Ask Me About Health Reform


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  • This presentation will review the public debate over health care, the results from a recent CA Endowment polling, the goal of our efforts, the public education campaign, and ask how you/your organization can participate. The Endowment’s goal for this campaign is to make implementation of health care reform a success so that Californians have better healthcare
  • Californians learned about health reform through the news and it influenced their views in a very partisan way.
  • Over the last several years, polls have shown that substantial majorities of voters believed that the health care system needed a total overhaul, even if they said they were satisfied with their own health care. So, the reform initiative started with strong support last spring. AND THEN OVER MANY MONTHS…support eroded. Media focused on the “partisan battle” in Congress and the streets, focusing on the intense and angry opposition. Tea parties began shaping the story over the summer of 2009 In this context, voters’ support or opposition to health care reform fundamentally tracked (and still follows) party affiliation. As a result, people understand health reform through the prism of the political process at the expense of understanding what is in the law. Republican messages about a “government takeover of our healthcare”, “rationing health care” and “death panels” worked to decrease support for reform.
  • To see how Californians feel about reform, the CA Endowment completed a poll in mid April. The poll was conducted by Fairbank, Maslin, Maullin, Metz & Associates (FM3). The survey sample was 800 voters with an oversample of 200 Decline to State Voters.
  • While national surveys continue to show pluralities of voters who are ambivalent about health reform, California voters support health care reform by a 49% to 42% margin before hearing any information from the pollsters about the law’s provisions or any of the messages in support or opposition.
  • When you look deeper at how various subgroups of the electorate view reform, you see that the fundamental differences are partisan. Support and opposition can be tracked by party. Democrats and Independents are in support while Republicans oppose. 52% of Democrats strongly support (this measures levels of intensity) reform while 72% of Republicans strongly oppose..the opposition is more intense.
  • As you can see from these numbers, a substantial number of people who will directly benefit from reform don’t think it will directly benefit their families. Clearly, education about the direct benefits to people in these categories makes a lot of sense. These numbers represent the initial question, before information about the law was given. So for example, half of those who had trouble paying for health care in the past 3 years and more than half of those denied coverage for a pre-existing condition didn’t think reform would benefit them.
  • As the chart on the left shows, learning more about the provisions of the law causes a significant shift in support to a 56% majority in support and 40% opposed; essentially widening a seven point margin to a full sixteen points. This majority remains even after additional pro and con arguments. The chart on the right indicates how learning more about the provisions also increases the level of intensity of supporters from 31% to 40%, a full nine points.
  • Over the course of the survey, voters were asked 4 different times whether they support reform: before information, after hearing provisions, after each of the arguments pro and con, and the final ask. This pie chart shows that 85% of the electorate is fairly dug in to their position answering yes or no each of the four times. 15% shifted with information or remained undecided.
  • Now let’s look at who moves to support after hearing more information and examine why they move. There are two basic categories of positive movers: Those without a strong ideological predisposition to support or oppose reform – notably independents and moderates. Those with some specific likelihood to benefit from reform once they understand its provisions – including voters with pre-existing conditions, those who lack coverage, seniors, and some communities of color.
  • These are some of the categories of people who move to support.
  • In the survey, people were read a list of 19 provisions of the new health law in 4 categories, those that relate to expanding access to services, cost & quality of care, insurance company reform, and how health reform will be funded.
  • These are worded in a neutral way, simply explaining what the law does..these are the top rated provisions that received over 60% support.
  • Messages stressing the broad distribution of benefits and insurance company reforms are generally the most compelling. The most important provisions to people depend on their circumstances but it’s also good to let people know about the ones that are most popular so that they get repeated..the key to marketing.
  • What do we want to do? This moment is unique; when was the last time we had such a major reform? There is a wide base of supporters – and the potential for many more Health care has now moved from a cloudy problem to a political issue Health reform will touch everyone. Potential to create a strong constituency empowered to push for more and better health care. Health that expands access to services – has better quality of care – and honestly invests in prevention. Our goal for public education: Leverage this unique moment of health care reform to build a broader and stronger constituency for health, committed to building a health system that improves access and quality of care, and invests in prevention.
  • With the passage of health reform, this high profile moment presents a key opportunity to establish a stronger base of support for health issues and raise the bar for consumers’ expectations of their health care. The key to better healthcare is a more empowered consumer who understands what they have and begins to make demands for higher quality and better value. To change the culture from consumer passivity to active involvement begins with an understanding of the new law. That understanding will be beneficial for all that we want to do. And as implementation rolls out, public education must continue. This year is critical because there are many who want to weaken, repeal and replace the law and we need to meet them and beat them in their attempts to take these benefits away from people. If reform becomes known to people as coverage and benefits rather than framed as a mandate and taxes—each step of the way will become easier for reformers. Empowered consumers can create a game-changing new direction for health in our state.
  • What can you/your organization do to support health care reform in California?
  • Let’s talk about how you/your organization would like to participate. Who are you constituents or members? How would you approach them?
  • Ask Me About Health Reform

    1. 1. A Public Education Campaign to Support Health Care Reform Implementation in California
    2. 2. Our Presentation <ul><li>Prologue: Evolution of a Public Discussion </li></ul><ul><li>Polling: California – Where We Are Now </li></ul><ul><li>Goal: A Stronger Constituency for Better Health Care </li></ul><ul><li>Campaign: “Ask Me About Health Care Reform” </li></ul><ul><li>Fit: Where Do You/Does Your Organization Fit </li></ul>
    3. 3. Evolution of Public Discussion
    4. 4. Evolution of Public Discussion <ul><li>Health Reform was 2008 campaign promise, 2009 priority, 2010 passage </li></ul><ul><li>Congressional process / partisan battle focus </li></ul><ul><li>Tea Party protests </li></ul><ul><li>Public doubt </li></ul><ul><li>Obama focuses </li></ul><ul><li>Law Passes </li></ul>
    5. 5. California Voters and Health Care Reform: Current Attitudes and Strategic Implications Survey Conducted: April 8-12, 2010 800 Californians Surveyed; 200 Oversample of DTS Voters Survey conducted by Fairbank, Maslin, Maullin, Metz & Associates (FM3) - Public Opinion Research & Strategy
    6. 6. <ul><li>Initially, a plurality of Californians support reform. </li></ul>Q5. Total Support 49% Total Oppose 42% In general, do you support or oppose the new healthcare law/health reform plan recently approved by Congress and signed by the President?
    7. 7. First Ask: Initial Support for Reform by Party 5. In general, do you support or oppose the new healthcare law/health reform plan recently approved by Congress and signed by the President? 83% 36% 14% 49% 76% 15% The fundamental divisions on the issue are partisan.
    8. 8. <ul><li>Many groups that reform will help do not initially see a direct benefit to their families. </li></ul><ul><li>A direct benefit to their family is only perceived by: </li></ul><ul><ul><li>50% of those who have had trouble paying for health care in the past three years; </li></ul></ul><ul><ul><li>49% of those who have been denied coverage for a pre-existing condition; </li></ul></ul><ul><ul><li>48% of those who lack coverage today; </li></ul></ul><ul><ul><li>41% of those in households where a member has lacked coverage at some point in the past three years; </li></ul></ul><ul><ul><li>36% of those with household incomes under $60,000 per year; and </li></ul></ul><ul><ul><li>35% of those with no more than a high school education. </li></ul></ul>
    9. 9. Detailing provisions of reform leads to a significant increase in support 5/12/16. In general, do you support or oppose the new healthcare law/health reform plan recently approved by Congress and signed by the President?
    10. 10. <ul><li>Fully 85% of voters are dug in to positions of support or opposition – as is the case on many contentious policy issues. </li></ul><ul><li>Voters can be divided into three groups, based on the consistency of their support for reform in the four support/oppose questions in the survey: </li></ul><ul><ul><li>Consistent supporters (47% of the electorate): indicated that they support reform each of the four times they were asked; </li></ul></ul><ul><ul><li>Consistent opponents (38% of the electorate): indicated that they would oppose reform each of the four times they were asked; </li></ul></ul><ul><ul><li>Swing voters (15% of the electorate): shifted positions (in any direction) over the course of the survey, or remained consistently undecided. </li></ul></ul>
    11. 11. The Persuadables <ul><li>Ideology – Independent, Moderate </li></ul><ul><li>The Gainers – Most notably the uninsured </li></ul>
    12. 12. <ul><li>Groups that shift to support reform over the course of the survey that respond to information. </li></ul>SUPPORT Opposition 7% Shift to Support Reform (Positive Movers) Lack Health Insurance Coverage Sacramento/Rural Northern California DTS/Other Men Latinos DTS/Other 18-49 Under Age 30 High School Education or Less Household Income Under $60K DTS/Other Men Age 18-49 Work as a Health Care Provider Democrat 18-49
    13. 13. <ul><li>Provisions of the Law </li></ul>
    14. 14. <ul><li>Three out of five Californians offer strong support for several provisions of the law. </li></ul>(% Rating Each Item a 6/7 on 7-Point Support Scale) Prohibits insurance companies from dropping people’s health insurance when they get sick Prohibits insurance companies from denying coverage because of pre-existing conditions Allows young people to stay on their parents’ health plans until age 26 Allows individuals and small businesses to choose from the same health insurance plans offered to members of Congress Cuts waste, fraud, and abuse in Medicare and ensures that funds go toward improving care Reduces overuse of emergency rooms by ensuring that everyone has coverage and can go to their own doctors Gives seniors a rebate for some prescription drug costs not covered by Medicare
    15. 15. <ul><li>Key Poll Conclusions and Lessons </li></ul>
    16. 16. Poll Conclusions <ul><li>Support today for health care reform is greater in California than many other regions nationally but still a highly partisan issue. </li></ul><ul><li>Receiving information about health care reform content builds and intensifies support among all Californians regardless of party or “decline-to-state” registration. </li></ul><ul><li>Californians who are self-described moderates in political outlook and independent voters who register “decline-to-state” are particularly responsive to information about health care reform’s provisions, as are Californians who would most directly benefit from health care reform. </li></ul>
    17. 17. Lessons from the Poll <ul><li>First , explain what’s in the law. </li></ul><ul><ul><li>Benefits </li></ul></ul><ul><ul><li>Most Popular </li></ul></ul><ul><ul><ul><li>No more dropping people when they’re sick </li></ul></ul></ul><ul><ul><ul><li>No more denials for pre-existing conditions </li></ul></ul></ul><ul><ul><ul><li>Young adults stay on plan </li></ul></ul></ul>Listener/Audience
    18. 18. Lessons from the Poll <ul><li>Second , show how reform will: </li></ul><ul><ul><li>Benefits </li></ul></ul><ul><ul><li>And, </li></ul></ul><ul><ul><ul><li>Give people peace of mind </li></ul></ul></ul><ul><ul><ul><li>Strengthen their relationship with their doctor </li></ul></ul></ul>Boost Prevention
    19. 19. Conclusions <ul><li>Polling shows that a public education campaign on health reform benefits is a great investment to build support and make implementation a success. </li></ul>
    20. 20. A Stronger Health Base for Better Health Care
    21. 21. Building a Stronger Health Base <ul><li>High-Profile Moment </li></ul><ul><li>Success of Implementation Key </li></ul><ul><li>Health Base Grows </li></ul><ul><li>New Directions for Health </li></ul>
    22. 22. New Direction for California’s Health <ul><li>The California Endowment is launching a public education campaign to inform Californians on the benefits of health care reform. </li></ul><ul><li>We understand that the passage of health care reform is a starting point, not a finish line. </li></ul><ul><li>Join us to educate and engage Californians and empower a “health base” to transform people’s lives through better health care and provide the peace of mind that comes with good health. </li></ul>
    23. 23. Where Do You Fit?
    24. 24. Where Do You Fit? <ul><li>Talking, Writing </li></ul><ul><li>Supporting Reform </li></ul><ul><li>Educating Members </li></ul><ul><li>Community Outreach </li></ul><ul><li>Resources </li></ul>Ask Me About the New Health Care Law Give Health Care to a Graduate Send a gift of health care coverage to a graduate. Let them know how the new health care bill will protect them.
    25. 25. The Three Things To Remember <ul><li>Support California legislation to implement reform so its successful. </li></ul><ul><li>Educate “persuadables” (moderates and people who will gain benefits) on the benefits of reform. </li></ul><ul><li>Keep in mind the most popular benefits: </li></ul><ul><ul><ul><li>No more dropping people when they’re sick </li></ul></ul></ul><ul><ul><ul><li>No more denials for pre-existing conditions </li></ul></ul></ul><ul><ul><ul><li>Young adults stay on parents’ plan </li></ul></ul></ul>
    26. 26. Resources <ul><li>Website </li></ul><ul><li>Presenter name, email </li></ul>
    27. 27. Messages That Work
    28. 28. 65% 60% Ranked by % Very Convincing 13. Here are some statements from people who support the new healthcare law approved by Congress and the President. Please tell me whether you find it very convincing, somewhat convincing, or not convincing as a reason to support the plan. *Split Sample Messages stressing the broad distribution of benefits and insurance company reforms are generally most compelling. The new healthcare law prevents insurance companies from getting in between individuals and their doctors . It keeps insurance companies from dropping coverage when you or someone in your family gets sick. And it will mean more information is available so doctors can provide better treatment and help people stay healthy . Everyone will benefit from healthcare reform , whether they have health insurance today or not. The new healthcare law guarantees coverage for everyone, regardless of pre-existing conditions, while helping to make insurance affordable for low- and moderate-income people. And people who have insurance today can keep their current coverage, and will benefit from lower costs and higher quality.
    29. 29. 63% 61% 13. Here are some statements from people who support the new healthcare law approved by Congress and the President. Please tell me whether you find it very convincing, somewhat convincing, or not convincing as a reason to support the plan. *Split Sample Continued 61% Health reform provides a safety net to protect Californians so that getting sick or losing a job doesn’t mean financial ruin. And it establishes the principle that when you get sick, you have a community there to help you get back on your feet. Our healthcare system is broken and needs fixing. The new healthcare law keeps our current private system of care, but improves it – putting government in a stronger position to enforce laws that make health insurance more affordable and available. Healthcare costs have been going up and up while insurance covers less and less. This health reform law is a step in the right direction to get runaway healthcare costs under control . It ensures more competition among healthcare plans, eliminates waste in the healthcare system, and targets healthcare dollars to provide better care.
    30. 30. 59% 61% 13. Here are some statements from people who support the new healthcare law approved by Congress and the President. Please tell me whether you find it very convincing, somewhat convincing, or not convincing as a reason to support the plan. *Split Sample Continued 61% This law provides peace of mind and security for all Californians . For the first time, there are limits on how much people have to spend for their healthcare. Nobody has to worry about losing their house or going bankrupt if they or someone they love gets sick. The healthcare reform law will help California seniors get better care . It will close the “doughnut hole” in Medicare, helping seniors get the prescription drugs they need. And it will help eliminate waste, fraud, and abuse in Medicare –focusing dollars on giving California seniors the care they need and deserve. The new healthcare law breaks new ground by promoting healthy behaviors, reducing the risk of serious health problems and the costs that go with them . It eliminates co-pays for preventive care like cancer screenings and promotes healthy living through worksite wellness programs, community grants to increase access to healthy foods and physical activity and requirements for restaurants to provide nutrition information on their menus.