Health Care: Most Oppose House Bill, Favor Single-Payer Plan–Unless It Raises Taxes

SAN FRANCISCO, May 31 -- The Public Policy Institute of California issued the following news release:

Most Californians have an unfavorable opinion of the bill to repeal and replace the Affordable Care Act (ACA) that was passed by the US House of Representatives. A majority favor a single-payer state health insurance program, although support drops to less than half if the plan would require raising taxes.

These are among the key findings of a statewide survey released today by the Public Policy Institute of California (PPIC) with funding from the James Irvine Foundation.

A majority of all adults (57 percent) and likely voters (64 percent) say they have a generally unfavorable opinion of the House bill passed earlier this month. In the survey--taken before the Congressional Budget Office released its assessment--most Democrats (75 percent) and independents (63 percent) view the bill unfavorably. Republicans are more likely to view it favorably (48 percent) than unfavorably (33 percent).

When asked about the Affordable Care Act, Californians are divided, with 48 percent of all adults and 49 percent of likely voters having a favorable view of the law. Opinions were similar in January of this year and in December 2015. Partisan differences on this question persist as well: 65 percent of Democrats view the ACA favorably and 72 percent of Republicans view it unfavorably. Independents are split (45 percent favorable, 45 percent unfavorable).

As the state legislature considers Senate Bill 562, which would establish a single-payer state health insurance program, 65 percent of all adults and 56 percent of likely voters say they favor such a plan. But support falls to 42 percent of adults and 43 percent of likely voters if the plan would raise taxes. Overall, strong majorities of Democrats (75 percent) and independents (64 percent) favor a single-payer plan, while a strong majority of Republicans (66 percent) are opposed.

Mark Baldassare, PPIC president and CEO, summed up: "Californians are open to the idea of single-payer health insurance at a time when they are divided about the Affordable Care Act and oppose the House Republicans' bill to repeal and replace it."

Pessimism about Direction of the Nation

Four months after the new president and Congress took office, two-thirds of Californians (65 percent) believe the United States is going in the wrong direction, and half (50 percent) expect that the nation will have bad times financially in the next year.

About two-thirds (67 percent) disapprove of the way President Trump is handling his job (27 percent approve). Strong majorities of Democrats (88 percent) and independents (70 percent) disapprove of the president's job performance, while a strong majority of Republicans (74 percent) approve. Only 26 percent of adults approve of the way Congress is handling its job--a 10-point drop from March. Notably, approval of Congress among Republicans (32 percent approve) has declined by 16 points since March.

"Californians have become more pessimistic about the nation's direction and the US economy since the beginning of the year," Baldassare said. "Less than a third of state residents approve of the president and Congress today."

Half Worry That Someone They Know Could Be Deported

Asked about the effect of increased federal immigration enforcement, about half of Californians (49 percent) say it will have a negative impact on businesses, jobs, and the economy in their part of California. Fewer say it will have a positive impact (24 percent) or not much of an impact (21 percent). A strong majority of Democrats (66 percent) and half of independents (50 percent) say increased enforcement will hurt the economy in their part of the state, while 48 percent of Republicans say it will have a positive impact.

The survey also asked a more personal question about immigration: how much do you worry that someone you know could be deported? Half of adults say they worry a lot (30 percent) or some (21 percent). Fewer say they don't worry much (15 percent) or at all (32 percent). Most Latinos (59 percent) say they worry a lot that someone they know could be deported, as do half of residents born outside the United States (50 percent). Californians under age 55 are much more likely than older adults to say that they worry a lot (36 percent to 19 percent).

"In the context of increased federal immigration enforcement, many Californians think this will have negative impacts on their local economy and fear that someone they know will be deported," Baldassare said.

The legislature is considering a "sanctuary state" law that would limit cooperation between state and local government agencies and federal immigration officials. When asked their opinions of the proposal, 48 percent of adults are in favor and 42 percent are opposed. Our January survey asked more generally if Californians favored the state and local government making policies--separate from the federal government--to protect the legal rights of undocumented immigrants in California. The response then: 65 percent of adults and 58 percent of likely voters were in favor.

Most Believe Russia Tried to Influence Election

Amid investigations into Russia's activities during the presidential campaign, 58 percent of Californians say they think the Russian government tried to influence the outcome of the election. Nearly half of Californians (47 percent) say members of the Trump campaign intentionally helped Russian efforts. How confident are Californians that the congressional investigation of Russia's role will be conducted fairly? Only 38 percent say they are confident and 54 percent say they are not. Again, partisan differences are stark: 56 percent of Republicans are confident the investigation will be fair, while 61 percent of Democrats and 62 percent of independents are not.

Skeptical of Trump's Approach on North Korea, Syria

As North Korea continues tests to advance its missile technology, only 28 percent of Californians have confidence in the president's ability to handle the situation with that nation's nuclear program, and 68 percent are uneasy about his approach. Just 21 percent of Californians think Trump has a clear plan for dealing with the situation in Syria, while 70 percent think he does not.

Most Oppose Federal Enforcement of Marijuana Laws in State

The Trump administration has indicated it may increase enforcement of federal laws prohibiting the use of marijuana in states that have legalized its use. Solid majorities of Californians (60 percent adults, 66 percent likely voters) oppose enforcement of these federal laws. Strong majorities of Democrats (72 percent) and independents (68 percent) as well as a slight majority of Republicans (51 percent) say the federal government should not enforce these laws. As local governments consider regulations to implement marijuana legalization, about half of adults (48 percent) and likely voters (53 percent) favor retail sales of recreational marijuana in their communities. Residents of Orange/San Diego (43 percent) are the least likely to favor retail sales, compared with about half of residents in other regions.

Jobs, Economy Seen as Top State Issue

Californians are most likely to name jobs and the economy as the top issue facing people in California today (22 percent), as they did last May. However, this issue is less frequently mentioned than it was a year ago (30 percent May 2016). The second most frequently named issue today is immigration (11 percent). When asked to assess their own financial situation, 40 percent of adults say they are in excellent or good shape.

On the issue of poverty, 39 percent of adults say it is a big problem in their part of the state (40 percent somewhat of a problem). A solid majority of adults (61 percent) say the gap between the rich and the poor is getting larger in their part of California, while a third (33 percent) say it has stayed the same and 2 percent say it is getting smaller. Should state government do more to reduce the gap between rich and poor? A solid majority (61 percent) say yes. A third (32 percent) say the state should not do more.

Regional Housing Affordability Viewed as Big Problem

Most adults (59 percent) say housing affordability is a big problem in their part of the state. Opinions range widely across California. Fewer than half say it is a big problem in the Central Valley (35 percent) and Inland Empire (46 percent), compared to majorities in Orange/San Diego (59 percent), Los Angeles (63 percent), and the San Francisco Bay Area (79 percent).

As the legislature considers several bills focusing on affordability, 47 percent of adults say the cost of their housing is placing a financial strain on them--a lot of strain, according to 27 percent. Majorities of renters (61 percent), those who are younger than age 55 (54 percent), those with annual household incomes below $40,000 (59 percent), those with children in the household (57 percent), or those with no college education (55 percent) say that housing costs are a financial strain. Latinos (55 percent), African Americans (54 percent), and Asian Americans (48 percent) are somewhat more likely than whites (39 percent) to say that housing costs are a strain. The survey asks about two housing policies under consideration.

* State bond measure to pay for affordable housing projects: 70 percent of adults and 57 percent of likely voters would vote yes, including solid majorities across the state's regions. But partisans differ, with 81 percent of Democrats and 61 percent of independents in favor, compared to only 34 percent of Republicans.

* Changing California's environmental regulations and local permitting: 61 percent of adults and just under half of likely voters (47 percent) are in favor of doing this to make housing more affordable in their part of the state. Across parties, Republicans (59 percent) are somewhat more likely than Democrats (51 percent) to be in favor.

"Many Californians feel financial strain over their housing costs and even more perceive housing affordability to be a big problem in their region," Baldassare said. "Many favor state government actions to address this crisis."

Majorities Favor Governor's Revised Budget

When Californians are read a brief description of Governor Brown's revised state budget for the next fiscal year, 63 percent of adults and 57 percent of likely voters say they are in favor of the plan, which includes increased spending for K-12 education and the state's rainy day fund. In January, opinion was less favorable toward his budget, which included slowing education spending (47 percent adults, 43 percent likely voters in favor). The governor's job approval rating is 52 percent among all adults and 50 percent among likely voters, similar to his rating in April. The legislature's job approval rating is also similar to what it was in April: 46 percent among all adults and 41 percent among likely voters.

About the Survey

The PPIC Statewide Survey was conducted with funding from the James Irvine Foundation, the California Endowment, and the PPIC Donor Circle. Findings are based on a telephone survey of 1,707 California adult residents, including 1,107 interviewed on cell phones and 600 interviewed on landlines. Interviews took place from May 12-22, 2017. Interviews were conducted in English or Spanish, according to respondents' preferences.

The sampling error, taking design effects from weighting into consideration, is a3.2 percent for all adults, a3.6 percent for the 1,382 registered voters, and a4.2 percent for the 1,019 likely voters. For more information on methodology, see page 21.

Mark Baldassare is president and CEO of PPIC, where he holds the Arjay and Frances Fearing Miller Chair in Public Policy. He is founder of the PPIC Statewide Survey, which he has directed since 1998.

The Public Policy Institute of California is dedicated to informing and improving public policy in California through independent, objective, nonpartisan research. We are a public charity. We do not take or support positions on any ballot measure or on any local, state, or federal legislation, nor do we endorse, support, or oppose any political parties or candidates for public office. Research publications reflect the views of the authors and do not necessarily reflect the views of our funders or of the staff, officers, advisory councils, or board of directors of the Public Policy Institute of California.