The KFF COVID-19 Vaccine Monitor is an ongoing research project tracking the public’s attitudes and experiences with COVID-19 vaccinations. Using a combination of surveys and qualitative research, this project tracks the dynamic nature of public opinion as vaccine development and distribution unfold, including vaccine confidence and acceptance, information needs, trusted messengers and messages, as well as the public’s experiences with vaccination.

Key Findings:

• With pandemic-related restrictions being lifted in many states as well as local areas and remaining mask mandates set to expire soon, most of the public (59%) say they have personally returned to doing some of their pre-pandemic activities, but not all, or say they are still doing very few of the activities they were doing before the pandemic. Two years into the pandemic, about a quarter of adults say they have basically returned to normal while one in seven say they never changed their activity level during the pandemic.
• With people returning to some pre-pandemic activities, majorities still report wearing masks in public indoor areas. Eight in ten adults say they’ve worn a mask in public indoors at least some of the time in the last 30 days. Similarly, most say people should continue to wear masks in some public places to minimize the spread of COVID-19 and avoid another surge in cases (59%) while four in ten say people should stop wearing masks in public so things can get back to normal. Views of the federal mask mandate on airplanes and public transit are divided, with half of the public wanting the mandate extended and half wanting it to expire.
• Larger shares of Democrats and vaccinated adults report they’ve been wearing masks and want others to continue doing so, while most Republicans and unvaccinated adults are eager to return to normal and lift mask mandates. Further, compared to their counterparts, Black adults, Hispanic adults, and those with lower incomes are less likely to say they’ve returned to normal, more likely to say they’re wearing masks frequently, and much more likely to say people should continue to wear masks to minimize the spread of the virus and prevent another surge. With Black and Hispanic adults and those with lower-incomes more likely to work in jobs that are highly impacted by COVID-19, the survey finds that they’re more likely to show concerns over reopening and unmasking measures.
• The pandemic has taken a heavy toll on adults and children over the last two years with many reporting difficulties balancing their child’s education and their work, household finances, and mental or physical health. Six in ten parents say the pandemic has negatively affected their children’s schooling and over half saying the same about their children’s mental health. In addition, half of adults overall say their own personal mental health has been negatively affected, and four in ten say the same about their physical health and their financial situation. Those with lower incomes are more likely to report a negative impact on their finances, while young adults are more likely than older adults to say the pandemic had a negative impact on their mental and physical health as well as their employment situation.
• Asked to say in their own words what has been the biggest challenge and/or any positive change brought about by the pandemic over the past two years, the top responses on both the negative and positive side related to human interactions and relationships or lack thereof. On the negative side, 27% say the hardest thing has been isolation and not seeing people. When asked if anything has changed for the better because of the pandemic, 24% say they’re closer to their family or spent more time with their families.

How Ready Is The Public To Return To “Normal” And Who Is More Hesitant About Lifting Mask Restrictions?

The latest analysis from a KFF COVID-19 Vaccine Monitor survey¹  finds that as the omicron surge recedes, a majority of adults say they are limiting their activity levels from pre-pandemic at least somewhat in order to protect themselves from COVID, with 42% who are doing some but not all the activities they did before the pandemic and 17% who are doing very few of the activities they did before COVID-19. Around four in ten adults say they have basically returned to normal in terms of activities that they engaged in before the pandemic (27%) or that they never changed their activity level to begin with (14%).

Unvaccinated adults (57%), Republicans (55%), and White adults (47%) are the groups most likely to say they never changed activity levels or have basically returned to normal. Nearly half of those with household incomes of $90,000 or more say the same. Black adults (34%), those with a chronic condition that puts them at higher risk for COVID-19 (25%), and those living in households with incomes less than $40,000 (23%) are the most likely to say they are doing very few of the activities they did before the pandemic.

About six in ten adults (59%) say that now that COVID-19 case rates are lower, people should continue to wear masks in some public places to minimize the spread and avoid another surge in cases, while four in ten say that people should stop wearing masks in most public places so things can go back to normal. There are significant divides not only by partisanship, and vaccination status, but also by race, ethnicity, and income.

Eight-five percent of Democrats say that people should continue to wear masks, as do 57% of independents and 67% of vaccinated adults. Around seven in ten Republicans (69%) say that people should stop wearing masks so that things can return to normal, as do 67% of unvaccinated adults.

While White adults are split (49% say people should stop wearing masks, 49% say they should continue to wear them in some public places), large majorities of Black adults (88%) and Hispanic adults (69%) say that people should continue to wear masks in some public places to minimize the spread of COVID-19. Around two-thirds of those with a household income of less than $40,000 a year (68%) say the same, compared to 55% of those with an income between $40,000-$89,900 and 54% of those with an income of $90,000 or more. This finding that people of color are more likely to support continued mask wearing may reflect larger shares of Black and Hispanic adults being employed in service industries compared to White adults, putting them at an increased risk of exposure to COVID-19.

This finding is consistent with previous Vaccine Monitor surveys, which found Black and Hispanic adults were more likely to be worried that they personally will contract COVID-19, as well as be worried that someone in their family or their child will get sick. Black and Hispanic adults, as well as those with lower incomes were also more likely to say they don’t get paid time off if they get COVID-19.

On the more specific question of mandating masks on public transportation, the public is more evenly divided. The federal government currently requires people to wear masks on airplanes, trains, and other public transportation. With this requirement set to expire on April 18, adults are split on whether the federal government should let the requirement expire (51%) or extend the requirement (48%).

Majorities of Democrats (72%) and vaccinated adults (54%) support extending the masking requirement on transportation. By contrast, three-quarters of Republicans (76%) and unvaccinated adults (73%), and over half of independents (55%) would prefer to let the requirement expire on April 18.

However, preferences for this federal mandate extend beyond partisanship and vaccination status, with lower income adults and people of color voicing support for keeping the requirement after April 18. At least six in ten of Black (69%) and Hispanic adults (61%) say the federal government should extend the requirement, compared to 41% of White adults. Over half of adults with lower incomes (55%) want to extend the masking requirement, compared to 44% of those with a household income of between $40,000-$89,900, and 45% of those with an income of $90,000 or more. Similar to views of general masking, this divide by racial and ethnic groups as well as income groups may reflect those most likely to be working in areas where they would be exposed to COVID-19 without mask mandates.

Those with chronic conditions are also more likely to support extending the federal mask mandate on transportation (56%), while more than half (55%) of those without chronic conditions want to let the mandate expire.

current MASK USAGE

Most adults report continuing to wear a mask at least sometimes in public places. Around half of adults (51%) say that in the past 30 days they wore a mask every time or most of the time when indoors in public places, including 28% who say they wore one every time. Another 29% say they wore a mask some of the time, and 19% say they never wore a mask indoors in public places.

In line with attitudes about mask requirements on transportation, Democrats are more likely to say they always or mostly wore a mask indoors in the past 30 days (75%), compared to independents (46%) and Republicans (30%).

Two-thirds of unvaccinated adults say they have been wearing a mask some of the time or never have worn a mask indoors in the past 30 days (67%), while one-third (32%) report wearing one every or most of the time. A majority of vaccinated adults say they wore a mask every or most of the time (56%).

Showing differences by race and ethnicity, twice the share of Black adults compared to White adults report wearing a mask always or most of the time in the past 30 days (80% vs. 39%). Around two-thirds of Hispanic adults say the same (65%).

The Pandemic’s Toll On Families Two Years In

IMPACTs ON MENTAL, PHYSICAL, and FINANCIAL HEALTH

The survey finds the pandemic has taken a heavy toll on adults and children over the last two years.  Whether it comes to their education, work, finances, mental or physical health, many – regardless of race, ethnicity and income – report feeling the negative effects of the pandemic.

The most common negative effects of the pandemic, as reported by parents, are about their children’s education and mental health. Almost two-thirds of parents say that the pandemic has negatively affected their children’s education (63%), with 28% saying it had no effect, and 9% who report it had a positive effect. Moreover, over half (55%) of parents say the pandemic has had a negative impact on their children’s mental health, compared to 36% who say it made no difference, and 9% saying it had a positive effect.

Among all adults, half say the pandemic has had a negative effect on their personal mental health (49%), and 41% say it has had a negative impact on their physical health. Few say it has had a positive effect on either their physical (11%) or mental health (9%).

About four in ten adults say the pandemic had a negative impact on their financial situation (41%) while a similar share report it had no impact (44%), with 15% who say it had a positive impact. One-quarter of adults say the pandemic has had a negative impact on their employment situation (26%), with 59% who report it has not had an impact.

Results are more mixed when it comes to the pandemic’s effect on family relationships. Around a third say the pandemic has had a negative impact on their relationships with family members (32%) while 18% say it has had a positive impact. Half say it has not had any impact one way or another.

Adults in households with lower incomes report being harder hit by the pandemic, especially when it comes to financial and employment impacts. Adults with a household income of less than $40,000 a year are more likely to say the pandemic has had a negative impact on their financial situation (56%), compared to 43% of those with an income of between $40,000 and $90,000 and 23% of those with a household income of $90,000 or more a year.

In addition,  the share of those with lower incomes who say the pandemic had a negative impact on their employment situation (37%) is more than twice the share of  those with annual incomes greater than $90,000 (15%).

Younger people also report disproportionate effects from the COVID-19 pandemic, especially when it comes to their mental and physical health. Two-thirds of young adults aged 18-29 (67%) report that the pandemic has had a negative impact on their mental health, compared to just over half of 30-49 year-olds (54%), and under four in ten 50-64 year-olds (38%) and those over the age of 65 (37%).

Young adults are also more likely to report difficulties with their physical health due to the pandemic, with 53% of those under 30 reporting a negative impact, 47% of those 30-49, 37% of those 50-64, and 28% of those over the age of 65. In addition, larger shares of young adults report negative effects on their employment situation (36%) compared to older adults, including those ages 50-64 (23%) and those 65 and older (17%).

PANDEMIC IMPACTS: IN THEIR OWN WORDS

In their own words, when asked about the biggest challenge and/or positive change brought about by the pandemic over the past two years, the top responses regarding both negative and positive effects were related to human interactions and relationships, or the lack thereof.

When asked about changes that have been brought about by the pandemic over the past two years, 27% say the hardest thing has been isolation and not seeing people. Another 13% say they have struggled with not being able to do things or travel, and 13% cite the financial impact, including inflation.

Some say the hardest part has been avoiding COVID-19 and staying safe (6%), employment changes and job loss (5%), having to wear a mask (4%), the effect on mental health (4%), the impact on kids and online schooling (3%), and losing family members and loved ones (3%).

When asked if anything has changed for the better in the last two years, 24% say they are closer to their family or have spent more time with their families. Some (8%) also say that job changes or remote work were a positive change, 7% cited improvements in their financial situation, 5% said they had better health practices or awareness, and 4% cited a general appreciation of life or their current situation. A third of respondents said nothing changed for the better.

This KFF Health Tracking Poll/COVID-19 Vaccine Monitor was designed and analyzed by public opinion researchers at the Kaiser Family Foundation (KFF). The survey was conducted March 15-22, 2022 online and by telephone among a nationally representative sample of 1,243 U.S. adults, conducted in English (1,188) and in Spanish (55). The sample includes 1,004 adults reached through the SSRS Opinion Panel either online or over the phone (n=39 in Spanish). The SSRS Opinion Panel is a nationally representative probability-based panel where panel members are recruited randomly in one of two ways: (a) Through invitations mailed to respondents randomly sampled from an Address-Based Sample (ABS) provided by Marketing Systems Groups (MSG)  through the U.S. Postal Service’s Computerized Delivery Sequence (CDS); (b) from a dual-frame random digit dial (RDD) sample provided by MSG. For the online panel component, invitations were sent to panel members by email followed by up to three reminder emails. 974 panel members completed the survey online and panel members who do not use the internet were reached by phone (30).

Another 239 (n=16 in Spanish) interviews were conducted from a random digit dial telephone sample of prepaid cell phone numbers obtained through MSG. Phone numbers used for the prepaid cell phone component were randomly generated from a cell phone sampling frame with disproportionate stratification aimed at reaching Hispanic and non-Hispanic Black respondents. Stratification was based on incidence of the race/ethnicity groups within each frame.

The combined cell phone and panel samples were weighted to match the sample’s demographics to the national U.S. adult population using data from the Census Bureau’s 2021 Current Population Survey (CPS). Weighting parameters included sex, age, education, race/ethnicity, region, and education. The sample was also weighted to match patterns of civic engagement from the September 2017 Volunteering and Civic Life Supplement data from the CPS. The sample was also weighted to match frequency of internet use from the National Public Opinion Reference Survey (NPORS) for Pew Research Center.  The weights take into account differences in the probability of selection for each sample type (prepaid cell phone and panel). This includes adjustment for the sample design and geographic stratification of the cell phone sample, within household probability of selection, and the design of the panel-recruitment procedure.

The margin of sampling error including the design effect for the full sample is plus or minus 4 percentage points. Numbers of respondents and margins of sampling error for key subgroups are shown in the table below. For results based on other subgroups, the margin of sampling error may be higher. Sample sizes and margins of sampling error for other subgroups are available by request. Sampling error is only one of many potential sources of error and there may be other unmeasured error in this or any other public opinion poll. Kaiser Family Foundation public opinion and survey research is a charter member of the Transparency Initiative of the American Association for Public Opinion Research.

This work was supported in part by grants from the Chan Zuckerberg Initiative DAF (an advised fund of Silicon Valley Community Foundation), the Ford Foundation, and the Molina Family Foundation. We value our funders. KFF maintains full editorial control over all of its policy analysis, polling, and journalism activities.

1. The latest data from the KFF COVID-19 Vaccine Monitor includes interviews conducted over the phone and online using a probability-based sample. ↩︎

Key Findings

• As the nation’s economy and rising prices are on the forefront of the public’s mind, the latest KFF Health Tracking Poll finds the public wants lawmakers to prioritize out-of-pocket health care costs as Congress debates current health legislative priorities. A majority of the public (61%) say limiting how much drug companies can increase the price of prescription drugs each year to not surpass the rate of inflation should be a “top priority” for Congress. Slight majorities also say capping out-of-pocket costs for insulin at $35 a month (53%) and placing a limit on out-of-pocket costs for seniors (52%) are top priorities for Congress to take action on in the coming months. Majorities across partisans say many of the health care priorities asked about are important for Congress to work on in the coming months.
• As many people move on from the COVID-19 pandemic, only about a quarter of the public say providing more funding to continue the COVID-19 pandemic response (25%) or making permanent the financial help that was part of the COVID-19 relief bill for people who buy their own insurance (21%) are top congressional health care priorities.
• Twelve years since the passage of the Affordable Care Act, a majority of the public (55%) continue to view the law favorably, but opinions towards the 2010 health reform law are still divided by partisanship. Majorities of Democrats (87%) hold favorable views of the law and many (43%) say the law has directly helped them and their families. On the other side of the political aisle, most Republicans (79%) view the law unfavorably and four in ten say the ACA has hurt them and their families.
• The No Surprises Act went into effect earlier this year and began protecting people with private health insurance from receiving surprise out-of-network medical bills when they received care from an in-network hospital. However, more than half of adults, 18-64, with private insurance say they know nothing at all about this legislation (56%), with an additional one in five (22%) saying they only know “a little.”
• With a renewed focus from the Biden administration on reforming long-term care facilities such as nursing homes that have been much in the news during the COVID pandemic, KFF polling finds majorities of adults say this country’s nursing homes, assisted living facilities, and other long-term facilities are doing a “bad job” of maintaining adequate staffing levels (70%), offering affordable care (64%), or providing high-quality care to residents (54%). Views of the type of care provided by long-term facilities is even more negative among the one-fourth of adults who have a direct, recent connection with a long-term care facility. On the other hand, many (55%) say the country’s nursing homes are doing a “good job” of protecting residents and staff from COVID-19.

Economy and Inflation Are Public’s Top Concerns, Many Worry About Affording Basic Living Expenses

The latest KFF polling finds more than half of the public (55%) say inflation and rising prices is the biggest problem facing the U.S. right now, more than three times the share who say the same about any other issue included in the survey. About one in five (18%) say the Russian invasion into neighboring Ukraine is the biggest problem facing the U.S., followed by six percent each who say the same about the COVID-19 pandemic, crime, and climate change.

Inflation and rising prices is the top issue across partisans, with about half of Democrats (46%) and independents (53%) and seven in ten Republicans (70%) saying it is the biggest problem facing the U.S. About one in four Democrats (23%) say the Russian invasion into Ukraine is the biggest problem, as do 17% of independents and 14% of Republicans. One in ten Democrats also say either climate change (10%) or the COVID-19 pandemic (9%) is the country’s biggest problem, but few Republicans agree.

The economy, inflation, and rising prices are also the top issue for voters as the country begins the ramp up to the 2022 midterm elections. When asked to name in their own words the issue they think will be most important when deciding which candidate to vote for, more than one-third of voters (37%) offer responses related to the economy. A handful of other issues also mentioned by voters include climate change (4%), crime (3%), the Russian invasion into Ukraine (3%), taxes (2%), the COVID-19 pandemic (2%), gas or energy (2%), or immigration (2%).

The economy is also the top voting issue across partisan voters, with three in ten Democratic voters, more than a third of independent voters (36%), and nearly half of Republican voters (48%) offering economic issues as their top voting concern. Some partisan voters offer things other than policy issues as the biggest driver of their vote, including wanting to vote their party’s candidates into office: one in ten (11%) Democratic voters say the most important thing to them is voting for Democratic candidates, while 6% of Republican voters offer voting Republican as the most important aspect of their voting decision.

Many Americans are also concerned about being able to afford basic living expenses for their families. At least half say they are either “very worried” or “somewhat worried” about being able to afford gasoline or other transportation costs (71%), unexpected medical bills (58%), or monthly utilities like electricity (50%). At least four in ten are worried about being able to afford food (47%), long-term care services for themselves or a family member (45%), their health insurance deductible (44%), their rent or mortgage (43%), or their prescription drug costs (43%). More than one-third (36%) are also worried about being able to afford their monthly health insurance premium. The share of people who say they are now worried about affording gas prices and monthly utilities has increased since February 2020, when roughly four in ten were worried about paying for gas (40%) and monthly utilities (38%).

Worries about being able to afford living expenses are also largely dependent on an individual’s household income, with at least six in ten of those living in households with incomes of less than $40,000 annually saying they are worried about being able to afford gasoline or other transportation costs (79%), unexpected medical bills (66%), monthly utilities (65%), their rent or mortgage (63%), or their food costs (62%). However, with gas prices averaging over $4 a gallon across the country, a majority of individuals, regardless of income, report worries about being able to afford gasoline or other transportation costs.

In addition to being worried about affording health care costs along with other household expenses, half of adults (51%) report that they have delayed or gone without medical services due to costs in the past year. This includes more than one-third who have put off dental services (35%), and one-fourth who have put off vision care (25%) or general visits to their doctor or health care provider (24%). Fewer say they have put off mental health care (18%) or hospital services (14%) due to cost. One in ten say they have put off hearing services including getting hearing aids due to cost – including one in five (18%) older adults (ages 65 and older) who report this.

Lowering the price of prescription drugs has been a major tenet of President Biden’s health care agenda and a constant source of debate among legislators. The latest polling finds three in ten adults (29%), including four in ten (43%) adults with household incomes of less than $40,000, saying they have either not filled a prescription, cut pills in half or skipped doses, or taken an over-the-counter medication instead due to the cost of their prescription drugs.

The Public’s Health Care priorities For Congress Are Focused on Bringing Down Costs

With economic issues at the forefront of the public’s mind, it is perhaps unsurprising that the top health care priorities the public wants Congress to focus on involve controlling out-of-pocket costs for families and individuals. Six in ten (61%) say limiting how much drug companies can increase the price of prescription drugs each year to not surpass the rate of inflation should be a “top priority” for Congress. Slight majorities also say capping out-of-pocket costs for insulin at $35 a month (53%) and placing a limit on out-of-pocket costs for seniors (52%) are top priorities for Congress to take action on in the coming months. About half of the public (48%) continue to say allowing the federal government to negotiate with drug companies to get a lower price on prescription drugs for people with Medicare is a top priority. Four in ten say expanding health coverage to people with lower incomes in states that have not expanded their Medicaid programs (42%), increasing government funding for access to mental health services and training for mental health providers (42%), and taking federal action to improve the safety and quality of nursing home care (40%) are top priorities for Congress. Smaller shares say providing more funding to continue the COVID-19 pandemic response (25%) or making permanent the financial help that was part of the COVID-19 relief bill for people who buy their own insurance (21%) should be top congressional health care priorities.

Across most of the health care priorities asked about, majorities – regardless of partisanship – say each is at least an “important priority” while many rise to the “top priority” more often among Democrats. Large majorities of Democrats, independents, and Republicans say limiting how much drug companies can increase the prices of prescription drugs, allowing the federal government to negotiate with drug companies to get a lower price on prescription drugs for people with Medicare, capping out-of-pocket costs for insulin at $35 a month, taking federal action to improve the safety and quality of care in nursing homes, and increasing government funding for access to mental health care are important priorities for Congress to work on in the coming months. Smaller shares of Republicans say expanding coverage for lower-income people living in non-expansion states and providing more funding for the COVID-19 pandemic response are important priorities for Congress.

Prescription drug costs

When the public are asked which party they think deserves the most blame if Congress is unable to pass legislation lowering the cost of prescription drugs, they place the blame evenly across policymakers from both sides of the aisle. About half of the public say that either President Biden (23%) or Democrats in Congress (29%) will deserve the most blame, while more than four in ten (44%) say Republicans in Congress will deserve the most blame.

The vast majority of Democrats say the blame will fall on Republicans in Congress (82%), while equal shares say the blame falls on President Biden (8%) and Democrats in Congress (8%). Among Republicans, Democrats in Congress get the majority of the blame (58%), while 29% say the blame will fall on President Biden. Four in ten independents (43%) say Republicans in Congress will deserve the most blame, while about half say Democrats in Congress (24%) or President Biden (27%) will.

Affordable Care Act and No Surprises Act

On the 12^th anniversary of the Affordable Care Act (ACA), the latest KFF polling finds a majority (55%) of the public continue to hold favorable views of the 2010 health reform law. This is consistent with KFF polling from last fall with no significant changes among key demographic groups. Since 2017, views of the ACA have consistently been more favorable than unfavorable, but are still largely driven by partisanship: nearly nine in ten Democrats (87%) along with six in ten independents (58%) view the law favorably, while eight in ten Republicans (79%) hold unfavorable views.

In addition, partisans hold very different perceptions of whether the ACA has directly helped or hurt them and their families. Four in ten Democrats (43%) say the ACA has “helped” them and their families, compared to one-fourth of independents (24%) and seven percent of Republicans. On the other hand, four in ten Republicans (40%) say the ACA has “hurt” them, compared to one in six independents (16%) and six percent of Democrats. At least half of all adults, regardless of self-identified party affiliation, say the ACA has had “no direct impact” on them or their family members.

About half of those who say the ACA helped them say allowing someone in their family to get or keep their health coverage has been the main way the health care law has helped them (48%, or 12% of total adults). Three in ten say the law has made it easier for them to get the health care they need (7% of total) and one in five say it has lowered the cost of their health care or health insurance (5% of total).

On the other side, more than half of those who say the ACA has hurt them believe it has increased the cost of their health care or health insurance (59%, 12% of total). This is more than twice the share who say the main way the ACA has hurt them is by making it more difficult to get the care they need (22%, 5% of total), or causing someone in their family to lose their health coverage (11%, 2% of total).

There are twelve states that have not expanded their Medicaid programs to cover more lower-income adults as part of the ACA. Among those living in non-expansion states, two-thirds (65%) say they think their state should expand Medicaid to cover more low-income uninsured people, while one-third (34%) say they think their state should keep Medicaid as it is today.

No Surprises Act

Earlier this year, a new law went into effect protecting people with private health insurance from receiving large medical bills when they accidentally received out-of-network care. Among adults, 18-64 years old, with private health insurance, about one in five say they know “a lot” (3%) or “some” (18%) about this new law. More than half say they know nothing at all about this new law (56%) while one in five say they know “a little.” Notably, partisanship does not seem to have affected awareness of the No Surprises Act with similar shares of Democrats (27%) and Republicans (22%) with private health insurance saying they knew “a lot” or “some” about the law but at least half saying they don’t know anything.

Many Are Concerned About Quality And Cost Of Care At Long-Term Care Facilities

In his State of the Union address on March 1, 2022, President Biden announced steps to improve care for residents at nursing homes, assisted living, and other long-term care facilities. The latest polling finds that nearly half of adults (45%), including 51% of adults 50 and older, worry about being able to afford long-term care services like nursing home care, and less than half rate the quality and cost of care at this country’s nursing homes positively.

Majorities of adults say this country’s nursing homes, assisted living facilities, or other long-term facilities are doing a “bad job” of maintaining adequate staffing levels (70%), offering affordable care (64%), or providing high-quality care to residents (54%). However, many (55%) say the country’s nursing homes are doing a “good job” of protecting residents and staff from COVID-19.

Views of long-term care facilities are consistent across age groups: majorities, regardless of age, say the facilities are performing poorly in maintaining adequate staffing and providing high-quality or offering affordable care. One-fourth (24%) of adults have a direct, recent connection with a long-term care facility, with them or a family member being a resident in the past three years. These individuals with a direct connection are more likely to say these facilities are doing a “bad job” at offering affordable care (70%, compared to 62% of those without a direct connection) or providing high-quality care (62% v. 51%).

In addition, nine percent of adults and six percent of older adults, ages 65 and older, say there was time in the past twelve months when they or a family member did not get long-term care because they couldn’t afford the cost.

This KFF Health Tracking Poll was designed and analyzed by public opinion researchers at the Kaiser Family Foundation (KFF). The survey was conducted March 15-22, 2022 online and by telephone among a nationally representative sample of 1,243 U.S. adults, conducted in English (1,188) and in Spanish (55). The sample includes 1,004 adults reached through the SSRS Opinion Panel either online or over the phone (n=39 in Spanish). The SSRS Opinion Panel is a nationally representative probability-based panel where panel members are recruited randomly in one of two ways: (a) Through invitations mailed to respondents randomly sampled from an Address-Based Sample (ABS) provided by Marketing Systems Groups (MSG)  through the U.S. Postal Service’s Computerized Delivery Sequence (CDS); (b) from a dual-frame random digit dial (RDD) sample provided by MSG. For the online panel component, invitations were sent to panel members by email followed by up to three reminder emails. 974 panel members completed the survey online and panel members who do not use the internet were reached by phone (30).

Another 239 (n=16 in Spanish) interviews were conducted from a random digit dial telephone sample of prepaid cell phone numbers obtained through MSG. Phone numbers used for the prepaid cell phone component were randomly generated from a cell phone sampling frame with disproportionate stratification aimed at reaching Hispanic and non-Hispanic Black respondents. Stratification was based on incidence of the race/ethnicity groups within each frame.

The combined cell phone and panel samples were weighted to match the sample’s demographics to the national U.S. adult population using data from the Census Bureau’s 2021 Current Population Survey (CPS). Weighting parameters included sex, age, education, race/ethnicity, region, and education. The sample was also weighted to match patterns of civic engagement from the September 2017 Volunteering and Civic Life Supplement data from the CPS. The sample was also weighted to match frequency of internet use from the National Public Opinion Reference Survey (NPORS) for Pew Research Center.  The weights take into account differences in the probability of selection for each sample type (prepaid cell phone and panel). This includes adjustment for the sample design and geographic stratification of the cell phone sample, within household probability of selection, and the design of the panel-recruitment procedure.

The margin of sampling error including the design effect for the full sample is plus or minus 4 percentage points. Numbers of respondents and margins of sampling error for key subgroups are shown in the table below. For results based on other subgroups, the margin of sampling error may be higher. Sample sizes and margins of sampling error for other subgroups are available by request. Sampling error is only one of many potential sources of error and there may be other unmeasured error in this or any other public opinion poll. Kaiser Family Foundation public opinion and survey research is a charter member of the Transparency Initiative of the American Association for Public Opinion Research.

This work was supported in part by grants from the Chan Zuckerberg Initiative DAF (an advised fund of Silicon Valley Community Foundation), the Ford Foundation, and the Molina Family Foundation. We value our funders. KFF maintains full editorial control over all of its policy analysis, polling, and journalism activities.