Concerns with Health Care Costs and Coverage Unchanged by COVID-19, Study Shows

CHICAGO – Despite the coronavirus outbreak drawing attention to the U.S. health care system, Americans’ fundamental concerns about health care costs and coverage have not significantly changed in recent months, according to a recent study from the University of Chicago Harris School of Public Policy and The Associated Press-NORC Center for Public Affairs Research.

The study features two surveys measuring attitudes about health care, the first conducted in early February, before widespread COVID-19 cases in the United States, and the second conducted in early May, after the pandemic had spread widely.

The results show that Americans’ concerns over the country’s health care system continue to loom larger than worries about their own personal health care. For example, only 19% of Americans are now concerned about personally losing or not having health insurance, while 56% are worried about coverage issues for others in the country.

The two surveys also highlight that the COVID-19 pandemic has not fundamentally altered views about key aspects of the health care system. Public attitudes about the government’s spending to improve and protect the nation’s health have not shifted since the outbreak, with 56% saying in May it spends too little compared with 55% reporting the same in February.

“The pandemic has brought to the forefront the importance of social safety net programs—for both income and health care,” said Katherine Baicker, dean and Emmett Dedmon Professor at Harris. “Many people are concerned about health care costs and access for fellow Americans, but there are sharp partisan differences about the role of government in financing health care and whether the government or the private sector can best handle key elements of health care.”

Americans’ attitudes toward the trade-offs between health care costs, access, and innovation have held remarkably stable since the outbreak, as has the strong partisan divide about the best approach for the health care system. Political independents fall in the middle of this partisan split as they tend to have more mixed views on health care than Democrats or Republicans.

For example, 78% of Democrats say that they would rather pay less for health care and more in taxes compared with 52% of independents and 35% of Republicans.

Partisan differences extend to beliefs on whether the government or private sector can better handle some key aspects of health care. Majorities of Democrats say that the government is better than the private sector at reducing costs and providing coverage, while Republicans tend to believe the private sector is better at handling most aspects of health care. Both Republicans and Democrats think that the private sector is better able to drive health care innovation.

“The public’s concerns about the U.S. health care system have not been significantly altered even in the midst of a pandemic,” said Trevor Tompson, director of The AP-NORC Center. “The results also show the stark partisan divide on how best to address these concerns.”

Among the key findings from the report:

• Most Americans are not concerned with their insurance coverage, but those who identify as being in moderate or poor health are more likely than those in very good health to worry about having insurance (40% vs. 25%).
• About two-thirds of Americans (64%) want to pay less for prescription drugs, even if it means fewer new drugs would be available in the future.
• Democrats are more than twice as likely as Republicans to say that Americans should pay less for health care and more in taxes (78% vs. 35%).
• Respondents remain divided about the features of health insurance plans that are most important to them. Fifty percent would prefer an insurance plan with lower out-of-pocket costs and higher monthly premiums, while 45% would rather have one with lower monthly premiums and higher out-of-pocket costs.
• In both May and February, 50% say they would prefer a health insurance plan that provided broader coverage with higher premiums and out-of-pocket costs rather than a plan with lower costs and more limited coverage.
• The partisan gap related to whether the government spends too little money overall has increased from 32 percentage points in February (54% of Democrats vs. 22% of Republicans) to 53 percentage points in May (66% of Democrats vs. 12% of Republicans).

About the Study

This study was conducted by the University of Chicago Harris School of Public Policy and The Associated Press-NORC Center for Public Affairs Research with funding from NORC at the University of Chicago. Staff from Harris Public Policy and The AP-NORC Center collaborated on all aspects of the study.

The study featured two surveys, and data for both were collected using the AmeriSpeak Omnibus®, a monthly multi-client survey using NORC’s probability-based panel designed to be representative of the U.S. household population.

The first survey was conducted between February 13 and 16, 2020, with adults age 18 and over representing the 50 states and the District of Columbia. Panel members were randomly drawn from AmeriSpeak, and 1,015 completed the survey. The overall margin of sampling error is +/- 4.15 percentage points at the 95% confidence level, including the design effect.

The second survey was conducted between May 14 and 18, 2020, with adults age 18 and over representing the 50 states and the District of Columbia. Panel members were randomly drawn from AmeriSpeak, and 1,001 completed the survey. The overall margin of sampling error is +/- 4.37 percentage points at the 95% confidence level, including the design effect.

The margin of sampling error may be higher for subgroups.

A full description of the study methodology for the survey can be found at the end of the report.

The proper description of the survey’s authorship is as follows: This study was conducted jointly by the University of Chicago Harris School of Public Policy and The Associated Press-NORC Center for Public Affairs Research.

About the University of Chicago Harris School of Public Policy

One of the largest graduate professional schools at the University of Chicago, Harris Public Policy has been driven by the belief that evidence-based research, not ideology or intuition, is the best guide for public policy. For more than three decades, our exceptional community of scholars, students, and alumni have applied this exacting perspective to the world’s most pressing problems using the latest tools of social science. Through our undergraduate and graduate programs, we empower a new generation of data-driven leaders to create a positive social impact throughout our global society.

About The Associated Press-NORC Center for Public Affairs Research

The AP-NORC Center for Public Affairs Research taps into the power of social science research and the highest-quality journalism to bring key information to people across the nation and throughout the world. www.apnorc.org The Associated Press (AP) is an independent global news organization dedicated to factual reporting. Founded in 1846, AP today remains the most trusted source of fast, accurate, unbiased news in all formats and the essential provider of the technology and services vital to the news business. More than half the world’s population sees AP journalism every day. www.ap.org NORC at the University of Chicago is an objective and non-partisan research institution that delivers reliable data and rigorous analysis to guide critical programmatic, business, and policy decisions. Since 1941, NORC has conducted groundbreaking studies, created and applied innovative methods and tools, and advanced principles of scientific integrity and collaboration. Today, government, corporate, and nonprofit clients around the world partner with NORC to transform increasingly complex information into useful knowledge.

The two organizations have established The AP-NORC Center for Public Affairs Research to conduct, analyze, and distribute social science research in the public interest on newsworthy topics, and to use the power of journalism to tell the stories that research reveals.