The 2020 election was defined by a wide range of unique, and in some cases, unprecedented factors. From a global pandemic to never before seen rates of mail-in ballot casting and record voter turnout across the country, this election cycle was unlike any other we have seen in recent history. Thus, it may not be surprising that in some cases where we saw candidates adhering too closely to a traditional campaign playbook, election outcomes turned out in ways we did not anticipate.
That’s because voters’ concerns and priorities have evolved, with the economy and COVID-19 being top issues overall and rising out-of-pocket costs and declining coverage driving concerns from a health care perspective. Prescription drug affordability was a narrower electoral issue this year, and it fits within a larger insurance coverage conversation. As a result, some candidates with too narrow a focus on drug pricing had some trouble reaching their constituents and bringing in the votes they had hoped to earn.
One thing is clear coming out of this election: policymakers need to meet voters where they are by addressing the health care issues most important to them. We know from the latest data that top health care concerns center around coverage issues – in particular out-of-pocket costs and pre-existing condition protections – and it’s reinforced by voters’ own perspectives based on recent focus groups:
- One Georgia voter expressed that “health care insurance is too expensive for the regular family to be able to afford and still have money to get groceries and essentials and to pay their mortgages.” Another voter from North Carolina said his top health care concern was “not having enough coverage to get the care I need that I can afford.” These sentiments were echoed by our November 2020 exit poll that found 60% of voters are worried about not having the coverage they need in the event of a major medical event.
- A voter in Florida underscored that “coverage should be affordable and there needs to be some reform; costs shouldn't be passed to consumers or punish us for being sick.” 73% of voters agree that sick individuals should not pay a larger portion of their care compared with healthy individuals.
- An Ohio voter said, “My biggest fear is that millions of people who rely on the ACA to purchase their insurance will be left out, along with the idea that anyone with pre-existing conditions could be denied coverage.” Another voter from Florida said she felt that “deductibles are hurting people with pre-existing conditions the most.” Americans more broadly share a similar perspective. In fact, 29% of voters believe pre-existing conditions protections are the top health care issue for them, alongside the cost of health insurance premiums and out-of-pocket costs not covered by insurance (e.g., copays, deductibles).
The data and real-life voter accounts demonstrate that today voters see coverage and related issues, including their deductibles, copays and other out-of-pocket costs from routine and potentially surprise medical bills, as a top priority. Voters want elected officials to address these systemic issues as a way to address health care costs broadly. Candidates and elected officials should show they are listening to voters and work to address their health care concerns and priorities.
