Regardless of party affiliation, health is important to us all — but just how important? As the United States presidential elections approach, we take a look at healthcare and its place among voters’ priorities. We also examine how voters’ priorities have shifted from earlier this year.

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Since the beginning of the year, the place of healthcare among voters’ priorities has shifted.

The majority of respondents prioritized healthcare over the economy — as revealed by a Kaiser Family Foundation (KFF) poll, for example, which found that 26% of respondents thought healthcare issues were the most important factor for electing a president. Respondents believed this regardless of their political leaning.

Other surveys found similar results at the time. Politico, in collaboration with the Harvard T.H. Chan School of Public Health in Boston, MA, found that within domestic policy, voters were most concerned about healthcare costs.

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In the survey, 80% of respondents expected the president and congress to take steps to lower the cost of healthcare, while 75% wanted them to reduce prescription drug costs, regardless of their voting intentions.

Issues of economy or immigration policies came second or third among voters’ priorities. But this was in February 2020. Since then, we have witnessed a global pandemic that has exposed society to an unprecedented degree and revealed flaws in healthcare systems and governing bodies not just in the U.S., but across the world.

So what are American voters’ priorities now, ahead of the upcoming presidential election? The latest KFF health tracking poll for September 2020 asks exactly this, and in this Special Feature, we summarize its key findings.

Liz Hamel, Vice President and Director of Public Opinion and Survey Research at KFF, is the first author of the research, followed by Audrey Kearney, Ashley Kirzinger, Lunna Lopes, Cailey Muñana, and Mollyann Brodie.

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Unlike in February, the KFF poll reveals that healthcare is no longer a top priority for voters. Instead, 32% of registered voters placed the economy at the top of their list, saying it is the most important factor in their decision for a president.

However, the COVID-19 outbreak, which is intimately related to healthcare, took the second spot, with 20% of registered voters saying it was the most important issue for them. Therefore, respondents rank the current pandemic as the second most important issue after the economy.

Furthermore, criminal justice and policing came third, with 16% of the respondents placing it at the top of their list, while race relations took fourth place among Americans’ priorities, with 14% of voters ranking it as their main criterion for choosing a president.

Overall, there has been a major shift in the issues that Americans prioritize in the run-up to this election.

Since February, the percentage of voters who placed healthcare at the top of their list dropped by 16 points, while healthcare dropped to the fifth spot in U.S. adults’ list of top issues, not counting the coronavirus outbreak as part of healthcare.

“In the early months of 2020 and during the height of the Democratic primary contest, healthcare was consistently rated as one of the top issues for voters and was the top issue for Democratic primary voters in all of the seventeen Democratic contests analyzed by KFF researchers,” write the poll authors, who also hint at some of the reasons for this shift.

“But the latest KFF poll finds voters’ priorities have shifted during the last 6 months with the coronavirus outbreak, the closing of businesses due to the spread of the virus and subsequent recession, the police shootings of unarmed Black Americans, and violence occurring around protests.”

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Going into more depth, the survey also asked respondents what specific healthcare issues get their vote.

In response, the participants mentioned:

  • increasing access to health insurance coverage, such as universal coverage (18% of respondents)
  • the cost and affordability of healthcare, including the cost of prescription drugs (15%)
  • the COVID-19 outbreak (8%)
  • “Medicare or senior concerns” (7%)

By contrast, other issues seem to have fallen off the radar. “A healthcare issue that no longer seems to be resonating with voters, especially Republican voters, is the 2010 Affordable Care Act (ACA),” the KFF report states.

Namely, only 5% of Republican voters said they would oppose or wish to get rid of the ACA “as a top healthcare issue (compared to 29% of Republican voters who said the same prior to the 2016 presidential election).”

Currently, according to this specific KFF poll, 35% of voters report that they are “definitely going to vote for President Trump,” and 38% say they are “definitely going to vote for Joe Biden.”

However, there remains a significant proportion of voters who will vote “probably” for the Democratic candidate, “probably” for the Republican candidate, or report still being “undecided.”

These undecided swing voters make up 24% of all registered voters. Importantly, healthcare is no longer a top priority among them either.

In February 2020, 28% of swing voters said healthcare was the top issue for them, and 23% said the economy.

Now, 35% of swing voters place the economy at the top of their priorities. This is followed by criminal justice and policing (17%), the coronavirus pandemic (15%), and race relations (14%).

The new analysis also reveals, as always, different parties have different priorities.

Overall, Republicans prioritize the economy and “criminal justice and policing,” whereas Democratic voters care about ending the current pandemic first and race relations second.

More specifically, Republican voters are overwhelmingly concerned with the economy: 53% place it at the top of their priorities when electing a president, while 29% of independent voters also prioritize it.

By contrast, 36% of Democratic voters report they are preoccupied with the handling of the coronavirus pandemic. The next issue that will decide who they choose for president is race relations, with 27% prioritizing this topic.

Despite the Centers for Disease Control and Prevention (CDC) recently prompting all states to prepare for distributing a vaccine as early as November 1, just 2 days before the presidential election, a whopping 81% of voters do not believe this is achievable.

In fact, 62% of voters — 85% of Democrats, 35% of Republicans, and 61% of independent voters — worry that the Food and Drug Administration (FDA) will hastily approve a vaccine that may not be wholly safe and effective as a result of political pressure from the current administration.

To be specific, respondents answered the question “How worried are you, if at all, that the U.S. FDA will rush to approve a coronavirus vaccine without making sure that it is safe and effective due to political pressure from the Trump Administration?” thus:

  • 33% of total voters said they were “very worried”
  • 29% of total voters said they were “somewhat worried”
  • 16% were “not too worried”
  • 20% said they were “not at all worried”

Overall, attitudes towards the pandemic have changed significantly compared with another poll that the KFF conducted in April. At the time, 74% of respondents said they believed “the worst is yet to come,” whereas now only 38% believe this. Another 38% of the respondents agreed with the statement, “the worst is behind us” in September.

On a different note, misconceptions about the new coronavirus continue to prevail. As many as 1 in 5 U.S. adults still believe wearing a face mask is damaging to one’s health, for example.

Another significant trend noted by the poll is the public’s declining trust in the CDC and in Dr. Anthony Fauci’s leadership. Namely, regardless of party affiliation, the proportion of people who trust the CDC for reliable coronavirus information dropped by 16% since April.

In particular, the decline in trust of Dr. Anthony Fauci is notably “steep” among Republicans.

“While the share of Democrats who say they trust Dr. Fauci has increased slightly since April (86%, up from 80%), among Republicans, the share who trust Dr. Fauci has decreased by 29 percentage points (48%, down from 77%),” notes the report.

It is important to note that KFF conducted its latest Health Tracking Poll right after the police shooting of Jacob Blake in Kenosha, Wisconsin. The authors write:

“The recent police shootings of unarmed [B]lack Americans and subsequent protests have resonated with voters with both criminal justice and policing and race relations ranking among the top election issues, depending on party identification.”

In fact, 27% of Democratic voters say race relations constitute “the most important issue in deciding their vote for president.” Similarly, 23% of Republicans say criminal justice and policing will be the top issue that will help them decide.

“In addition, large majorities of voters view racism, police violence, and violence caused by protestors as at least “somewhat of a problem” in the U.S.,” write Hamel and colleagues. They continue:

“About six in ten (58%) say racism is a “big problem” while about four in ten say the same about police violence against the public (43%).”

However, the concern goes both ways, as 52% of respondents say “violence caused by the protestors” is also a “big problem” in the U.S. The past 3 months saw a 15 percentage point increase in the proportion of voters who think this — from 37% in June to 52% now.

This year’s BLM protests started at the end of May.

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