The 2020 Health Care Voter: Trends to Watch

Signal Group

With the 2020 election approaching, voter concerns are driving our news cycle. Signal Group hosted a webinar to discuss the emerging tipping point of voter priorities: health care.

We sat down with some of our colleagues leading advocacy and communications in the health care space, as well as two guest speakers, John Schall, CEO Of Caregiver Action Network, and Jesse Barba, Senior Director of External Affairs for Young Invincibles, to discuss how the 2020 health care voter may impact the election. Here is a snapshot of our Q&A discussion.

Q: Individuals can take on a family caregiving role at any time in their lives and many young people are joining the sandwich generation, caring for children and aging parents at the same time. How do you see the increased need for caregiving playing into the upcoming elections for all generations?

John: At Caregiver Action Network we have seen the numbers of family caregivers explode exponentially over the last few years – two out of every five adults in America are family caregivers. The demographics of America are aging, but it isn’t just that. Certainly, numbers of people caring for someone with Alzheimer’s are exploding, but so are cases of autism.

Caregiving could become the sleeper issue of the 2020 election if candidates are smart and sincere in talking about family caregiving as an issue. Because so many of us are in the caregiving situation across our whole lifespan, the issue motivates voters on both sides.

Jesse: No matter your age, elections come down to pocketbook issues and this one is no different. At Young Invincibles, we are looking at this problem through the lens of young people. For example, 73% of millennial caregivers also work full time jobs on top of their care duties. And, they are spending roughly $6,800 out of their own pockets for their caregiving services, including 67% who use their own personal savings and retirement funds to pay for that care.

Q: Mental health challenges continue to increase across the country, and with that comes a need for more services. Why hasn’t this issue risen to the top in political debates, and do you think it will get more airtime as we near November?

John: There’s still far too much stigma in the United States around mental health challenges. I’m hopeful that mental health will get more airtime, since thankfully, debates are not just structured and monitored questions to candidates. There are a lot of town hall opportunities for real life people and voters to raise issues. If they are used to bring up mental health issues it could make a huge difference.

Jesse: Stigma is definitely #1. There are also issues with access to mental health services, which are expensive and hard to find. For millennials, we know that mental stress comes from economic anxiety. For Gen Z, it comes from economic anxiety as well as social and isolationist anxieties. Estimates show that one third of all college students have been diagnosed with mental health conditions, but only 25% actually receive treatment.

Rising rates of suicide and addiction are pushing federal lawmakers and state lawmakers to talk about these issues. It’s important to reduce stigma, but we also need to make sure young people can access the services they need.

Q: Two things driving today’s health care debate are drug pricing and access to care. Any insights into how this debate plays out with family caregivers and young voters?

Jesse: The 2018 midterm elections were a clear sign that voters want to protect the Affordable Care Act, and specifically coverage for people with pre-existing conditions. Almost 30 million young adults have a pre-existing condition. Health coverage, access, and cost will be top of mind for voters.

The ACA has decreased the uninsured rate among young adults from 29% in 2010 to 14% in 2018. Despite this progress, the Trump administration has caused serious harm and a potential federal appeals court decision could put popular policies like guaranteed coverage for pre-existing conditions back on the chopping block – and therefore back at the center of the healthcare debate.

John: As much as we are hearing conversations about reducing the price of pharmaceutical drugs, I don’t think there are any heroes in this story. The fact is, no patient or family member ultimately cares whether a drug costs $300 or $30,000 or $300,000. What they care about is what they pay out of pocket at the pharmacy counter.

This is about access, not price. As family caregivers, we want to make sure that our loved ones are able to get the care that is going to help.

Q: The disability vote is something to watch for in 2020, with more and more people with disabilities joining the conversation. 20% of all voters either had a disability or lived with a person with a disability at the time of the last election. Do you think we can expect this again?

John: There is an important opportunity for the disability community to come together around these issues. Back in 1990 when President Bush signed the Americans with Disabilities Act, people of both sides pushed the bill. You haven’t really seen that yet with both sides today, but that potential exists.

Q: We saw some stats earlier about rural health and quality of care. And, according to the Center on Budget and Policy Priorities, about 1 in 5 Americans live in rural communities, including millions of young adults. Given what we know about the declining number of rural health providers, how do you think voters in rural areas are prioritizing health care?

Jesse: One in five Americans live in rural communities, and these folks already face huge challenges when it comes to access to health care. We are seeing higher unemployment rates, lower household incomes and lower rates of employer sponsored health plans, as well as the rapid closure of rural hospitals and health centers. The result is widening health disparities and a greater need for Medicaid coverage.

Young adults living in non-metro areas are most likely to be unemployed and rely on Medicaid. Many states with huge rural populations are attempting to institute these worker requirements that force Medicaid recipients to submit proof of employment every month to keep their health care. In fact, Young Invincibles recently published a blog post that found that because of these work requirements, nearly 95,000 adults in Kentucky could lose their coverage. That’s 39% of the young medicated population, and of that, 14% are African Americans.

We know that seven million first-time voters of color are slated to vote in 2020, and this is surely an issue to watch.

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