KFF Health Tracking Poll – December 2020: COVID-19 and Biden’s Health Care Agenda

Main results

• With the country experiencing a record number of cases, hospitalizations and deaths, pessimism about the course of the coronavirus pandemic continues to mount. Half of adults say the worst is yet to come and go back to the levels recorded in May. In addition, the proportion of the public who say they are concerned that they or someone in their family is developing coronavirus has been highest since KFF started following the issue in February (68%).
• With a COVID-19 vaccine on the horizon, most adults (70%) say they can stick to social distancing guidelines for six months or more, or until a vaccine is widely available. With some states and municipalities imposing new home stay contracts and restrictions on some companies to limit the spread of coronavirus, about four in 10 adults believe that their state companies and individuals have the right restrictions. About half of Democrats (49%) say their state doesn't have enough restrictions on businesses, while half of Republicans (50%) say their state has too many restrictions.
• Compared to May, a greater proportion say they wear a mask every time they leave (73%, an increase of 21 percentage points since May, including increases between partisans and age groups).
• Given the large percentage who say they wear face masks regularly, most citizens think that wearing a mask to prevent the spread of COVID-19 is part of everyone's responsibility (73%), although Republicans are more divided and half says it is everyone's responsibility to protect the health of others and 45% say it is a personal choice.
• The majority of the public would like Biden's new administration and Congress to either build on the Affordable Care Act (ACA) or leave it as it is (62%), despite the fact that partisans are different. There is bipartisan support for President-elect Biden's proposal to allow the federal government to negotiate with drug companies to get a lower price on drugs (89%). While the majority of the population is in favor of ensuring health coverage for lower-income people whose states have not expanded their Medicaid program (76%), are establishing a public option (71%), and are expanding government funding for those who have their own insurance Complete for the US On the market (66%) and with the Medicare Eligibility Age lowering to 60 (65%), fewer Republicans support these proposals.

Growing pessimism about the coronavirus outbreak

With coronavirus cases and hospital stays at record highs across the country, the latest KFF Health Tracking survey shows the public is feeling increasingly negative about how the pandemic is progressing. Half of adults (51%) believe the worst is yet to come – an increase from September and October when around four in 10 believed the worst is yet to come. A quarter of the public (25%) say the worst outbreak is behind us, and about one in five say coronavirus is or will not be a major problem in the US (19%).

Among the partisans, seven in ten Democrats (72%) say the worst is yet to come. Notably, about a third (32%) of Republicans say the worst pandemic is yet to come, twice as many as in October (15%). Among the independents, half say the worst coronavirus is still to come (50%), while 28% say the worst is behind us. About six in ten black adults (62%) – a group disproportionately affected by coronavirus – say the worst coronavirus outbreak is yet to come, while about half of white adults (53%) and four in ten Hispanic adults ( 41)%) Say the same.

Figure 1: Half of adults say the worst coronavirus outbreak is yet to come

The U.S. recently set a daily COVID-19 death record in which more than 3,000 people died from the disease in a single day. Three in ten adults say they are “very concerned” that they or a family member will get coronavirus, and another 38% say they are “a little concerned”. About eight in ten Democrats say they are concerned that they or a family member will get sick, including 42% who are “very concerned”. While the majority of independents (68%) say they are at least “slightly concerned” that they or a family member will develop coronavirus, less than half of Republicans express that concern (46%).

Notably, about three in four black adults (75%) and Hispanic adults (77%) say they are worried that they or a family member will contract coronavirus, while about two in three white adults (64%) express that concern.

Figure 2: The majority of Democrats and Independents are concerned that they or someone in their family will contract coronavirus

Amid the worsening outbreak, the percentage of the public who say they are "very concerned" or "slightly concerned" that they or someone in their family will contract coronavirus is at its highest since KFF started doing it in February Following up on this question 68% now say they are concerned. The proportion of Democrats and Independents who say they fear they or a family member will get sick was similar in October, but lower in April when small majorities said they were concerned (56% Democrats, 54% of Independents) . Since the beginning of April, fewer than half of Republicans feared they or a family member would contract coronavirus.

Figure 3: Compared to February, greater proportions of partisans say they are worried that they or a family member will contract coronavirus

Ten months after the coronavirus spread across the country, half of adults (51%) said worries or stress related to the pandemic had a negative impact on their mental health, including one in four who said it was significantly has affected. This compares to the proportion in July who said pandemic stress and worry had a negative impact on their mental health (53%) and higher than the proportion who said it in May (39%). Women are more likely than men to report that their mental health has been negatively impacted by the coronavirus outbreak (57% versus 44%). Similarly, younger adults, ages 18-29, are more likely than their older counterparts to say that stress and worries about the pandemic have negatively impacted their mental health. The economic impact of the pandemic is also taking its toll, as six in ten adults whose households have lost a job or an income as a result of the pandemic say that coronavirus-related stress and worries have had a negative impact on their mental health.

Figure 4: About six in ten women, young adults, black adults, and those with financial implications report an impact on mental health

With the promise of a vaccine on the horizon, seven in ten adults say they can continue to follow social distancing guidelines for more than six months or until a vaccine becomes widely available. The majority of Democrats (87%) and Independents (68%) say they can follow social distancing guidelines for an additional six months or more, or until a vaccine is available, and half of Republicans say the same. In particular, one in five Republicans says they can't follow social distancing guidelines at all.

Figure 5: Most say they can follow social distancing guidelines for more than six months or until a vaccine is widely used

The reluctance of some Republicans to follow social distancing guidelines could be due to perceptions that the severity of the coronavirus is exaggerated. Overall, the public is divided on whether the coverage of the coronavirus conveys its severity (35%) or portrays it correctly (36%), while one in four believes that the severity of the coronavirus is underestimated (25%).

Partisans are divided according to state restrictions on businesses and individuals

In response to increasing cases, some states and municipalities have placed residence orders and restrictions on some companies to help slow the spread of the coronavirus. Four in ten adults say their state has around the right restrictions on businesses (40%) and individuals (42%) on efforts to slow the outbreak. However, around a third of the population think their state doesn't have enough restrictions on businesses (32%) and individuals (36%), while one in four says their state has too many restrictions on businesses and one in five states That this is also the case has many restrictions on individuals.

There is a large party political divide on this issue. While about half of Democrats (49%) say their state doesn't have enough restrictions on businesses, a similar proportion of Republicans (50%) say their state did too many Restrictions. While a small majority of Democrats (53%) say their state doesn't have enough restrictions on individuals to limit the spread of the coronavirus, about four in 10 Republicans (43%) say their state has too many restrictions. Among the independents, the pluralities indicate that their state has roughly the right restrictions on businesses (45%) and individuals (42%).

Figure 6: About half of Democrats believe their state does not currently have enough restrictions on businesses and individuals

Larger sections of the public now wear masks every time they leave home than in May

Recent media coverage has highlighted the politicization of the use of face masks. Overall, around three in four adults say they wear a protective mask every time they leave their home and that they may have contact with other people (73%). While large majorities among partisans – including three in four Republicans (76%) – say they wear a mask at least “most of the time”, they leave home, while large proportions of Democrats (87%) and independents (71%) say Wear a protective mask every time They are leaving their home compared to fewer Republicans (55%).

Figure 7: Majorities between the parties say they wear a protective mask every time they leave their home

Compared to May, the proportion of adults who state that they wear a mask every time they leave has increased significantly. About three in four adults say they wear a mask every time, an increase of 21 percentage points since May. The proportion of those who say they wear a protective mask every time they leave the house has risen by double-digit percentage points among partisans and age groups since May.

Figure 8: Compared to May, the public is now much more likely to say they wear a mask every time they leave the house

Who doesn't wear face masks regularly?

Because mask mandates exist in many parts of the country, most citizens report that they wear masks and may be in contact with other people, at least most of the time they leave home. However, a small minority of the public (11%) say they only wear protective masks sometimes. This group is disproportionately made up of whites (70%), men (65%) and Republicans (54%) and are more likely to have no college education than those who wear masks more often.

The reported increase in consistent mask use reflects the attitude of 73% of adults that wearing a mask to prevent the spread of COVID-19 is "part of everyone's responsibility to protect the health of others". While an overwhelming majority of Democrats (93%) and a vast majority of Independents (70%) say that wearing a mask is everyone's responsibility to protect public health, Republicans are more divided on this matter, with the Half (50%) say it is everyone's responsibility and a similar proportion say it is a personal choice (45%).

Figure 9: Around seven in ten say wearing a mask is part of everyone's responsibility to prevent the spread of COVID-19

The view that wearing masks is a personal choice or part of everyone's responsibility seems to be linked to the use of personal masks. Those who believe wearing a mask to prevent the spread of COVID-19 are more than twice as likely as those who believe it is a personal choice to say they wear a mask every time They leave their homes and may come into contact with others (85% versus 37%).

Figure 10: Those who view wearing a mask as a personal choice are far less likely to say they wear one every time they leave the house

Most citizens rightly know that wearing a face mask can help limit the spread of the coronavirus (78%) and that wearing a face mask is not harmful to health (77%). Last month, the Centers for Disease Control said that wearing a mask can help protect the wearer from the coronavirus. Most adults believe that this is actually the case. 70% say a face mask will protect them from coronavirus.

Figure 11: Most citizens know the benefits of wearing a public health mask to help limit the spread of the coronavirus

While most citizens know these important facts about using face masks as a preventive measure against coronavirus, a third consider at least one misunderstanding. In particular, the majority of Republicans (54%) have at least one misunderstanding about face masks, including 44% saying that wearing a face mask does not help protect against coronavirus. Among adults who believe at least one misunderstanding about face masks, six in ten (61%) say the severity of the coronavirus is exaggerated, and half say that wearing a mask is a personal choice (50%).

	total	Party ID
		Democrats	Independent	republican
Percent who believe in at least one misunderstanding:	34%	14%	38%	54%
Percent who say:
… Wearing a face mask does not protect you from coronavirus	25th	6th	29	44
… Wearing a face mask is harmful to your health	21st	8th	22nd	34
… Wearing a face mask does nothing to limit the spread of the coronavirus	17th	4th	19th	33

President-elect Biden's potential health agenda

While fighting the pandemic will no doubt be a top priority for the future Biden government, there are other health care proposals – some of which are bipartisan – that can also serve as cornerstones in Biden's health agenda.

Two health care priorities, supported by both parties, are price transparency and legislation to curb surprise medical bills. President Trump recently announced new transparency requirements that require employer-based group health plans to communicate price and cost-sharing information to attendees. Congress is working on a bipartisan law to protect patients from unexpected medical bills off the network. It is hoped that legislation to cope with surprise laws will be passed by Congress before the end of the year. The latest KFF poll found that a large majority of the public – including the majority of the partisans – prefer to provide patients with more information about the price of doctor visits, tests and procedures (93%) and laws to protect patients to advocate against high stress. of-network surprise medical bills (80%).

Figure 12: Large majorities are in favor of price transparency and measures to protect patients from unexpected medical bills

The majority of the public also endorses many of President-elect Joe Biden's key health care proposals, including large stakes that will allow the federal government to negotiate with drug companies to get a lower price on drugs that are both Medicare and individuals would apply insurance (89%). The support of the partisans is high. More than eight in ten Democrats (97%), Independents (87%) and Republicans (84%) support this proposal. A majority of partisans are also in favor of providing health insurance to lower-income individuals whose states have not expanded their Medicaid programs (76% overall, 95% Democrats, 74% Independents, and 54% Republicans). Overall, a majority also support other aspects of President-elect Biden's health agenda, which seeks to include about seven in ten people who prefer a government-administered health plan to be available to all Americans as a public option (71%) , and about two. One-third are in favor of expanding government financial aid to those who buy their own insurance in the market (66%) and lowering the age of Medicare-eligible people from 65 to 60 (65%).

Figure 13: Majority supports key health care proposals presented by President-elect Joe Biden

Democrats and Republicans, however, differ in Biden's proposals for expanding health care. While an overwhelming majority of Democrats (95%) are in favor of providing health insurance to lower-income people whose states have not expanded their Medicaid program, a smaller majority of Republicans (54%) support this proposal. Likewise, more than nine in ten Democrats support a public option compared to less than half of Republicans who say the same (92% versus 45%).

Currently, most adults are not eligible for Medicare health benefits until they are 65. Almost two-thirds of adults – including the majority of Democrats and Independents and half of Republicans – support Biden's proposal to lower the age if people are eligible for Medicare, while seven in ten adults aged 18 to 64 (70%) are in favor of lowering the Medicare Eligibility Age to 60, less than half of adults 65 and over (46%) are in favor of this proposal.

Percent they say Like Any of the following Health care proposals::	total	Party ID
		Democrats	Independent	republican
Federal government permission to negotiate with drug companies to get a lower price on drugs that would apply to both Medicare and private insurance	89%	97%	87%	84%
Providing health coverage to lower-income individuals whose states have not expanded their Medicaid program	76	95	74	54
A government administered health insurance plan, sometimes called a public option, that competes with private health insurance plans and is available as an option to all Americans	71	92	71	45
Expand government financial aid to those who buy their own insurance in the market	66	84	64	48
Reduce the age of people eligible for Medicare from 65 to 60	65	79	61	51

Most want to build on the ACA or leave it as it is

In November, the Supreme Court heard arguments in the California v Texas case questioning the constitutionality of the Affordable Care Act 2010. The Trump administration filed a brief on the case asking the Supreme Court to repeal the law. President-elect Joe Biden has repeatedly expressed his support for the Affordable Care Act during his campaign and recently selected California Attorney General Xavier Becerra, who was a strong ACA defender in court, as his election for Secretary of Health and Human Services . The most recent poll by KFF Heath Tracking found that roughly half of the public (53%) have a positive opinion about the ACA, while 34% have a negative opinion about the law.

Figure 14: Larger proportions of the public The ACA is cheaper than unfavorable

Building on the ACA was a focus for Joe Biden's presidential bid as he proposed creating a government-run public option health plan that competes with private insurers and is available to all Americans. Almost half of adults would like the future Presidential Administration and Congress to build on the activities of the ACA (48%). A smaller proportion want to leave the law as it is (14%), and around three in ten want to either reduce the law (9%) or repeal it entirely (20%). Partisans differ in these approaches: three in four Democrats want the new administration and Congress to build on what the law does (74%), and six in ten Republicans want the law to be scaled back (15%) or all of it is canceled (44%)).

Figure 15: Most would like to build on the ACA or leave it unchanged, although the partisans are different

The Trump administration shortened both the open filing period for the ACA marketplaces and funding for marketing and outreach efforts that publicize the filing deadline, eligibility, and process. With the enrollment deadline being recent in many states and fast approaching in other states, the latest KFF Health Tracking survey found that only one in seven adults under 65 either have their own insurance or are uninsured, and therefore likely that Aim for ACA marketplace plans know the correct registration deadline (14%). One possible action the future Biden administration could take to help further strengthen the ACA would be to restore funding for marketing and outreach to help Americans who wish to purchase their own insurance through the ACA marketplaces.

Figure 16: Few people know the marketplace for registering for their own health insurance