MEMORANDUM

TO: Interested Parties
FROM: Priorities USA
DATE: March 24, 2017
RE: Health Care Survey of Voters in GOP-Held Battleground CDs

The survey finds that information about the Republicans’ plan to repeal and replace the Affordable Care Act—combined with voters knowing their Republican member of Congress supports the plan—results in a net 13- point swing away from the Republicans in the vote for Congress, including substantial movement in districts President Trump carried in November.

Key Findings

1. Voters are paying an unusually high level of attention to Trump and the Congressional Republicans’ efforts to repeal and replace the ACA, and the intensity of opinion lies with the law’s opponents.

Across the 20 districts, two-thirds (66%) of voters report having heard “a lot” about the proposal of the Republicans in Congress to repeal and replace the ACA—including 77% of Democrats and 59% of Republicans. And they are not fond of what they hear: by 49% to 43%, voters are unfavorable toward the GOP plan, including 52%-40% unfavorable in the districts Clinton won, and 47%-44% in those Trump won. Overall, opponents are more intense in their views than supporters, as 37% describe themselves as “very” unfavorable toward the law, while only 15% describe themselves as “very” favorable. And while 80% of Democrats are very unfavorable toward the plan, only 30% of Republicans are very favorable.

Additionally, the more voters learn about the Republican health care plan, the less they like it. Among those who report having heard “a lot” about the proposal, views are 39% favorable and 57% unfavorable (including 47% who are “very” unfavorable). Among those who have heard less, 49% describe themselves as favorable while 35% are unfavorable (but only 14% are “very” favorable).

2. Republican incumbents in these swing districts are held in reasonably good standing as of now—but support is soft, and information about the health care proposal has a dramatic impact on moving voters against reelecting Republicans.

Across districts, Republican incumbents (respondents each heard the name of their own representative) have a 35% positive and 30% negative personal favorability rating—with a combined 35% saying they are neutral or don’t know enough to offer an opinion. (This compares to a much cooler 39% positive, 51% negative rating toward President Trump, even though this set of districts as a whole was evenly split in November.) Across districts, the Republicans’ job approval stands at 46% approve, 34% disapprove, with 1 in 5 (20%) volunteering that they are not sure.

At the outset of the poll, voters are inclined to re-elect their incumbent over a generic Democratic challenger, but only by 44% to 38%—with these Republicans notably under the 50% mark. With no information given, Trump districts vote for the Republican by 9 points (43% to 34%) with almost 1 in 4 (23%) saying they are not sure, while Clinton districts begin at a near dead heat (43% Republican, 42% Democrat).

However, on both approval and the trial heat for Congress, there is potential for real, substantial movement toward the Democrats—including in districts Trump won in November. After hearing a positive argument in favor of the GOP plan, information about its provisions and consequences, and messages against their own incumbent for supporting it, we are able to really move the needle in a way that is rarely driven by a single issue, as it is in this case. Overall, voters move from approving of their congressperson by 12 points (46% approve, 34% disapprove) to disapproving by 21 points (35% approve, 56% disapprove)—a net shift of 33 percentage points. This includes a net shift of 31 points across the Clinton districts (47% approve, 36% disapprove to 37% approve, 57% disapprove) as well as a notable 36-point shift across the Trump districts (44% approve, 32% disapprove to 32% approve, 56% disapprove).

And movement on the actual vote for Congress is substantial as well, including a net 13-point shift away from the Republicans among voters overall, and impressive movement among key subgroups:

Voters strongly oppose a wide array of components of the GOP plan, especially provisions that will raise costs for older people and give tax breaks to the wealthy while hurting the middle class. But the bottom line is: under this plan, costs will go up, and coverage will go down.

The top-testing message against the GOP proposal (as drafted at the time of fielding) is that it allows insurance companies to charge people over age fifty five times more than younger people for their care—with 61% of voters saying this raises “very” big concerns for them. This is the top-testing message among key target groups, garnering “very” big concerns among 75% of those who move on their vote, 66% of independents, 53% of Obama-Trump voters, and 69% of white non-college women. However, an argument that the plan gives tax cuts to the top two-percent and tax breaks to health insurance companies while raising costs for average Americans also tests very strongly at 54% “very” big concerns, as do items around cutting Medicaid/slashing nursing home funding (51% very big concerns) and taking insurance away from more than 24 million people (51% very big concerns).

After hearing several provisions of the plan such as these—all of which are broadly unpopular—voters were asked in an open-ended fashion what their biggest concerns were now that they knew more about the plan. Their answers are loud and clear: it will make insurance coverage too costly or unaffordable (20% volunteer this), and it will lead to millions losing their coverage and putting their health at risk (19% volunteer this). What’s more, a combined 14% mention that the plan will give tax breaks to the rich (7%) but hurt the middle class or poor (7%), and 7% mention hurting the elderly. And by 29% to 50%, they tell us that knowing their own congressperson supports this plan makes them less favorable toward him or her.

Despite President Trump’s warnings that House Republicans will lose their seats if they do not repeal the ACA, this poll suggests that support for this proposal presents a significant danger for Republicans come 2018. Democrats have a clear opportunity to harness the current battle over ACA repeal—an issue with which voters are unusually engaged, and one which affects them directly— to show that their Republican members of Congress are not looking out for them, instead putting the health and economic wellbeing of Americans at risk. Finally, instead of focusing on only a narrow swath of districts carried by Hillary Clinton in November, this poll suggests that communicating across a wider playing field of competitive districts can potentially pay big dividends for Democrats in 2018.