Release #2448 Embargoed for Print Publication: Monday, August 19, 2013

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1 THE FIELD POLL THE INDEPENDENT AND NON-PARTISAN SURVEY OF PUBLIC OPINION ESTABLISHED IN 1947 AS THE CALIFORNIA POLL BY MERVIN FIELD Field Research Corporation 601 California Street, Suite 900 San Francisco, CA (415) FAX: (415) Release #2448 Embargoed for Print Publication: Monday, August 19, 2013 HALF OF CALIFORNIA VOTERS SAY THEIR HEALTH CARE COSTS INCREASED THIS YEAR AND MAINTAINS THAT HEALTH CARE IS DIFFICULT TO AFFORD. MAJORITIES DESCRIBE MEDICARE AND MEDI-CAL AS IMPORTANT PROGRAMS AND SAY THEY RE SUCCESSFULLY MEETING THEIR GOALS. By Mark DiCamillo and Mervin Field Half of the state s voters (50%) say they are now paying more for health care than they were last year. The same proportion (50%) describes health care costs as being difficult to afford. Uninsured voters, low income residents, voters insured through Medi-Cal or through the individual market and those with children in their household are more likely than others to report difficulties in paying for their health care costs. The survey also updated California voters overall views of the Medicare and Medi-Cal programs. The poll finds 81% of voters saying Medicare is to them and their families, and 58% say this about Medi-Cal. The latter proportion is up seven points from 51% who reported this in When asked to evaluate the success of Medicare in meeting its goals, eight in ten California voters (79%) believe the program has been. When asked a similar question about Medi-Cal, two in three voters (64%) term it a success. Views about this extend across party lines, with majorities of both Democrats and Republicans concurring that each program has been in meeting its goals. These are the topline findings from the first in a series of three Field Poll reports from the 2013 TCWF-Field Health Policy Survey conducted June 26 - July 21, among 1,687 California registered voters in seven languages under a grant from The California Wellness Foundation. A second report for publication tomorrow, August 20 will update California voter views about the Affordable Care Act. An additional report for publication Wednesday, August 21 will examine a number of specific issues relating to implementation of the law here in California.

2 #2448 Monday, August 19, 2013 Page 2 Half of the state s voters say their health care costs have increased this year When California voters are asked to compare the total amount they are now paying for health care to the amount they were paying last year, 50% say that their health care costs increased this year. This compares to 41% who report paying about the same this year as last, while just 5% say their health costs declined. The remaining 4% have no opinion. Price increases are most commonly reported by voters who say they have the most difficulty paying for the costs of their health insurance. Nearly three in four (73%) of these voters reported increasing health care costs this year. Somewhat smaller proportions report cost increases among those who say they have the most difficulty paying for insurance deductibles and co-pays or for health services not covered by insurance. Half of voters report difficulty in paying for their health care Similarly, half of the state s voters (50%) report their health care costs are very or somewhat difficult for them to afford, with 21% saying very difficult and 29% somewhat difficult. This compares to 47% who report little or no difficulty in paying for health care. Uninsured voters (72%), low income residents whose household incomes are less than 139% of the federal poverty level (71%), and voters insured through Medi-Cal (63%) or through the individual market (60%) report the most difficulty in paying for their health care costs. An increasing majority of voters describes Medi-Cal as Nearly six in ten (58%) describe the state s Medi-Cal program, which provides health insurance and long-term care to low-income adults and children, as being to themselves and their families. This includes 38% who say it is very and 20% describing it as somewhat. The proportion of Californians reporting that Medi-Cal is to them increased since this question was last asked in the 2011 TCWF-Field Health Policy Survey. At that time 51% described Medi-Cal as very to them and their families, with 29% saying it was very and 22% somewhat. Medi-Cal beneficiaries, lower income voters and those with children most likely to say Medi- Cal is to them Not surprisingly, the voter sub-group most likely to describe Medi-Cal as being are those who are current Medi-Cal beneficiaries themselves. Greater than nine in ten (91%) of these voters describes the program as, of whom 78% say it is very. Views about the importance of Medi-Cal are also related to household income and whether or not children under age 18 live in their household. Among voters whose household income is less than 139% of the federal poverty level, 84% describe Medi-Cal as an program. By comparison, only half as many voters (42%) whose household income exceeds 400% of the federal poverty level say this.

3 #2448 Monday, August 19, 2013 Page 3 Greater than two in three voters (68%) living in households with children under age 18 consider Medi-Cal an program. Among voters who reside in households where no children are present a somewhat smaller majority (55%) reports this. Two in three feel Medi-Cal is ly meeting its goals Two in three California voters (64%) believes the state s Medi-Cal program is ly meeting its goals, including 20% who say it has been very and 44% somewhat. This compares to just 20% who feel it is not ly meeting its goals and 16% with no opinion. These results are very similar to those obtained in 2011, the last time the TCWF-Field Health Policy Survey included this question. While Medi-Cal beneficiaries are most likely to describe the program a success, majorities of Democrats and Republicans also say this An overwhelming proportion of voters covered by Medi-Cal (83%) believe the program is ly meeting its goals, making them the subgroup most likely to say this. There is also bipartisan agreement in California that Medi-Cal is ly meeting its goals. Seven in ten Democrats (72%) feel this way, as do 53% of Republicans and 62% of voters with no major party preference. Eight in ten describes Medicare as being to them Greater than eight in ten California voters (81%) describe Medicare, the government health program for people 65 or older and those with long-term disabilities, as being to them and their families. This includes 65% who say it is very and 16% somewhat. The overall proportion of voters describing Medicare as has not changed much since 2011, when 80% felt this way. However, the proportion saying it is very has increased eight points over the past two years. Medicare considered by voters across all subgroups, especially older voters and current beneficiaries Majorities of voters across all segments of the California voter population consider Medicare an program to themselves and their families. Most likely to feel this way are Medicare beneficiaries, 92% of whom say the program is to them, including 84% who describe it as very. The older a voter is, the greater the importance attached to Medicare. For example, among voters under age 30, 71% say Medicare is, with 45% saying it s very. These percentages increase with each successive age category and increase to nine in ten (89%) among seniors age 65 or older, 80% of whom say it is very.

4 #2448 Monday, August 19, 2013 Page 4 Eight in ten think Medicare is ly meeting its goals When asked to evaluate the success of Medicare in meeting its goals, eight in ten California voters (79%) term it as being, with 34% saying very and 45% somewhat. This is similar to the assessments voters in 2011 when 78% rated the Medicare program as ly meeting its goals. Strong bipartisan agreement that the Medicare program is a success There is bipartisan agreement among California Democrats and Republicans that Medicare is ly meeting its goals, with 84% of Democrats and 73% of Republicans in agreement. Three in four voters with no major party preference (76%) also feel this way. Among current Medicare beneficiaries 90% believe Medicare is ly meeting its goals About the Survey The 2013 TCWF-Field Health Policy Survey is the seventh in an annual series of health policy surveys conducted among California voters by through a grant from The California Wellness Foundation. This year s findings are based on a survey of 1,687 California registered voters completed by telephone in seven languages and dialects English, Spanish, Cantonese, Mandarin, Korean, Vietnamese and Tagalog. The survey included interviews with a random sample of 1,199 registered voters statewide and was supplemented with 488 additional interviews among the Asian American and African-American voters. A total of 1,298 of the interviews were conducted in English and 389 in non-english languages. Interviewing was conducted June 26 July 21, 2013 from Field Research Corporation s central location call center. Up to six attempts were made to reach and interview each randomly selected voter on different days and times of day during the interviewing period. Interviews were completed on either a voter s landline phone or a cell phone. After the completion of interviewing, the overall sample was weighted to align it to the proper statewide distribution of voters by race/ethnicity and other demographic, geographic and political characteristics of the California registered voter population. Sampling error estimates applicable to any probability-based survey depend upon its sample size. According to statistical theory, 95% of the time results from the overall sample are subject to a maximum sampling error of +/- 2.6 percentage points. The maximum sampling error is based on percentages in the middle of the sampling distribution (percentages around 50%). Percentages at either end of the distribution have a smaller margin of error. Sampling error will be larger for analyses based on subgroups of the overall sample. About The California Wellness Foundation The California Wellness Foundation is a private, independent foundation created in 1992, with a mission to improve the health of the people of California by making grants for health promotion, wellness education and disease prevention. The Foundation prioritizes eight issues for funding: diversity in the health professions, environmental health, healthy aging, mental health, teenage pregnancy prevention, violence prevention, women s health, and work and health. It also responds to timely issues or special projects outside these funding priorities. Since its founding in 1992, the Foundation has awarded 6,919 grants totaling more than $852 million. For more information, visit the Foundation s website, or contact Cecilia Laiché, communications officer, at (818)

5 2013 TCWF-Field Health Policy Survey (Part 1 of 3) California Voter Views of Health Care Costs and Assessments of the Medi-Cal and Medicare programs Conducted by for The California Wellness Foundation for release Monday, August 19, 2013

6 About the Survey Population surveyed: California registered voters. Number of interviews: 1,687 interviews, including a random crosssection sample of 1,199 voters and augmented samples of 488 interviews among Asian- American and African-American voters. Data collection: Languages of administration: Sampling error: June 26-July 21, 2013 by cell and landline telephone using live interviewers from Field Research s central location call center. English, Spanish, Cantonese, Mandarin, Tagalog, Korean and Vietnamese. 1,298 in English and 389 in non-english languages. Overall findings have a sampling error of +/- 2.6 percentage points at the 95% confidence level. The California Wellness Foundation 1

7 Graph 1a Perceived changes in amount paid by voters for health care over the past year Decreased 5% 4% Not reported About the same 41% Increased 50% The California Wellness Foundation 2

8 Graph 1b Changes in amount paid for health care over the past year by subgroups of the registered voter population % Increased Total registered voters 50% Portion of health costs most difficult to afford Insurance costs 73% Insurance deductible/co-pays Health services not covered by insurance 59% 58% The California Wellness Foundation 3

9 Graph 2a Voters reported difficulty in paying for health care No opinion 3% Not at all difficult 23% difficult 21% Difficult 50% Not too difficult 24% Somewhat difficult 29% The California Wellness Foundation 4

10 Graph 2b Difficulty in paying for health care by insurance status and household income % Difficult to afford Total registered voters Insurance status/coverage type Uninsured Insured through employer/labor union Insured through Medicare Insured through the individual market Insured through Medi-Cal 50% 72% 43% 43% 60% 63% Household income and Federal Poverty Level Less than 139% FPL 139% 400% FPL More than 400% FPL 36% 53% 71% The California Wellness Foundation 5

11 Graph 3a Importance of the state s Medi-Cal program to California voters and their families (2011 vs. 2013) No opinion No opinion 3% 4% Not at all 29% 29% Not at all 27% 38% Not too 17% Somewhat 22% 51% Important Not too Somewhat 11% 20% % Important Note: Medi-Cal described as California s health program that provides health insurance and long-term care to certain low-income adults and children. The California Wellness Foundation 6

12 Graph 3b Importance of Medi-Cal among Medi-Cal recipients, and by household income and presence of children Total registered voters % Important Somewhat 38% 20% 58% Insured through Medi-Cal Household income & Federal Poverty Level Less than 139% FPL 78% 65% 13% 91% 19% 84% 139% - 400% FPL 39% 23% 62% More than 400% FPL 24% 18% 42% Children in household Yes 46% 22% 68% No 35% 20% 55% The California Wellness Foundation 7

13 Graph 4a Perceived success of the Medi-Cal program in meeting its goals: 2011 vs Not at all 7% No opinion 12% 15% Successful 64% Not at all 6% No opinion 16% 20% Successful 64% Not too 17% Somewhat 49% Not too 14% Somewhat 44% The California Wellness Foundation 8

14 Graph 4b Perceived success of the Medi-Cal program in meeting its goals: by party registration and among Medi-Cal recipients % Successful Somewhat Total registered voters 20% 44% 64% Insured through Medi-Cal 40% 43% 83% Party registration Democrats 25% 47% 72% Republicans 15% 38% 53% No party preference/other 19% 43% 62% The California Wellness Foundation 9

15 Graph 5a Importance of the Medicare program to California voters and their families (2011 vs. 2013) Not too Not at all 10% 9% 1% No opinion Not at all Not too 9% 8% 2% No opinion Somewhat 23% 57% Somewhat 16% 65% Note: Medicare was described as the government health program for people 65 or older and certain people with long-term disabilities. The California Wellness Foundation 10

16 Graph 5b Proportions describing Medicare as among Medicare recipients and by age % Important Somewhat Total registered voters 65% 16% 81% Insured through Medicare 84% 8% 92% Age % 26% 71% % 22% 76% % 18% 83% % 11% 87% 65 or older 80% 9% 89% The California Wellness Foundation 11

17 Graph 6a Perceived success of Medicare in meeting its goals: 2011 vs Not at all Not too 12% No opinion 4% 6% 29% Not at all 3% Not too 10% No opinion 8% 34% Somewhat 49% 78% Successful Somewhat 45% 79% Successful The California Wellness Foundation 12

18 Graph 6b Success of Medicare in meeting its goals: by party registration and among Medicare recipients % Successful Somewhat Total registered voters 34% 45% 79% Insured through Medicare 58% 32% 90% Party registration Democrats 41% 43% 84% Republicans 26% 47% 73% No party preference/other 29% 47% 76% The California Wellness Foundation 13

19 Field Research Corporation San Francisco, CA 2013 TCWF-Field Health Policy Poll Part 1: California Voter Views of Health Care Costs and Assessments of the Medi-Cal and Medicare Programs 1. How for you and your family is Medicare, the government health program for people 65 or older and certain people with long-term disabilities? Is it very for you and your family, somewhat, not too or not at all? 2. Overall, how do you think Medicare has been in meeting its goals very, somewhat, not too or not at all? 3. How for you and your family is Medi-Cal, California s health program that provides health insurance and long-term care to certain low-income adults and children? Is it very for you and your family, somewhat, not too or not at all? 4. Overall, how do you think Medi-Cal has been in meeting its goals very, somewhat, not too or not at all? VERY IMPORTANT... 65% SOMEWHAT IMPORTANT NOT TOO IMPORTANT... 8 NOT AT ALL IMPORTANT... 9 NO OPINION... 2 VERY SUCCESSFUL... 34% SOMEWHAT SUCCESSFUL NOT TOO SUCCESSFUL NOT AT ALL SUCCESSFUL... 3 NO OPINION... 8 VERY IMPORTANT... 38% SOMEWHAT IMPORTANT NOT TOO IMPORTANT NOT AT ALL IMPORTANT NO OPINION... 4 VERY SUCCESSFUL... 20% SOMEWHAT SUCCESSFUL NOT TOO SUCCESSFUL NOT AT ALL SUCCESSFUL... 6 NO OPINION Think for a moment about the total amount of money you now pay out-of-pocket for health care. This includes any costs you pay to get insurance coverage, any portion of your health care bills that you pay out of pocket when you use health care services, such as deductibles and co-pays, as well as any health care services you receive that are not paid for by insurance. 5. Overall, how difficult would you say it is to pay for the costs of your health care very difficult, somewhat difficult, not too difficult or not at all difficult? VERY DIFFICULT... 21% SOMEWHAT DIFFICULT NOT TOO DIFFICULT NOT AT ALL DIFFICULT NO OPINION... 3 IF VERY OR SOMEWHAT DIFFICULT, ASK: 6. What part of your health care expenses is most difficult to afford? (READ CATEGORIES IN RANDOM ORDER) 50% ( ) The amount that you pay for insurance coverage ( ) The portion of your health care bills that you have to pay out-of-pocket when you use health services, such as deductibles or co-pays ( ) The costs of any health services you receive that are not paid for by insurance DON T KNOW/NO ANSWER In the past year, has the total amount you pay for you and your family's health care increased, decreased or remained the same? (new) INCREASED... 50% DECREASED... 5 REMAINED THE SAME NO OPINION... 4 H:\600044\Report\Press releases\marginals - Story #1.doc 1

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