go down” Make health care more accessible, available to more people 21% “I feel that there should be a mandate that everyone participate in national health insurance” “Universal health care” “Health care for everybody regardless of age and pre-existing conditions” “That everyone in the United States should have health care” “To get more health care for people” “Having a broader spectrum of health coverage” “More health care for the elderly” Less federal government intervention 19% “Get their nose out of health care and just open up competition amongst the health care providers” “Get out of the way and let people who are involved in the industry do their job” “Get out of the health care business” “Let people take care of themselves financially including health insurance. I just don’t think the government should be telling people what to do” “Get rid of ObamaCare” “The federal government should stay out of it. Leave it up to local government” “Start with repealing the Affordable Care Act” Note: Only responses of 5 percent or more shown. Other, Don’t know/Refused answers not shown. What Role Should the Federal and State Governments Play in Improving the Health Care System? Underlying the partisan divisions on specific aspects of health care policy and government spending lie real differences of opinion about the role of the federal and state governments in making the American health care system work well. Most Democrats say the federal government should play a “major role” in this arena (67 percent), and only slightly fewer say the same about state governments (58 percent). But while most Republicans do see some role for the federal and state governments in improving health care access and quality, the plurality see that role as a “minor” one. Independents are even more divided when it comes to how involved government should be.

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