How is Coronavirus affecting Support for Universal Health Coverage?

• In Event: Relevance, Quality, and Expedience: Political Science Responds to COVID-19: COVID-19 and Political Behavior: Public Opinion and Political Participation

Abstract

In 2020, The United States remains the only high-income country that relies on employer-sponsored health coverage to insure the majority of its population, with significant gaps in coverage. Lay-offs associated with the economic downturn produced by the Coronavirus lock-downs are estimated to have already resulted in 27 million Americans having lost their employer sponsored health insurance leaving many uninsured and with unaffordable options for coverage in the midst of a pandemic. We conducted a survey experiment with a Qualtrics sample of 1,200 Americans to examine whether priming people about the risk of losing employer-sponsored health coverage during a pandemic affects their attitudes towards tax-financing health insurance compared with no priming or priming about non- COVID-related job loss. We also examine how ideology moderates the priming effect. The survey experiment was pre-registered with Evidence in Governance and Politics (EGAP) and results are reported according to the original study design. We find no overall effect of priming respondents with a pro-social vignette about the effects of job loss on insurance coverage on their support for universal health coverage measured in several different ways. Contrary to expectation, priming seems to have more of an impact on respondents who identify as Democrats rather than Independents who we hypothesized would have more malleable views, though with borderline statistical significance (p<0.2). Priming was not more impactful on those had lost employer-sponsored coverage, though those who reported losing their coverage were more favorable to Medicare for All overall (77% compared with 60%, p<0.01). Additionally, 54% of respondents report they have become more favorable to moving towards a “Medicare-for-All” plan in light of Coronavirus and 67% report favoring a Medicare for All Plan. These results are likely limited by statistical power considerations, but also suggest that people’s attitudes towards government financing of health coverage are fairly fixed even in the face of unprecedented evidence of the challenges associated with providing health insurance through employers during a pandemic.

Authors

• Ashley M Fox, SUNY at Albany

• Yongjin Choi, London School of Hygiene and Tropical Medicine