Voters Prioritize Insurance Company Accountability in Health Care Reform
Voters want reforms that curb insurer steering, increase transparency, and guarantee savings reach patients.
Key Takeaways
Voters prioritize insurance-focused reforms: curb steering, increase transparency, ensure savings reach patients.
Insurer and middleman accountability is the strongest performing center-right message.
Most voters believe insurer-provider integration raises prices and a plurality supports limits on insurer ownership.
Voters oppose penalizing patients for choosing lower-priced, independent providers.
Voters prioritize reforms targeting insurance companies — especially proposals that curb insurer steering, guarantee savings flow directly to patients, and increase upfront transparency on total and out-of-pocket costs. Reflecting these priorities, among four center-right positioning statements tested, the message emphasizing insurance company and middleman accountability performed best.
Most voters also believe vertical integration in health care — particularly insurer ownership of providers — raises patient costs.
Why it Matters
Recent ANMP surveys show health care costs are voters’ No. 2 economic concern, driven largely by rising premiums and out-of-pocket costs. Voters consistently blame insurance companies more than other parts of the health care system for affordability challenges.
These findings identify which reforms prioritize most and which candidate messages generate the strongest support.
How to Use This Data
Candidates and advocates should frame health care reform around:
✓ Increasing insurer and middleman accountability
✓ Protecting patients from unfair practices
✓ Guaranteeing savings reach patients
View the full data by clicking below, or read key highlights in the summary.
Voters Prioritize Insurer-Focused Reforms
Reforms targeting insurer steering, passing savings directly to patients, and enhancing transparency draw the broadest support from voters.
The most intense support, with 39% saying it is a “top priority,” is for requiring insurance companies to pass 100% of discounts on medicines directly to patients at the pharmacy counter.
Prohibiting PMBs from making more money when patients are steered toward higher priced drugs is the next most intense – with 37% saying the reform is a top priority.
Demographic differences by party and race are minimal. Older voters react more intensely to reforms they see as saving them money on prescription drugs.
Insurer Accountability Message Tests Strongest
A candidate focused on curbing insurer and middleman abuses and requiring savings to be passed directly to patients tests strongest out of the four positioning statements tested, defeating the other three candidates by a roughly 20-point margin.
Candidates focused on price transparency and drug price controls were less effective, while a candidate focused on expanding Health Savings Accounts (HSAs) tested the worst.
These results strongly reflect the priority level voters give to certain reforms, not their overall popularity.
Independents favor the transparency-focused candidate more than other demographic groups, though the insurer focused candidate still performs best with them.
Voters Skeptical of Vertical Integration in Health Care
59% believe vertical integration in health care – specifically insurers owning providers and other parts of the system – makes health care more expensive.
68% say insurers should not be allowed to charge patients higher out-of-pocket costs if they choose a lower priced, independent provider not owned by the insurer.
43% – a plurality – favor more limits on insurers owning other parts of the health care system. 26% oppose.
Demographic differences by party are minimal, but there are some differences by race and age. Black voters make up the only group who believes fewer limits should be placed on this sort of ownership, while older voters are more likely to favor more limits than younger.
The Bottom Line
Health care reform messages centered on insurance company accountability, patient savings, and transparency generate the broadest and most intense voter support. Candidates emphasizing insurer and middleman crackdowns hold a clear advantage over those focused primarily on transparency, drug pricing, or HSAs.
What’s Next
We will have more analysis from this health care survey, data on apprenticeships, and more.
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