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As Democrats Debate in Des Moines, Health Care Reform Tops Iowans’ Wish Lists

Previous debates have delivered skimpy details on Democratic presidential candidates’ proposals to rein in high health care costs, but a new survey shows voters are eager for solutions.

A worker clears snow outside a venue at Drake University on Monday ahead in Des Moines, Iowa, in advance of a Democratic presidential primary debate that is scheduled for Tuesday. (Patrick Semansky/Associated Press)

Democratic candidates hoping to generate support ahead of next month’s caucuses would be wise to focus on fixing the nation’s broken health care system during tonight’s debate in Iowa.

With the national conversation focused on tensions with Iran, it’s unclear how much time candidates will spend on Tuesday’s debate stage talking about domestic policy matters. And while several candidates have previously touched on health care, the debates have largely lacked depth and detail about proposed reforms to rein in the high prices that are affecting families across the nation.

But a recent poll by Morning Consult, in coordination with the Bipartisan Policy Center, found that more than half of Iowans surveyed — 59 percent — place health care among their top three most important issues heading into the 2020 presidential election, coming out ahead of the economy, immigration and taxes.

That sentiment is reflected in two other swing states — New Hampshire and South Carolina — that have early primaries and are considered critically important to the Democratic nominee selection, according to the poll results.

Moreover, heading into a general election in the fall, the poll’s results are consistent regardless of party — with 66 percent of Democrats and 46 percent of Republicans listing health care as one of the most important issues in their 2020 vote choice — underscoring that a decade after the passage of the Affordable Care Act, the cost of health care remains a significant topic of discussion at kitchen tables across America.

As Democrats prepare for the Iowa caucuses in February, this latest survey provides an important reminder that voters care about health care — specifically their out-of-pocket costs and prescription drug prices — and they want to see change.

Amount Iowans polled who put health care among their top three most important issues heading into the 2020 presidential election Source
Amount of Iowans polled who said they want to reform the system in place Source
Amount of Iowans polled who support a Medicare for All proposal Source
Amount of Iowans polled who favor a repeal and replace plan Source

Voters surveyed across the three states and across the political spectrum tended to identify the same top two problems: out-of-pocket costs and prescription drug costs, with an equal percentage of Republicans and Democrats identifying the issues among their top three most significant concerns ahead of the election, according to the poll.

Those findings align with other national polls, including Arnold Ventures-funded surveys last year that found near-unanimous support for Congressional action to lower prescription drug prices and a separate poll that revealed overwhelming bipartisan agreement on ending surprise billing practices.

Federal legislation has been proposed to address some of the key drivers behind the nation’s skyrocketing health care costs — such as high drug prices and out-of-network bills — but momentum has stalled.

Still, the appetite for reform among the nation’s voters remains strong, and voters appear to support improving the current health care system over some of the more disruptive proposals, such as repealing and replacing the Affordable Care Act — a solution advanced by some Republicans — or implementing a Medicare for All, single payer-type system where everyone is covered by government insurance, a proposal that has been touted by some of the more progressive Democratic candidates.

Of the bipartisan group surveyed, 39 percent said they want to reform the system in place, while 22 percent supported a Medicare for All proposal and 23 percent favored a repeal and replace plan, according to the results.

As federal health spending continues ballooning, voters were asked to weigh in on several proposals that have been floated to continue funding U.S. health programs — and the consensus was clear, no matter the party affiliation.

The survey found the strongest bipartisan support for proposals that call for tying medical providers’ reimbursements to the value of the services rather than volume, closely followed by reforms that would allow the government to negotiate for prescription drugs and other services within government programs, like Medicare.”

Least popular were any ideas that would impact existing Medicare benefits. Democrats and Republicans surveyed both panned proposals to slash Medicare benefits, hike Medicare premiums or delay Medicare eligibility by two years to the age of 67.