Shifting Concerns

September 29, 2020

Photo by David Sachs/SEIU licensed under CC BY 2.0

The 2020 election was supposed to be all about health care. Then 2020 happened. We check the latest polling on voters’ attitudes on health care this election season.

Listen to the full episode below, read the transcript and scroll down for more information.

Click here for more of our coverage of health care and the 2020 election.

How the Role of Health Care in the 2020 Election Has Changed

A lot has happened since we first talked to Kaiser Family Foundation pollster Ashley Kirzinger in early February about the role health care was likely to play in the 2020 election. Ashley and her colleagues have been gauging voters’ attitudes throughout the year, and their latest polls show that much has changed.

1. Health Care No Longer Voters' Top Issue

More than a quarter of voters at the start of the year ranked health care as their top issue. But after months of pandemic, economic hardship and protests for racial justice and against police violence, only 10% of voters still feel that way.

“Health care only has emerged as a top issue in elections when there aren’t other major crises in America,” Ashley says. “And unfortunately, in 2020, I feel like every day we have a new crisis.”

However, health care is still coming up on the campaign trail. According to analysis by the Wesleyan Media Project, about one-third of Biden ads and one-fourth of Trump ads are about health care.

2. Access Unseats Costs as Top Health Care Concern

Health care costs were the top health care concern of voters back in February at 24%, followed closely by increasing access at 22%. But with the coronavirus becoming a major concern and threatening health care access for millions who have lost their jobs, access has leapfrogged costs, although both have dropped as concerns over COVID-19 have grown.

“It makes complete sense in terms of how the coronavirus is affecting daily life in the U.S.,” Ashley says of the switch. “And we’re also seeing people putting off routine care, so they may not have as many or as high of health care costs as they did prior to the pandemic.”

3. ACA, Pre-Existing Conditions Back in the Spotlight

With the death of Supreme Court Justice Ruth Bader Ginsburg and the court set to hear arguments on the constitutionality of the Affordable Care Act a week after the election, the landmark health care law and especially its protections for people with pre-existing conditions are front and center again.

Democrats are hoping the possibility of a Trump appointee helping strike down the law could galvanize support, but it’s unclear from early polling whether that will be the case. But majorities of voters — including all-important swing voters — trust Joe Biden more on the ACA and protecting pre-existing conditions.

I think the increased attention on the ACA Supreme Court case allows Democrats to talk about health care in a way that they are very comfortable with and in a way that voters give them the advantage,” Ashley says.

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Episode Resources

Previous Episodes Featuring Ashley Kirzinger:

Primary Concerns (2/5/2020)

Summer Concerns (7/23/2020)

Relevant Kaiser Family Foundation Polling:

September 2020 Tracking Poll

Sun Belt Voices Project: The ACA and Health Care

Health Tracking Poll Archive

Other Select Research and Reporting:

Which Health Care Issues Matter Most to U.S. Voters? (Sara R. Collins, Munira Z. Gunja and Gabriella N. Aboulafia; Commonwealth Fund; 9/24/2020)

Trump Says He Will ‘Always’ Protect Those With Pre-Existing Conditions. He Hasn’t. (Margot Sanger-Katz, New York Times, 9/24/2020)

If the Supreme Court Ends Obamacare, Here’s What It Would Mean (Reed Abelson and Abby Goodnough, New York Times, 9/22/2020)

Episode Credits


Ashley Kirzinger, Associate Director of Public Opinion and Survey Research, Kaiser Family Foundation

Music composed by Ty Citerman, with additional music from Blue Dot Sessions

This episode was produced and mixed by Ryan Levi.