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7/27/2019 Field Poll Wed

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THE INDEPENDENT AND NON-PARTISAN SURVEY

OF PUBLIC OPINION ESTABLISHED IN 1947 AS

THE CALIFORNIA POLL BY MERVIN FIELD

Field Research Corporation601 California Street, Suite 900San Francisco, CA 94108-2814

(415) 392-5763 FAX: (415) 434-2541EMAIL: [email protected]/fieldpollonline

THE

FIELD

POLLRelease #2450 Embargoed for Print Publication: Wednesday, August 21, 2013

MOST CALIFORNIA VOTERS EXPRESS OPTIMISM ABOUT THE STATES

IMPLEMENTATION OF THE AFFORDABLE CARE ACT; WHILE FEW VOTERS

KNOW MUCH ABOUT THE STATES COVERED CALIFORNIA HEALTH

EXCHANGE, INTEREST IN LEARNING MORE ABOUT IT IS HIGH.

By Mark DiCamillo and Mervin Field

Majorities of California voters are optimistic when asked about the states chances of successfully

implementing the Affordable Care Act. Two in three (66%) expect implementation of the law

overall to be successful, and similar majorities also believe the state will achieve many of its more

specific goals, such as reducing the number of uninsured, providing consumers with more insurance

choices, and providing Californians with better consumer protections. However, opinions are highly

partisan, with Democrats extremely upbeat in their assessments and Republicans much more

skeptical.

A major challenge facing the state will be to first make those eligible for coverage benefits underthe law aware of their eligibility and then have them apply for these benefits. The survey finds low

voter awareness of the states Covered California health insurance exchange, with just 25% of

voters under age 65 saying theyve heard a lot or some about it.

When delving deeper, the survey finds that fewer than half of voters whose income, age and

insurance status qualify them for coverage benefits under the law know of their eligibility. For

example, just 48% of low-income voters eligible to receive free health coverage next year under the

expanded Medi-Cal program know that they are eligible. Similarly, just one in three (33%)

moderate-income voters not currently covered under an employer, union or government insurance

program who are eligible to receive tax credits to reduce the costs of their insurance are aware oftheir eligibility.

Nevertheless, expressed interest in obtaining more information is high. Statewide 65% of voters

under age 65 say theyre interested in learning more about Covered California and the kinds of

health insurance plans and coverage options available there. Interest is particularly high among

many of the exchanges key target audiences. This includes uninsured voters (83%), Latinos (79%),

African-Americans (82%) and non-English speakers (83%).


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The Field Poll #2450

Wednesday, August 21, 2013 Page 2

These are the topline findings from the third in a series ofField 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.

Voter expectations about the states implementation of the Affordable Care Act

Two in three California voters (66%) expect the state will be successful in its efforts to implement

the Affordable Care Act, while 32% think it will be unsuccessful. This is a somewhat more

optimistic assessment than was found two years ago when this question was last asked.

Majorities of Californians are also optimistic when asked about the likelihood of the state achieving

some of specific goals of the law. For example, between 60% and 66% of voters believe California

will be successful in achieving the following . . .

encouraging more low and moderate income residents who are currently uninsured to get

coverage (66%).

obtaining the federal funds needed to fully implement the law (64%).

establishing a one-stop place where it will be easy for consumers and small businesses to shop

for health insurance online (63%).

providing consumers with more insurance choices (61%).

regulating the insurance market so the average Californian has better consumer protections

(60%).

However, voters are divided when it comes to one other intended goal of the law limiting the rateincreases that insurance companies can charge their customers each year. Only half of the voting

public (50%) thinks the state will be successful in achieving this goal, while 47% feel it will not be.

Voter views about each of these matters are highly partisan, with Democrats very optimistic in their

assessments and Republicans much more skeptical.

Awareness of Covered California among voters under age 65

Voter awareness of Covered California health exchange, the online health insurance exchange or

marketplace currently under development, remains quite low. Just 25% of voters age 18-64

statewide say theyve heard a lot or some about Covered California. Much larger proportions reporthaving heard only a little about it (33%) or nothing at all (42%).

Awareness is also lower among many of the key constituencies being targeted for Covered

Californias services. For example, just 18% of voters who are currently uninsured say theyve

heard a lot or some about it. Similarly, only 18% of voters under age 30 report this level of

awareness, as do 16% of African-Americans and 20% of non-English speakers.


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Awareness of eligibility among specific populations who would benefit under the ACA

Two specific subgroups of voters who would directly benefit from the Affordable Care Acts

provisions were identified by the survey and asked whether or not they knew of their eligibility to

receive health coverage benefits under the law. The first includes low-income voters under age 65

who are eligible to receive free health coverage under the expanded Medi-Cal program and are not

currently covered through an employer, labor union or government program. A second subgroup

includes moderate-income voters under age 65 not currently receiving health coverage from an

employer, union or government program who are eligible to receive tax credits to reduce the costs

of their health insurance.

The survey finds that fewer than half of these voters are aware of their eligibility for these benefits.

For example, 48% of low-income voters eligible for free health coverage under the expanded Medi-

Cal program currently know of their eligibility. In addition, just 33% of moderate-income voters not

currently covered under an employer or government health insurance program are aware of their

eligibility when applying for it at Covered California.

Interest in learning more about Covered California

Nevertheless, there is considerable interest among voters under age 65 in learning more about

Covered California and the kinds of health insurance plans and coverage options offered there.

Statewide 65% of these voters report being interested, while 34% are not.

Interest is highest among many of the exchanges key constituencies. Greater than eight in ten

uninsured voters under age 65 (83%) say theyre interested, as do 79% of Latinos, 82% of African-

Americans, and 83% of non-English speakers.

One complicating factor relating to voter interest in Covered California has to do with the fact that

interest in the exchange is also influenced by a voters partisan and political leanings. For example,

while three in four Democrats under age 65 (75%) express interest in learning more about it,

significantly fewer Republicans (54%) say this. Similarly, while 79% of strong liberals say theyre

interested in what the exchange has to offer, just 53% of strongly conservative voters express

interest.


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Likelihood of applying for insurance coverage benefits among voter populations who would

benefit under the ACA

When voters eligible to receive coverage benefits either through expanded Medi-Cal or through

Covered Californias insurance tax credits are told of their eligibility and of the governments $95

penalty should they choose to go without insurance coverage, most but not all affected voters say

they would likely apply.

Three in four low-income voters (74%) eligible for free health coverage under expanded Medi-Cal

who are not currently insured through Medi-Cal or an employer or labor union say theyd likely

apply for coverage when it becomes available next year, but 22% say theyre not inclined to do so.

Similarly, 66% of moderate-income voters eligible for tax credits say its likely they would go to

Covered California to shop for health insurance next year, but 27% are not.

Non-English speakers preferred language to receive information

There is a strong preference among the non-English speakers to receive information from Covered

California in their own native languages. Statewide, 77% of the surveyed non-English speakers

under age 65 say this, while 20% say it would be acceptable to them to receive this information in

English.

Will Californias health care system be able to handle the expanded patient load?

By a five to three margin (59% to 35%) California voters do not think there will be enough primary

care physicians to handle the additional patients expected to receive health care benefits once the

Affordable Care Act is fully implemented.

Views about this tend to be partisan-based. Democrats are evenly divided, with 46% believing there

will be enough doctors to handle the additional patients and 47% saying there will not be.

Republicans, on the other hand, are more skeptical, with five times as many believing there will not

be enough doctors to handle the expanded patient load (80% to 16%).

One proposal that is currently being discussed among state lawmakers to address the burden of an

expanded patient load is to change state law to allow nurse practitioners to expand the kinds of

primary care services they can provide to patients. When asked about this proposal, voters are

strongly supportive. Nearly three in four voters (73%) endorse the idea of expanding the services

nurses can provide patients, while just 21% are opposed. Support extends across party lines, with79% of Democrats, 76% of non-partisans and 60% of Republicans in favor of this proposal.

-30-


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About the Survey

The 2013 TCWF-Field Health Policy Survey is the seventh in an annual series of health policy surveysconducted among California voters by The Field Poll through a grant from The California WellnessFoundation. This years 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, Vietnameseand Tagalog. The survey included interviews with a random wsample of 1,199 registered voters statewideand was supplemented with 488 additional interviews among the Asian American and African-Americanvoters. 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 Corporations central locationcall center. Up to six attempts were made to reach and interview each randomly selected voter on differentdays and times of day during the interviewing period. Interviews were completed on either a voterslandline phone or a cell phone. After the completion of interviewing, the overall sample was weighted toalign it to the proper statewide distribution of voters by race/ethnicity and other demographic, geographicand 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 themiddle of the sampling distribution (percentages around 50%). Percentages at either end of the distributionhave a smaller margin of error. Sampling error will be larger for analyses based on subgroups of theoverall sample.

About The California Wellness Foundation

The California Wellness Foundation is a private, independent foundation created in 1992, with a missionto improve the health of the people of California by making grants for health promotion, wellnesseducation and disease prevention. The Foundation prioritizes eight issues for funding: diversity in thehealth professions, environmental health, healthy aging, mental health, teenage pregnancy prevention,

violence prevention, womens health, and work and health. It also responds to timely issues or specialprojects outside these funding priorities. Since its founding in 1992, the Foundation has awarded 6,919grants totaling more than $852 million. For more information, visit the Foundations website,www.calwellness.org or contact Cecilia Laich, communications officer, at (818) 702-1900.


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Voter Assessments ofthe Implementation ofthe Affordable Care Act

in California

Conducted by

The Field Poll

for

The California Wellness Foundation

for release

Wednesday, August 21, 2013

2013 TCWF-Field Health Policy Survey(Part 3 of 3)


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The Field The California Wellness Foundation 1

About the Survey

Population surveyed: California registered voters.

Number of interviews: 1,687 interviews, including a random cross-

section sample of 1,199 voters and augmentedsamples of 488 interviews among Asian-American and African-American voters.

Data collection: June 26-July 21, 2013 by cell and landlinetelephone using live interviewers from FieldResearchs central location call center.

Languages of English, Spanish, Cantonese, Mandarin,

administration: Tagalog, Korean and Vietnamese. 1,298 inEnglish and 389 in non-English languages.

Sampling error: Overall findings have a sampling error of+/- 2.6 percentage points at the 95%confidence level.


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Graph 1a

Voter opinions of how successful California willbe in implementing the Affordable Care Act(2011 vs. 2013)

2011

Verysuccessful

13%

Not at allsuccessful

13%

Not toosuccessful

24%Somewhatsuccessful

47%

3%

Noopinion

2013

Not at allsuccessful

13%

Not toosuccessful

19%

Somewhatsuccessful

48%

No

opinion2%

Verysuccessful

18%


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Graph 1b

Voter opinions of Californias success inimplementing the Affordable Care Act by party

31%

55%

17%

32%

66%

41%

81%

66%

No party preference/other

Republicans

Democrats

Total registered voters

Successful Not successful

California will be

Note: Differences between 100% and the sum of each subgroups percentages equal proportion with no opinion.


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Graph 2

Voter opinions about how successful Californiawill be in achieving specific goals of the ACA

47%

37%

36%

33%

32%

32%

50%

60%

61%

63%

64%

66%

Limiting the rate increases thatinsurance companies charge to

their customers each year

Regulating the insurance marketso the average Californian has

better consumer protections

Providing consumers withmore insurance choices

Establishing a one-stopplace where it will be easy for

consumers/small businesses toshop for health insurance online

Obtaining the federal funds neededto fully implement the law

Encouraging more low and moderateincome residents who are currently

uninsured to get coverage

Successful Not successfulCalifornia will be

Democrat Republi

78% 49%

21 48

76% 47%

22 49

77% 44%

20 52

75% 39%

22 58

76% 38%

21 58

62% 30%

34 67

Note: Differences between 100% and the sum of each subgroups percentages equal proportion with no opinion.


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Graph 3a

Extent of voter awareness of the statesCovered California Health Insurance Exchange(among voters under age 65)

Heard nothing42%

Hearda lot6%

Heard some19%

Heard onlya little

33%

25%


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Graph 3b

Voters under age 65 who have heard a lot orsome about Covered California by insurancestatus, household income and age

32%

22%

26%

18%

30%

22%

22%

24%

28%

26%

18%

25%

50-64

40-49

30-39

18-29

More than 400% FPL139%400% FPL

Less than 139% FPL

Coverage intermittent past 2 years

Continuously covered past 2 years

Total insured

Uninsured

Total voters under age 65

% Heard a lot or some

Insurance status

Household income andFederal Poverty Level

Age


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Graph 3c

Voters under age 65 who have heard a lot orsome about Covered California byrace/ethnicity and language

20%

26%

25%

16%

23%

27%

25%

Non-English

English

Asian-American

African-American

Latino

White non-Hispanic


% Heard a lot or some

Race/ethnicity

Language spoken


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Graph 4

Voter awareness of their eligibility to receive freehealth coverage under the expanded Medi-Cal program(among those under 65 whose income qualifies themfor Medi-Cal who are not currently enrolled)

Yes,eligible

48%

No, noteligible

25%

Dont know27%


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Graph 5

Voter awareness of their eligibility to receive tax creditswhen applying for insurance through Covered California(among voters eligible for tax credits not currently coveredunder an employer, union or government program)

Yes, eligible33%

No, noteligible

28%

Dont know39%

* Includes voters under age 65 whose household income is 139%-400% of the Federal Poverty Level who are not currently covered finsurance through their employer or through a government program.


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Graph 6a

Voter interest in learning more about Covered Californiaand the kinds of health insurance plans and coverageoptions offered there (among voters under age 65)

Veryinterested

30%

Somewhatinterested

35%

Not toointerested

17%

Not at allinterested

17%

1% No opinion

Interested

65%


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Graph 6b

Proportions of voters under age 65 interested inlearning more about Covered Californiaby insurance status, household income and age

37%

35%

31%

17%

27%

32%

36%

30%

27%

28%

48%

30%

31%

33%

33%

44%

31%

36%

40%

40%

33%

35%

35%

35%

68%

68%

64%

61%

58%

68%

76%

70%

60%

63%

83%

65%

50-64

40-49

30-39

18-29

More than 400% FPL

139%400% FPL

Less than 139% FPL

Coverage intermittent past 2 years

Continuously covered past 2 years

Total insured

Uninsured


% InterestedVery Somewhat

Insurance status

Household income andFederal Poverty Level

Age


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Graph 6c

Proportions of voters under age 65 interested inlearning more about Covered Californiaby race/ethnicity and language

52%

28%

27%

46%

37%

25%

30%

31%

35%

37%

36%

42%

31%

35%

83%

63%

64%

82%

79%

56%

65%

Non-English

English

Asian-American

African-American

Latino

White non-Hispanic


% Interested

Very Somewhat

Race/ethnicity

Language spoken


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Graph 6d

Proportions of voters under age 65 interested inlearning more about Covered Californiaby party and political ideology

48%

36%

27%

23%

24%

27%

20%

39%

30%

31%

39%

37%

39%

29%

34%

34%

36%

35%

79%

75%

64%

62%

53%

61%

54%

75%

65%

Strongly liberal

Moderately liberal

Middle-of-the-road

Moderately conservative

Strongly conservative

No party preference/other

Republican

Democrat


% Interested

Very Somewhat

Party registration

Political ideology


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Graph 7

Stated likelihood of voters eligible for expanded Medi-Cal coverage to apply for it next year (among eligiblevoters not currently insured through Medi-Cal or anemployer or union)

Very likelyto apply

51%Somewhat

likely to apply23%

Not toolikely11%

Not at alllikely11%

4% Dont know

Likely74%


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Graph 8

Stated likelihood of voters eligible for tax credits tovisit Covered California to apply for tax credits(among eligible voters not currently covered through anemployer or government program)

Very likely36%

Somewhatlikely30%

Not too likely15%

Not atall likely

12%

Dontknow

7%

Likely66%


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Graph 9

Preferred language in which non-English-speakingvoters would like to receive information about CoveredCalifornia (among non-English speakers under age 65)

English19%

Native language78%

Not reported

3%


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Graph 10

Voter opinions about whether California will haveenough primary care physicians to handle the additionalpatients expected to receive health care benefits underthe Affordable Care Act

No opinion

Will haveenough

35%

Will not haveenough

59%

6%

55%

80%

47%

38%

16%

46%

No partypreference/ other

Republicans

Democrats

Will have enoughWill not have enough

Party registration


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Graph 11

California voter reactions to the idea of allowingnurse practitioners to expand the kinds ofprimary care services they can provide

No opinion

Oppose21%

Favor

73%

6%

18%

34%

14%

76%

60%

79%

No partypreference/ other

Republicans

Democrats

FavorOppose

Party registration


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H:\600044\Report\Press releases\Marginals - Story #3.doc 1

Field Research Corporation 600-044San Francisco, CA

2013 TCWF-Field Health Policy Poll

Part 3: Voter Assessments of the Implementation of the Affordable Care Act in California

1. Overall, how successful do you think the state of Californiawill be in implementing the health care law verysuccessful, somewhat successful, not too successful, or notat all successful?

VERY SUCCESSFUL .............................18%SOMEWHAT SUCCESSFUL....................48NOT TOO SUCCESSFUL........................19NOT AT ALL SUCCESSFUL ....................13NO OPINION...........................................2

2. I am going to read some of the goals that California is hoping to achieve when implementing the healthcare law. Please tell me how successful you think it will be in achieving each goal. (READ ITEMS INRANDOM ORDER, ASKING:) How successful do you think California will be in achieving this goal verysuccessful, somewhat successful, not too successful, or not at all successful?

VERY SOMEWHAT NOT TOO NOT AT ALL NO SUCCESSFULSUCCESSFULSUCCESSFULSUCCESSFULOPIN

( ) a. encouraging more low and moderate income

residents who are currently uninsured to get healthinsurance coverage...........................................................23%..........43.............20............12.........2

( ) b. regulating the health insurance market so that theaverage Californian has better consumer protections.....14%..........46.............22............15.........3

( ) c. obtaining the federal funding needed to fullyimplement the law.............................................................21%..........43.............20............12.........4

( ) d. providing California consumers with more healthinsurance choices.............................................................18%..........43.............22............14.........3

( ) e. limiting the rate increases that insurance companiescharge to their customers each year................................13%..........37.............25............22.........3

( ) f. establishing a one-stop place where it will be easy forconsumers and small businesses to shop for health

insurance online................................................................21%..........42.............21............12.........4

3. Many residents who currently do not have access to regularcare are expected to receive health care benefits under thenew law. Given this, do you think that California will or willnot have enough primary care physicians to meet the statesexpanding needs?

WILL....................................................35%WILL NOT.............................................59DONT KNOW/REFUSED .........................6

4. Do you favor or oppose changing state law to allow nursepractitioners to expand the kinds of primary care servicesthey can provide patients in California?

FAVOR ................................................73%OPPOSE ..............................................21DONT KNOW/REFUSED .........................6


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IF UNDER AGE 65:

California is currently developing Covered California, a health insurance exchange or marketplace whereconsumers and small businesses will be able to shop for health insurance online. At the Covered Californiawebsite, competing insurance companies will offer different policies at different premium levels, deductibles andco-pays to allow consumers to choose a plan that best fits their needs and budget. Low and moderate-incomeresidents will also be able to obtain tax credits or receive subsidies to lower or fully pay for their insurance costs.

5. How much have you heard about the states CoveredCalifornia health insurance exchange a lot, some, only alittle or nothing at all?

A LOT ....................................................6%SOME ..................................................19ONLY A LITTLE .....................................33NOTHING AT ALL..................................42NO OPINION............................................*

6. How interested are you in learning more about CoveredCalifornia and the kinds of health insurance plans andcoverage options offered there very interested, somewhatinterested, not too interested or not at all interested?

VERY INTERESTED...............................30%SOMEWHAT INTERESTED.....................35NOT TOO INTERESTED.........................17NOT AT ALL INTERESTED .....................17NO OPINION...........................................1

IF NON-ENGLISH SPEAKER:

7. If you needed to obtain more information about CoveredCalifornia, in which language would you prefer to receivethis information English or (LANGUAGE OF INTERVIEW)?

ENGLISH..............................................19%LANGUAGE OF INTERVIEW...................78DON'T KNOW .........................................3

IF < AGE 65& INCOME

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