6 things to know about consumers’ healthcare policy priorities

A new poll from the Kaiser Family Foundation asked what healthcare policies they’d most like to see Congress and the next president address—and making changes to the Affordable Care Act (ACA) wasn’t the most popular answer.

Out of the 1,205 respondents, only 37 percent said repealing the ACA should be a top healthcare priority. The answer had a sharp partisan divide, with only 17 percent of respondents identifying as Democrats prioritizing repeal compared to 40 percent of independents and 60 percent of Republicans. Addressing other parts of the ACA were also not top priorities to most respondents, like reducing subsidies for ACA exchange plans (25 percent) or repealing the “Cadillac tax” on higher-cost plans (24 percent).

Repealing the ACA’s individual mandate was deemed more important than repealing the law as a whole, with 38 percent of all respondents saying they consider it a top priority, including 51 percent of Republicans.

The highest policy priorities, according to the poll were:

1. Making sure high-cost drugs for chronic conditions are affordable.

This was considered a top priority by 74 percent of respondents and was one of the few options supported by a majority of all three partisan segments: 84 percent of Democrats, 73 percent of independents and 68 percent of Republicans.

2. Government action to lower prescription drug prices

More direct intervention on pharmaceuticals wasn’t as widely supported, but was still deemed a high priority by 63 percent of respondents. The partisan divide was wider, too, with only 49 percent of Republicans calling it a top priority compared to 75 percent of Democrats.

Congress has already focused more of its attention on rising drug prices, like the contentious hearings over Mylan’s price increases of EpiPen since acquiring the device. Pharmaceutical Research and Manufacturers of America (PhRMA) may be gearing up for a big lobbying battle, as it recently increased its dues to collect an additional $100 million from member companies.

3. Making sure health plans have sufficient provider networks of doctors and hospitals

This was considered a top priority for 57 percent of respondents. Narrow network plans have become more popular, and health maintenance organization plan designs have come to dominate offerings on the ACA exchanges.

4. Making information comparing the quality of healthcare provided by doctors and hospitals more available to patients

Some 53 percent of respondents called this a top priority, including 59 percent of Democrats, 54 percent of independents and 42 percent of Republicans.

CMS has taken steps towards quality transparency with its Hospital Compare star ratings, but the system has been criticized for accuracy and for seeming to favor hospitals that serve more affluent patients.

5. Making information about the price of doctors’ visits, tests and procedures such as hip replacements and MRI more available to patients

Price transparency was considered a top priority by half of respondents, with only a small partisan divide: 52 percent of Democrats, 51 percent of independents and 46 percent of Republicans want to see it addressed by lawmakers and the next president.

The availability of pricing information can lead to patients choosing lower-cost hospitals for certain procedures, according to a recent study published in JAMA.

6. The public option is popular—depending on how it’s described

Outside of the results on priorities, the poll asked for the respondents’ opinion on instituting a public health insurance option. Overall, 739 of the 1,201 participants supported it, but how it was explained had a significant effect on support.

When half of the participants were asked whether they supported “creating a public health insurance option to compete with private health insurance plans” on the ACA exchanges, 70 percent were in favor while 24 percent were opposed.

The results were different when the question was reworded for the other half of respondents. When it was described as a “government-administered” insurance option, 53 percent were in favor and 41 percent were opposed.

Additionally, opinion on a public option changed when opposing arguments were presented—21 percent changed from favor to oppose “after hearing the argument often made by opponents that doctors and hospitals would be paid less,” and 27 percent changed their answer to oppose “after hearing that the government plan would have an unfair advantage over private insurers.”