KFF Health Tracking Poll – Early April 2020: The Impact Of Coronavirus On Life In America

Published: Apr 2, 2020

Coronavirus Findings

Poll Findings: The Impact Of Coronavirus On Life In America

  • As coronavirus cases in the United States continue to rise quickly across the country, and with sobering projections from the White House that even with mitigation efforts, deaths could top 100,000, the outbreak has directly or indirectly reached most people in America. The latest KFF Health Tracking poll, conducted March 25th – 30th, finds seven in ten Americans (72%) saying their lives have been disrupted “a lot” or “some” by the coronavirus outbreak. This is a 32 percentage point increase in the share reporting disruption in the KFF Coronavirus Poll conducted just two weeks prior. Partisan differences on this question found in the earlier poll have largely been erased, and in the current poll, large majorities of Republicans (70%), independents (72%), and Democrats (76%) say their lives have been disrupted. And most also report no end in sight with three-fourths saying “the worst is yet to come” when it comes to the coronavirus outbreak in the U.S., while few (13%) say “the worst is behind us.”
  • An increasing share of the public report worrying about the economic impacts that coronavirus may have on their lives with more than half now reporting being worried that their investments will be negatively impacted for a long time (59%), they will be laid off or lose their job (52%), and nearly half worried they will lose income due to a workplace closure or reduced hours (45%). And while Americans increasingly worry about the impact on their own incomes, about half (53%) continue to be worried that they or a family will get sick from coronavirus.
  • Nearly six in ten adults (57%) report being worried they will put themselves at risk of exposure to coronavirus because they can’t afford to stay home and miss work (up from 35% earlier in March). This includes six in ten hourly or workers who get paid by-the-job (61%) as well as seven in ten employed adults who earn less than $40,000 annually (72%). These workers are also disproportionately likely to be worried about losing income or being laid off or losing their job because of the coronavirus outbreak. Overall, 39% of adults say they have already either lost their job, lost income, or had their hours reduced without pay because of the recent coronavirus outbreak.
  • The vast majority of the public, including majorities of Democrats, independents, and Republicans, say U.S. policy should be prioritizing the slowing down of the spread of the coronavirus rather than the U.S. economy. Eight in ten say “the U.S. should take measures aimed at slowing the spread of the coronavirus while more widespread testing becomes available, even if that means many businesses will have to stay closed.”1 Fewer, 14%, say “the U.S. should ease up on measures aimed at slowing the spread of the coronavirus soon, in order to open business and get the U.S. economy going again, even if that means more people would get coronavirus and could die.” On March 29th, 2020, President Trump announced the White House would be extending its social distancing recommendations and the closure of all non-essential businesses through April 30th.2
  • The share of U.S. residents who report taking precautions or making preparations in reaction to the coronavirus outbreak has increased dramatically in recent weeks. Nearly all Americans – including large majorities across partisans and age groups – report they have either been taking social distancing measures such as deciding not to travel, cancelling plans, or staying home instead of going to work, school, or other activities (92%), or say they have been sheltering-in-place and not leaving home except for essential services such as food, medicine, or health care (82%).

Americans See Major Disruptions to their Own Lives, Report No End in Sight

The latest KFF Health Tracking poll, conducted March 25th-30th, while many cities and states were issuing public health guidance requiring social distancing or shelter-in-place measures, finds seven in ten Americans (72%) saying their lives have been disrupted “a lot” or “some” by the coronavirus outbreak. This is a 32 percentage point increase in the share reporting disruption in the KFF Coronavirus Poll conducted just two weeks prior. No group seems immune to the disruption by coronavirus with at least seven in ten men (70%), women (74%), black adults (70%), white adults (78%), parents (73%), and non-parents (72%) saying their lives have been disrupted.

Figure 1: Most Americans – Across Demographic Groups – Say Their Lives Have Been Disrupted By Coronavirus Outbreak

Last month, there was a 19 percentage point difference in the share of Democrats who said their lives had been disrupted by the coronavirus outbreak (49%) compared to Republicans (30%). The most recent poll finds this difference almost entirely dissipated with at least seven in ten Democrats (76%), Republicans (70%), and independents (72%) saying their lives have been disrupted.

Figure 2: Partisan Divide On Self-Reported Life Disruption From Coronavirus Disappears After Two Weeks

Three-fourths (74%) of the public say “the worst is yet to come” when it comes to the coronavirus outbreak in the U.S. (up from 60% in an NBC News/Wall Street Journal survey conducted March 11-13), while few (13%) say “the worst is behind us.” Majorities of Democrats (82%), independents (77%), and Republicans (66%) all say the “worst is yet to come.”

Figure 3: Majority Say The Worst Of U.S. Coronavirus Outbreak Is Yet To Come

Economic and Public Health Worries, Both Personal and For the Country Overall

Economic impacts and health impacts are both at the top the list when the public is asked about various potential impacts of coronavirus in their own lives and on the country more generally.

As coronavirus spreads across the country subsequently closing schools and businesses, the public is now feeling worried by both the impact that the outbreak may have on their own health as well as their personal financial situation. In the March 11th-15th KFF poll, the public’s top personal worry was about themselves or a family member getting sick (62% “very” or “somewhat” worried). The most recent poll now finds the public similarly worried their investments or savings will be negatively impacted for a long time (59%), they will be laid off or lose their job (52%), or they will lose income due to a workplace closure or reduced hours (45%), as they are about they or a family member getting sick (53%).

Figure 4: Large Shares Of Americans Now Worry About Both Personal Economic Impact And About Them Or Their Families Getting Sick

Six in ten (57%) also now report being worried they will put themselves at risk of exposure to coronavirus because they can’t afford to stay home and miss work (up from 35% earlier in March). This includes six in ten hourly workers (60%) and workers who get paid by-the-job (61%) as well as seven in ten employed adults who earn less than $40,000 annually (72%). Part-time, hourly, and lower-income workers are also disproportionately more likely to be worried about losing income or being laid or losing their job because of the coronavirus outbreak. To see more check out Economic Insecurity among Part-time, Hourly, and Lower Income Workers.

Many also worry that they will not be able to afford testing or treatment for coronavirus if they need it (53%, up from 36% two weeks earlier). Few (2%) report being tested for coronavirus with an additional 3% saying they have tried to get tested but have been unable to.

America’s Uninsured Population

Prior to the coronavirus outbreak in the U.S., there were already nearly 28 million people in the U.S. between ages 18 and 64 who did not have health insurance. While most of the uninsured have a full-time worker in their family, many report they do not have access to coverage through a job and some people, particularly lower-income adults in states that did not expand Medicaid, are ineligible for financial assistance to help pay for coverage. While Congress has provided some relief, this is limited to testing and is a state option.3 Among these includes almost 6 million uninsured people who are at high risk for a serious illness related to COVID-19.4 Overall, eight in ten (82%) uninsured adults ages 18-64 say they are worried about not being able to afford testing or treatment for coronavirus if they need it.

And while many Americans worry about losing their jobs or the impact coronavirus may have on their personal finances, four in ten (39%) say they have already either lost their job, lost income, or had their hours reduced without pay because of the recent coronavirus outbreak. This includes nearly three in ten (28%) of all adults who say they have already lost their job, been laid off, or had their hours reduced without pay and one-fourth (26%) who say they have lost income from a job or business because of coronavirus.

Figure 5: Four In Ten Report Lost Job, Lost Income Due To Coronavirus

Significant shares of women (40%), men (37%), Hispanic adults (44%), black adults (42%), and white adults (36%), as well as nearly half (47%) of parents with a child younger than 18 years old report they have either lost their job, income, or had their hours reduced without pay.

Figure 6: Significant Shares Across Demographic Groups Already Report Personal Economic Impact From Coronavirus

The share who report losing a job, income, or hours is similar across household income groups, including about four in ten of those with incomes under $40,000 (42%), between $40,000 and $90,000 (38%), and $90,000 or more (38%). While 42% of those under age 65 report losing a job, income, or work hours due to coronavirus, older adults are not immune from this problem, with 25% of those ages 65 and over reporting this experience as well.

People are also increasingly reporting that coronavirus is having a negative effect on their mental health. More than four in ten adults overall (45%) feel that worry and stress related to coronavirus has had a negative impact on their mental health, up from 32% in early March.

Figure 7: Larger Share Now Reporting Negative Mental Health Impacts

About one in five (19%) say it is has had a “major impact” including about one-fourth of women (24%), Hispanic adults (24%), and black adults (24%). Large shares across demographic groups report that worry or stress related to coronavirus has had a negative impact on their mental health.

Figure 8: Significant Shares Say The Coronavirus Has Had A Negative Impact On Their Mental Health

PUBLIC WORRIES ABOUT LOCAL BUSINESSES AND AN ECONOMIC RECESSION

A majority of the public are worried that local businesses will close permanently because of the loss of revenue during the recent coronavirus outbreak in the U.S. (85%), and the U.S. economy will head into a recession (79%). Large majorities of Republicans (82%), independents (88%), and Democrats (89%) report being worried that local businesses will close permanently, as well as report being worried the U.S. economy will head into a recession (three-fourths of Republicans, eight in ten independents and 85% of Democrats).

Figure 9: Majorities Worry About U.S. Economic Impact Of Coronavirus On Local Businesses And The U.S. Economy In General

Majorities Worry about Possible Impact on Nation’s Health Care System and Workers

Nearly nine in ten adults say they are worried that health care workers will not have the necessary personal protective equipment such as masks to protect themselves including 62% who say they are “very worried.” This is closely followed by 82% who are worried the country’s health care system will be overrun and people won’t be able to get needed medical care and 78% who are worried their local hospital will run out of necessary equipment like beds or ventilators to treat patients. A recent analysis conducted by KFF has found the coronavirus could overburden the U.S. health care system.

Figure 10: Most Worry About Impact On U.S. Health Care Including Six In Ten Who Are “Very Worried” About PPE For Health Care Workers

Health care workers, or those who live in households with someone who works as a health care provider, are also more worried (compared to non-health care workers) that they will put themselves at risk of exposure to coronavirus because they can’t afford to stay home and miss work (69%), or that they or someone in their family will get sick from coronavirus (64%). More than eight in ten of those who work in health care delivery or live with someone who does are also worried that health care workers, generally, will not have the necessary personal protective equipment to protect themselves (90%), the country’s health care system will be overrun (87%), and their local hospital will run out of necessary equipment (85%).

Figure 11: Majorities Of Health Care Worker Households Worry About Their Own Safety And Impact On Health Care System

Precautions and Preparations

The share of U.S. residents who report taking precautions or making preparations in reaction to the coronavirus outbreak has increased dramatically in recent weeks. Three-fourths say they stayed home instead of going to work, school, or other regular activities, a nearly 50 percentage point increase from two weeks ago. Seven in ten (69%) now say they have decided not to travel or changed travel plans, up from 42% earlier in March and 13% in the February KFF Health Tracking Poll. Two-thirds say they canceled plans to attend large gatherings (up from 40% earlier in March), and six in ten say they have stocked up on items like food, household supplies, or medications (up from 35% earlier in March).

Figure 12: Many More People Now Report Taking Precautions

Overall, nearly all Americans report that they have either been taking social distancing measures such as deciding not to travel, cancelling plans, or staying home instead of going to work, school, or other activities (92%), or say they have been sheltering-in-place and not leaving home except for essential services such as food, medicine, or health care (82%).

Figure 13: Vast Majorities Report Social Distancing Or Sheltering In Place

The KFF Coronavirus Poll conducted earlier in March found a large partisan divide in the share of adults reporting taking precautions in reaction to the coronavirus outbreak. While those divisions have abated somewhat in the new poll, they haven’t completely gone away. Democrats are still more likely than Republicans to report sheltering in place (90% vs. 74%) and stocking up on food, supplies, or medications (72% vs. 50%). But at least nine in ten Democrats (95%), independents (91%) and Republicans (91%) now report engaging in some form of social distancing.

Table 1: Across Partisans, Nine in Ten Report Taking Precautions Because Of Coronavirus
Percent who say they have done each of the following because of the recent coronavirus outbreak:Party ID
DemocratsIndependentsRepublicans
Engaged in social distancing (NET)95%91%91%
Decided not to travel/changed travel plans756865
Stayed home instead of going to work, school, or other regular activities817171
Canceled plans to attend large gatherings716463
Sheltered in place, haven’t left their home except for essential services such as food, medicine, health care908074
Stocked up on items such as food, household supplies or prescription medications716050

In the previous KFF Coronavirus poll, older people and those who live in a household where someone has a serious health condition were not more likely than other groups to report taking various precautions, even though they are among the groups most at risk of developing serious complications if infected with coronavirus. The most recent poll finds some indication that these at-risk groups are now taking precautions with more than eight in ten adults 60 and older overall (86%) and adults 60 and older with a chronic condition in the household (88%) reporting they have been sheltering in place, meaning they haven’t left their home except for essential services.

Table 2: Taking Precautions Because Of Coronavirus By Age Group And Household Chronic Condition
Percent who say they have done each of the following because of the recent coronavirus outbreak:TotalAge 60 and older
Chronic Condition in HHNo Chronic Condition in HHChronic Condition in HHNo Chronic Condition in HH
Engaged in social distancing (NET)92%92%90%88%
Decided not to travel/changed travel plans69696062
Stayed home instead of going to work, school, or other regular activities74777676
Canceled plans to attend large gatherings66655258
Sheltered in place, haven’t left their home except for essential services such as food, medicine, health care78878488
Stocked up on items such as food, household supplies or prescription medications59625260

MANY REPORT BEING UNABLE TO GET MEDICAL CARE, PRESCRIPTION DRUGS, AND HOUSEHOLD SUPPLIES

Substantial shares of people report being unable to get medical care unrelated to coronavirus or get different types of supplies as a result of the outbreak, including prescription medications. One-third of adults (34%) say they have been unable to get needed medical care unrelated to coronavirus as a result of the outbreak. Three in ten (29%) say they were unable to get groceries, 27% say they were unable to get cleaning supplies or hand sanitizer and one-fourth (24%) say they were unable to get prescription medications.

Figure 14: Substantial Shares Report Being Unable To Get Medical Care, Household Supplies, And Prescription Medication

What Should The Government Prioritize?

The vast majority of the public say U.S. policy should be prioritizing the slowing down of the spread of the coronavirus rather than the U.S. economy. Eight in ten say “the U.S. should take measures aimed at slowing the spread of the coronavirus while more widespread testing becomes available, even if that means many businesses will have to stay closed.”5 Fewer, 14%, say “the U.S. should ease up on measures aimed at slowing the spread of the coronavirus soon, in order to open business and get the U.S. economy going again, even if that means more people would get coronavirus and could die.” On March 29th, 2020, President Trump announced the White House would be extending its social distancing and shelter-in-place guidelines through April 30th.6

Figure 15: Large Majority Say U.S. Should Prioritize Stopping The Spread Of Coronavirus Over Getting The Economy Going Again

A larger share of Democrats (94%), independents (78%), and Republicans (68%) say the U.S. should prioritize slowing the spread of coronavirus than say the U.S. should prioritize growing the economy (4%, 16%, and 25%, respectively).

WHAT SOURCES DO AMERICANS TRUST FOR RELIABLE INFORMATION?

About eight in ten adults say they trust the U.S. Centers for Disease Control and Prevention (CDC) (83%) and Dr. Anthony Fauci (78%), the director of the National Institute of Allergies and Infectious Diseases who has been the dominant source of information from President Trump’s administration, for reliable information on coronavirus. This is closely followed by three-fourths (74%) who say they trust state government officials (74%) and seven in ten who trust the World Health Organization (WHO) as reliable sources of information. All of these sources are also trusted by a majority of Democrats, independents, and Republicans. Not quite half say they trust either the news media (47%) or President Trump (46%) to provide reliable information on coronavirus.

Figure 16: Less Than Half Of The Public Trust President Trump And The News Media To Provide Reliable Information About Coronavirus

While majorities across partisans trust the CDC, Dr. Fauci, state government officials, and the WHO, there are large partisan differences on trust for both President Trump and the news media to provide reliable information. The vast majority of Republicans (89%) trust President Trump to provide reliable information on coronavirus, compared to nearly half of independents (47%) and a small share of Democrats (12%) say the same. On the other hand, a majority of Democrats (63%) trust the news media to provide reliable information but fewer independents (40%) and Republicans (33%) say they do.

Table 3: Trust In Sources of Coronavirus Information By Party Identification
Percent who say they trust each of the following a great deal or a fair amount to provide reliable information on coronavirus:TotalParty ID
DemocratsIndependentsRepublicans
The U.S. Centers for Disease Control and Prevention, or CDC83%86%81%90%
Dr. Anthony Fauci, the director of the National Institute of Allergies and Infectious Diseases78807677
State government officials74837175
The World Health Organization, or WHO70827057
The news media47634033
President Trump46124789

Economic Insecurity among Part-time, Hourly, and Lower Income Workers

With many businesses closing and many people experiencing symptoms of COVID-19, this month’s tracking poll also looks at the impact of coronavirus on America’s workforce including those who are employed either part-time or hourly. Overall, about half of workers (52%) say their employer offers them paid time off for when they are sick and for when caring for a sick family member. For more information on American paid leave policy, see Coronavirus Puts a Spotlight on Paid Leave Policies. But the share who report having paid time off is drastically different by types of employment. While the majority of full-time and salaried employees report getting both paid sick leave and paid family leave, fewer part-time workers (17%), hourly or contract workers (38%), and those earning less than $40,000 annually (37%) report the same.

Table 4: Many Part-Time, Hourly or Contract, and Lower Income Workers Do Not Get Paid Sick Leave Or Paid Family Leave
Total EmployedHoursCompensationHousehold income
Full-timePart-timeSalaryHourly/By the job<$40K$40 to <$90K$90K+
Percent who are offered both paid sick leave and paid family leave52%62%17%78%38%37%56%61%
Percent who are offered paid sick leave6978348957537576
Percent who are offered paid family leave5464207940395863
Percent who are not offered either paid sick leave or paid family leave3020631036442223

The KFF March Coronavirus Survey found 45% of employed adults say they could do “at least part of their job from home,” but a much smaller share of hourly or contract, part-time, or workers earning less than $40,000 annually said this was possible. This month’s KFF Health Tracking Poll finds at least half of all workers are worried about losing income due to a workplace closure (50%), being laid off or losing their job (52%), or putting themselves at risk because they cannot afford to miss work (58%). This includes nearly six in ten part-time workers and hourly or contract workers who report being worried about each of these things.

Table 5: Employment-Related Worries Related to Coronavirus
HoursCompensationHousehold income
Total EmployedFull-timePart-timeSalaryHourly/ By the job<$40K$40 to <$90K$90K+
Percent who are very or somewhat worried that they will…
Lose income due to a workplace closure or reduced hours50%47%60%36%58%655335
Be laid off or lose their job5250584557685042
Put themselves at risk because they can’t afford to and miss work5858585461725548
Percent who have experienced the following because of coronavirus…
Lost income or lost their job, been laid off or had their hours reduced without pay (NET)42%38%54%35%45%45%41%41%
Lost income from a job or business2521381927312520
Lost their job, been laid off, or had their hours reduced without pay3128412533292830

Additionally, at least half of part-time workers (54%) and nearly half of hourly or contract employees (45%) say they have either lost their job or lost income because of coronavirus.

Endnotes

1 – At the time of the field period, more than half of U.S. states had issued “shelter-in-place” restrictions, subsequently closing non-essential businesses and limiting restaurants to carry-out and delivery purchases only. For more information on the various restrictions, see https://www.nytimes.com/interactive/2020/us/coronavirus-stay-at-home-order.html

2 Trump extends federal social-distancing guidelines to April 30 after floating Easter deadline. USA Today. March 29, 2020. https://www.usatoday.com/story/news/politics/2020/03/29/coronavirus-trump-extends-social-distancing-guidelines-april-30/2937504001/

3 – Jennifer Tolbert, What Issues Will Uninsured People Face With Testing and Treatment for COVID-19? Kaiser Family Foundation, March 16, 2020. https://www.kff.org/uninsured/fact-sheet/what-issues-will-uninsured-people-face-with-testing-and-treatment-for-covid-19/

4 – Drew Altman, It may be time to waive patients’ costs for coronavirus treatment. Axios, March 19, 2020. https://www.axios.com/coronavirus-treatment-hospitals-cost-congress-waiver-9d1d69e7-d2ec-4457-b3a9-d4132422666d.html

5 – At the time of the field period, more than half of U.S. states had issued “shelter-in-place” restrictions, subsequently closing non-essential businesses and limiting restaurants to carry-out and delivery purchases only. For more information on the various restrictions, see https://www.nytimes.com/interactive/2020/us/coronavirus-stay-at-home-order.html

6 Trump extends federal social-distancing guidelines to April 30 after floating Easter deadline. USA Today. March 29, 2020. https://www.usatoday.com/story/news/politics/2020/03/29/coronavirus-trump-extends-social-distancing-guidelines-april-30/2937504001/

Politics Findings

Poll Findings: Coronavirus, 2020 Election and President Trump

  • Throughout the 2020 Democratic primary, KFF has found health care at the top of voters’ minds and this month’s KFF Health Tracking Poll finds the current coronavirus outbreak may be solidifying health care and the economy as the two top issues in the 2020 election. At least six in ten voters say health care (63%) and the economy (60%) are “very important” in their 2020 vote choice, ahead of foreign policy or national security (54%), taxes (47%), immigration (38%), climate change (37%), and international trade and tariffs (31%).
  • The latest KFF Health Tracking Poll analysis released on April 2nd found coronavirus affecting all aspects of life in America and this analysis finds it may also be influencing how voters think about their top two issues for the 2020 election. An increasing share of voters offer issues around increasing access to care as their top health care issue, and when asked what about the economy is important to their vote, about one in five voters overall offer responses related to unemployment or job security as their most important economic issue (18%) followed by 11% who offer responses explicitly about coronavirus’ impact on the economy.
  • Nearly half (48%) of Americans now approve of the way President Trump is handling his job as president, up from 42% in February, prior to the increasing concerns of a U.S. coronavirus outbreak. President Trump gets the most positive ratings on his handling of the economy (57% approve compared to 38% who disapprove). The public is divided in his handling of the current coronavirus outbreak with similar shares approving (50%) as disapproving (47%) of his handling of this issue.
  • Partisans are strongly divided in their assessment of President Trump’s job performance with large majorities of Republicans approving of his handling of every issue asked about while Democrats, on the other hand, largely disapprove of the way he is handling all issues.
  • Health care and the economy are also important to a crucial group of voters who have not yet made up their minds about who they plan to vote for in November. “Swing voters” are voters who say they are “undecided” about who they plan to vote for or say they “probably” are going to vote for one candidate over another, but haven’t decided yet and represent 34% of all voters. The latest KFF Health Tracking Poll finds swing voters give President Trump positive ratings on his handling of the economy (+34 net approval) and current coronavirus outbreak (+4 net approval).
  • In the midst of the coronavirus outbreak, the Early April KFF Health Tracking Poll finds a slight decline in public favorability of the 2010 Affordable Care Act with half of the public now viewing the law favorably, down from a high point of 55% in the February KFF Health Tracking Poll. Four in ten (39%) of the public hold unfavorable views of the law.
  • There has been no significant movement since February in the public’s attitudes towards a national health plan, or Medicare-for-all in which all Americans would get their coverage from a single government plan (54% favor) or a government-administered health plan or public option, that would compete with private health insurance plans and be available to all Americans (69% favor). For more on this, check out the Public Opinion on National Health Plan slideshow.

Health Care in the 2020 Election

Throughout the 2020 Democratic primary, KFF has been tracking the role health care has been playing in the presidential election. For the past six months, health care has been among the top issues that voters wanted to hear about in the Democratic presidential debates as well as top of mind for Democratic primary voters as they made their voting decisions according to KFF analysis of AP VoteCast data. The latest KFF Health Tracking Poll finds health care and the economy are once again among the top issues with voters, with about six in ten voters saying each is “very important” in making their decisions about who to vote for in this year’s presidential election. Health care and the economy were also sharing that top spot back in February, and continue to top other issues such as foreign policy or national security (54%), taxes (47%), immigration (38%), climate change (37%), and international trade and tariffs (31%).

Figure 1: Health Care Ranks Among Top Issues For Voters

Health care and the economy are also the top issues among the crucial group of voters who have not yet made up their minds about who they plan to vote for in November. This group of voters, known as “swing voters,” are those who say they are “undecided” about who they plan to vote for or say they “probably” are going to vote for one candidate over another, but haven’t decided yet. Similarly to overall voters, the share of swing voters (34% of all voters) who say health care is “very important” to their vote has stayed steady since February (62% in February to 63% in the most recent poll), but the share of voters who say the economy is “very important” to their vote has decreased from 72% to 65% in the most recent KFF Tracking Poll.

Figure 2: The Economy Has Decreased Slightly In Importance For Voters, But Remains Top Issue Along With Health Care

Health care is far and away the top issue for Democratic voters with eight in ten saying it is “very important” to their vote. It ranks among the top issues for independents along with the economy (60% and 64%, respectively), but ranks much lower for Republican voters at 45%, well behind the economy (69%), foreign policy and national security (62%), and more similarly to taxes (52%) and immigration (51%).

Figure 3: Health Care Is Top Issue For Democrats, Ranks Lower Among Republicans

What specifically about Health care is important to your vote?

With health care and the economy dominating the 2020 presidential election so far, this month’s KFF Health Tracking Poll asks voters what specifically about both issues is important to their vote. Amid concerns about the health care system potentially being overwhelmed by the current coronavirus outbreak, when voters are asked to say in their own words what specifically about health care is important to their vote, the most common responses offered by voters are about increasing access (29%) followed closely by the cost of health care and health insurance (20%). This is a slight shift in health care priorities from February, in which one-fourth of voters offered responses related to health care costs (27%) and increasing access (25%). Fewer voters explicitly mention Medicare or senior concerns (4%), opposition to Medicare-for-all or single-payer (5%), support for Medicare-for-all (4%), or explicitly offer responses directly related to the coronavirus outbreak (2%).

Figure 4: Increasing Access And Improving Costs Of Care And Coverage Driving The Role Of Health Care In 2020 Election

More than one-third of Democratic voters (36%) say increasing access to health care is the most important health care issue to their vote as do three in ten independent voters and a smaller share (13%) of Republican voters. One in five Democratic voters (21%), independent voters (21%), and Republican voters (21%) say the cost of health care and health insurance is the most important health care issue.

Figure 5: Partisans Differ Slightly On What Is Driving Their Views On The Role Of Health Care In 2020

What specifically about the economy is important to your vote?

When it comes to what about the economy is important to voters, many voters offer responses related to job security and unemployment (18%) as well as the impact of coronavirus on the U.S. economy (11%).

Figure 6: Concerns Over Economic Recession And Impact Of Coronavirus On U.S. Driving The Role Of The Economy In 2020 Election

President Trump’s Job Approval

Nearly half (48%) of Americans now approve of the way President Trump is handling his job as president, up from 42% in February, prior to the increasing concerns of a U.S. coronavirus outbreak. This is consistent with other national polling showing an uptick of President Trump’s job approval in recent weeks.

President Trump gets the most positive ratings on his handling of the economy with 57% of the public approving his job performance compared to 38% who disapprove. President Trump receives more mixed reviews of his handling of the current coronavirus outbreak with a similar shares approving (50%) as disapproving (47%) of his handling of this issue. President Trump receives more negative assessments in his handling of immigration (-11 percentage points net approval), and health care (-8 percentage points net approval).

Figure 7: President Trump Receives Most Positive Ratings In His Handling Of The Economy Followed By Coronavirus Outbreak

Partisans are strongly divided in their assessment of President Trump’s job performance with about nine in ten Republicans approving of the way he is handling the economy (93%), his job as president (90%), immigration (88%), and the current coronavirus outbreak in the U.S. (87%). A slightly smaller share (79%) of Republicans approve of the way he is handling health care. Democrats, on the other hand, largely disapprove of the way he is handling immigration (87%), his job as president (86%), health care (81%), the current coronavirus outbreak (77%), and the economy (72%). Independents are divided in their assessments of his job performance overall ad response to the current coronavirus outbreak, but give him more positive than negative assessments of the way he is handling the economy (+29 net approval). President Trump receives more negative ratings from independents on his handling of immigration (-13 net approval) and health care (-9 net approval).

Table 1: President Trump Job Approval By Party Identification
Do you approve or disapprove of the way Donald Trump is handling…?Party ID
DemocratsIndependentsRepublicans
His job as presidentApprove13%51%90%
Disapprove86479
The economyApprove266293
Disapprove72337
Health careApprove144179
Disapprove815014
ImmigrationApprove104188
Disapprove87549
The current coronavirus outbreak in the U.S.Approve215187
Disapprove774511

Swing voters, that crucial group of voters who have not yet made up their minds about who to vote for President in November, give President Trump very positive ratings on his handling of the economy (+34 net approval) as well as net positive approval on the current coronavirus outbreak in the U.S. (+6 net approval) and his job overall (+4 net approval). He receives more negative ratings on his handling of the immigration (-18 net approval) and health care (-18 net approval) from this group.

Figure 8: Swing Voters Give President Trump Very Positive Ratings On His Handling Of The Economy

Methodology

This KFF Health Tracking Poll was designed and analyzed by public opinion researchers at the Kaiser Family Foundation (KFF). The survey was conducted March 25-30th, 2020, among a nationally representative random digit dial telephone sample of 1,226 adults ages 18 and older, living in the United States, including Alaska and Hawaii (note: persons without a telephone could not be included in the random selection process). The sample included 293 respondents reached by calling back respondents that had previously completed an interview on the KFF Tracking poll at least nine months ago. Computer-assisted telephone interviews conducted by landline (253) and cell phone (973, including 689 who had no landline telephone) were carried out in English and Spanish by SSRS of Glen Mills, PA. To efficiently obtain a sample of lower-income and non-White respondents, the sample also included an oversample of prepaid (pay-as-you-go) telephone numbers (25% of the cell phone sample consisted of prepaid numbers) as well as a subsample of respondents who had previously completed Spanish language interviews on the SSRS Omnibus poll (n=10). Both the random digit dial landline and cell phone samples were provided by Marketing Systems Group (MSG). For the landline sample, respondents were selected by asking for the youngest adult male or female currently at home based on a random rotation. If no one of that gender was available, interviewers asked to speak with the youngest adult of the opposite gender. For the cell phone sample, interviews were conducted with the adult who answered the phone. KFF paid for all costs associated with the survey.

The combined landline and cell phone sample was weighted to balance the sample demographics to match estimates for the national population using data from the Census Bureau’s 2018 American Community Survey (ACS) on sex, age, education, race, Hispanic origin, and region along with data from the 2010 Census on population density. The sample was also weighted to match current patterns of telephone use using data from the July-December 2018 National Health Interview Survey. The weight takes into account the fact that respondents with both a landline and cell phone have a higher probability of selection in the combined sample and also adjusts for the household size for the landline sample, and design modifications, namely, the oversampling of prepaid cell phones and likelihood of non-response for the re-contacted sample. All statistical tests of significance account for the effect of weighting.

The margin of sampling error including the design effect for the full sample is plus or minus 3 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. Note that sampling error is only one of many potential sources of 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.

GroupN (unweighted)M.O.S.E.
Total1,226±3 percentage points
Party Identification
Democrats364±6 percentage points
Republicans311±6 percentage points
Independents418±6 percentage points
News Release

Poll: 4 in 10 Americans Report Losing Their Jobs or Work-Related Income Due to the Coronavirus Crisis, Including More Than Half of Part-Time Workers

9 in 10 Adults Now Report Social Distancing (92%), Up From 6 in 10 Two Weeks Ago; Previous Partisan Divide has Disappeared

Published: Apr 2, 2020

Americans, Regardless of Partisan Identity, Prioritize Slowing Coronavirus’ Spread over Restarting the Economy

With coronavirus cases rising and businesses shutting down, four in 10 (39%) U.S. residents say they already have lost a job or income due to the crisis, the latest KFF Health Tracking Poll finds. This includes most part-time workers (54%), as well as nearly half of parents with children under age 18 (47%) and those paid hourly or by the job (45%).

A large majority (82%) also report that they are sheltering-in-place and not leaving their homes except for essential needs such as food and medical care as most states have ordered or recommend. And nearly everyone (92%) now reports some kind of social distancing, such as cancelling travel plans and not attending large gatherings – up from 59% two weeks ago.

Fielded March 25-30, the poll finds that Americans are already reporting significant pandemic-related problems as the crisis disrupts their lives and threatens their health and finances:

  • Nearly half (45%) say that worry and stress related to coronavirus is affecting their mental health – up from 32% two weeks ago. About one in five (19%) say the situation has had a “major impact” on their mental health – including about a quarter of women, Hispanic adults and black adults.
  • One-third (34%) say they have been unable to get needed medical care unrelated to coronavirus. A quarter (24%) say they were unable to get prescription medications.
  • Overall 72% of the public say the pandemic has disrupted their lives – up 32 percentage points from two weeks ago. The shares reporting disruptions are similar among men and women, among parents and non-parents, and among Democrats, independents and Republicans.

“Most Americans are taking steps recommended by public health experts to protect themselves, and Republicans are now getting the message,” KFF President and CEO Drew Altman said.

The poll finds a dramatic increase in the share of adults who report taking precautions or making preparations in response to the coronavirus pandemic. Three-fourths (75%) say they stayed home instead of going to work, school, or other regular activities – roughly triple the share who said say two weeks ago.

Seven in 10 (69%) now say they have decided not to travel or changed travel plans. Two-thirds (66%) say they canceled plans to attend large gatherings, and six in 10 say they have stocked up on items like food, household supplies, or medications. In each case, the shares are substantially higher than reported two weeks ago.

Similar shares of Democrats (95%), independents (91%) and Republicans (91%) now report engaging in some form of social distancing – a significant shift since two weeks ago, when Republicans were less likely to say they were doing at least one of these things.

Importantly, those over age 60 and those with chronic conditions – two groups considered at high risk of developing COVID-19 complications – report taking these precautions at similar levels as the overall population.

In spite of the health, social and economic upheaval that Americans are already experiencing, about three in four (74%) say that the “worst is yet to come.”  The public has significant coronavirus-related worries related to their family’s health and wellbeing, as well as concerns for the nation and the health care system:

  • Most (57%) now say they are worried they will put themselves at risk of exposure to coronavirus because they can’t afford to stay home and miss work – up from 35% two weeks ago. Those most likely to fear such exposure include health care workers and their families (69%), lower-income workers (72%), and those paid hourly or by the job (61%).
  • About half of adults say they are worried someone in their family will get sick from coronavirus (53%, down from 62% two weeks ago) and that their investments will be negatively impacted for a long time (59%, up from 51% two weeks ago). About half (53%) worry that they will not be able to afford coronavirus testing or treatment if they need it, up from 36% in the earlier poll.
  • Large majorities worry that the nation’s economy will head into a recession (79%) and that local businesses will close permanently (85%) due to the epidemic. This includes at least three quarters of Democrats, independents and Republicans.
  • About eight in 10 say they are worried that the country’s health care system will be overrun and people won’t be able to get needed medical care (82%) and that their local hospital will run out of necessary equipment like beds or ventilators (78%). A large majority (88%) also worry that health care workers will not have needed personal protective equipment such as masks.

For Now, Americans Prioritize Slowing Coronavirus’ Spread over Reopening Businesses

In spite of concerns about its impact on the nation’s economy, a large majority (80%) say “the U.S. should take measures aimed at slowing the spread of the coronavirus while more widespread testing becomes available, even if that means many businesses will have to stay closed.”

Far fewer (14%) say “the U.S. should ease up on measures aimed at slowing the spread of the coronavirus soon, in order to open business and get the U.S. economy going again, even if that means more people would get coronavirus and could die.”

A larger share of Democrats (94%), independents (78%), and Republicans (68%) say the U.S. should prioritize slowing the spread of coronavirus than say the U.S. should prioritize getting the economy going again (4%, 16%, and 25%, respectively).

Public Trusts the CDC and Dr. Fauci Most; President Trump and Media Lag Well Behind

About eight in ten adults say they trust the U.S. Center for Disease Control and Prevention (CDC) (83%) and Dr. Anthony Fauci (78%), the director of the National Institute of Allergies and Infectious Diseases and the most visible public health official from the Trump Administration, for reliable information on coronavirus.

Nearly as many trust state government officials (74%) and the World Health Organization (WHO) (70%). Fewer than half say they trust either the news media (47%) or President Trump (46%) to provide reliable coronavirus information.

Unlike the other sources, which majorities across party lines trust, there are big partisan differences in trust in the news media and President Trump. Most Democrats (63%) but only a third of Republicans (33%) trust the news media to provide accurate coronavirus information, while the vast majority of Republicans (89%) but few Democrats (12%) trust President Trump.

Designed and analyzed by public opinion researchers at KFF, the poll was conducted March 25-30, 2020 among a nationally representative random digit dial telephone sample of 1,226 adults. Interviews were conducted in English and Spanish by landline (253) and cell phone (973). The margin of sampling error is plus or minus 3 percentage points for the full sample. For results based on subgroups, the margin of sampling error may be higher.

News Release

Kaiser Health News to Expand Coverage in the Mountain West

Expansion Results from New Partnership with the Montana Healthcare Foundation and the Headwaters Foundation

Published: Apr 2, 2020

KFF’s Kaiser Health News (KHN) will hire a full-time Montana-based correspondent and recruit a team of freelance reporters to expand its coverage of health care policy and politics in the region, including the unfolding COVID-19 pandemic.

The expansion is made possible by a new long-term partnership among KFF, the Montana Healthcare Foundation, and the Headwaters Foundation, and follows the opening last year of KHN’s Mountain States Bureau in Denver and its Midwest Bureau in St. Louis.

Media outlets from Montana and elsewhere can publish KHN stories from the region at no charge. KHN also will publish the stories on kffhealthnews.org and promote them through its social media platforms. KHN is an award-winning nonprofit news service that is an editorially independent program of KFF, formally The Henry J. Kaiser Family Foundation, a San Francisco-based nonprofit, nonpartisan organization engaged in policy analysis, polling, journalism, and communications to produce trusted information on national health issues.

“At a time when many local news organizations are scrambling to cover the coronavirus crisis, KHN’s model of partnering with local outlets and producing high quality health journalism should quickly translate into better informed communities,” said Drew Altman, KFF’s CEO and KHN’s founding publisher.  “Thanks to the support of the Montana Healthcare Foundation and the Headwaters Foundation, we will be bringing the Mountain West more in-depth coverage not only of COVID-19, but also issues such as the Medicaid expansion, health care costs, rural health care and health care in the 2020 elections.”

“Montana Healthcare Foundation is committed to ensuring that Montanans have solid information on key health care and health policy issues in our state,” said Aaron Wernham, MHCF CEO. “We’re excited to partner with the nation’s preeminent health journalism outlet to give all Montanans access to high-quality coverage of health issues that affect us.”

“The people of Montana deserve the caliber of journalism that Kaiser Health News can provide so they can make informed decisions about their lives,” said Headwaters Foundation CEO Brenda Solorzano. “Headwaters Foundation is excited to partner in supporting this effort dedicated to high-quality journalism covering health issues that affect Montanans.”

KHN employs more than 60 journalists, with most based in the KHN newsroom in KFF’s Washington D.C. offices and others working in California, Colorado, and Missouri. The 11-year-old news service has won numerous awards, including a prestigious Barlett & Steele Award for Investigative Journalism and five “Best in Business” awards from the Society for Advancing Business Editing and Writing (SABEW). KHN also is a finalist for the 2020 Goldsmith Prize for Investigative Reporting by the Shorenstein Center on Media, Politics and Public Policy at Harvard University’s Kennedy School of Government.

Journalists interested in the Montana correspondent’s job can find details about the position and information about how to apply on kff.org.

News organizations interested in working with KHN should contact the news service at KHNPartnerships@kff.org, and those interested in helping to expand and improve health journalism around the country should contact KFF at healthjournalism@kff.org.

For more on our partners in Montana, visit the Montana Healthcare Foundation and the Headwaters Foundation online.

About The Henry J. Kaiser Family Foundation and Kaiser Health News:

Filling the need for trusted information on national health issues, KFF (The Henry J. Kaiser Family Foundation) is a nonprofit organization based in San Francisco, California. KHN is an editorially independent program of KFF and is the nation’s leading and largest health and health policy newsroom, producing stories that run on kffhealthnews.org and are published by hundreds of news organizations across the country.

Examining Medicare Part D Policies for Extended Supplies of Medication

Authors: Juliette Cubanski, Karyn Schwartz, and Anthony Damico
Published: Apr 1, 2020

In response to the ongoing coronavirus pandemic, current recommendations are for older adults to stay home and away from others. To prepare for extended stays at home, the Centers for Disease Control and Prevention (CDC) recommends gathering extra supplies, including prescription medicines. Some patients may encounter difficulty in doing so, however, as a result of their health plan’s ‘refill too soon’ restrictions, which block coverage for a prescription that is being refilled early. For example, a plan may have a policy of not allowing refills of 30-day prescriptions until at least three weeks after the prescription was last filled.

In light of the coronavirus pandemic, the Coronavirus Aid, Relief, and Economic Security (CARES) Act requires Medicare Part D plans to provide up to a 90-day (3 month) supply of covered Part D drugs to enrollees who request it. Part D plans currently provide drug coverage to more than 46 million older adults and people with disabilities. Prior to this requirement, Part D plans had the option to relax their ‘refill too soon’ restrictions to ensure enrollees had access to a sufficient extended supply of medications, and some plans stated they would temporarily lifted these restrictions, but plans were not required to do so. The change in law is designed to ensure that all Part D enrollees can obtain an extended supply of medications if they request it during the COVID-19 public health emergency.

This analysis examines the share of Part D enrollees who have access to extended supplies of generic, brand-name, and specialty-tier drugs covered by their plan in 2020, under policies that applied prior to the change in law, and that will apply after the COVID-19 emergency declaration ends, when Part D plans will no longer be required by law to issue extended supplies for all Part D drugs they cover.

Findings

Under Part D plan policies on extended supplies that were in effect at the start of the 2020 plan year and will be in effect after the COVID-19 emergency declaration ends:

  • Three-quarters of Medicare Part D enrollees (27.5 million enrollees) are in a plan that covers extended supplies of all drugs on at least one of the plan’s two tiers for generic drugs (Figure 1).
  • Nearly half of all Part D enrollees (47%, or 17.5 million enrollees) are in a plan that covers extended supplies of all drugs on at least one of the plan’s two tiers for brand-name drugs.
  • Only 4 percent of Part D enrollees (1.5 million) are in a plan that covers extended supplies of all specialty tier medicines. Specialty tier medicines are defined by Medicare as medicines that cost more than $670 per month and include drugs to manage conditions such as cancer, hepatitis C, multiple sclerosis, and rheumatoid arthritis.
  • A larger share of stand-alone drug plan enrollees than Medicare Advantage drug plan enrollees are in plans covering extended supplies of generic drugs (80% vs. 67%, respectively) and brand drugs in 2020 (56% vs. 37%, respectively), but the opposite is true for specialty tier drugs (2% vs. 6%, respectively) (Figure 2).
Figure 1: Most Medicare Part D Enrollees Are in Plans Covering Extended Supplies of Generic Drugs, But Only 4% Are in Plans Covering Extended Supplies of Specialty Tier Drugs
Figure 2: A Larger Share of Stand-Alone Drug Plan Enrollees Than Medicare Advantage Drug Plan Enrollees Are in Plans Covering Extended Supplies of Generic and Brand Drugs, But the Opposite is True for Specialty Tier Drugs

Discussion

This analysis shows that most Medicare Part D enrollees are in plans covering extended supplies of relatively low-cost generic drugs in 2020, but just under half are in plans that cover extended supplies of brands and only a small share of enrollees are in plans that cover extended supplies of more expensive specialty-tier medications. These coverage policies will be in effect after the COVID-19 emergency declaration ends, when plans will no longer be required by law to issue extended supplies for all Part D drugs they cover.

In light of the CDC recommendations for older adults and people with serious chronic medical conditions to take actions to reduce the risk of becoming infected with the new coronavirus, including staying home and having extra supplies of necessary medications, the requirement that all Part D plans provide up to a 3-month supply of medications to enrollees who request it will help Medicare beneficiaries avoid trips to the pharmacy when there is increased risk of spread of coronavirus in their communities.

Juliette Cubanski and Karyn Schwartz are with KFF. Anthony Damico is an independent consultant.

Data and Methods

This analysis is based on 2020 Medicare Part D plan enrollment and benefit data. The analysis focuses on 36.9 million Part D enrollees who are in a non-employer Part D plan (including both stand-alone prescription drug plans and Medicare Advantage drug plans) with five or six formulary tiers in 2020 (93% of all non-employer Part D enrollees). The analysis excludes 7.0 million enrollees in employer group health insurance plans that offer Part D coverage because details on their plan benefits are not available.

As a result, the U.S. missed a critical early window to test, contact trace, isolate, and contain the outbreak early on, leaving social distancing measures as the main tool to interrupt the spread of the virus, including stay-at-home orders, closures of non-essential businesses and schools, and bans on large gatherings throughout much of the country. (more…)

Put to the Test: Can the U.S. Get to the Next Phase of the COVID-19 Response?

Published: Apr 1, 2020

By now, it’s well known that there have been multiple challenges to and failures in rolling out testing for coronavirus in the United States, including:

As a result, the U.S. missed a critical early window to test, contact trace, isolate, and contain the outbreak early on, leaving social distancing measures as the main tool to interrupt the spread of the virus, including stay-at-home orders, closures of non-essential businesses and schools, and bans on large gatherings throughout much of the country. (more…)

By now, it’s well known that there have been multiple challenges to and failures in rolling out testing for coronavirus in the United States, including:

As a result, the U.S. missed a critical early window to test, contact trace, isolate, and contain the outbreak early on, leaving social distancing measures as the main tool to interrupt the spread of the virus, including stay-at-home orders, closures of non-essential businesses and schools, and bans on large gatherings throughout much of the country. (more…)

Virtual Briefing About the Coronavirus Pandemic

Published: Mar 31, 2020

KFF’s Jen Kates and Josh Michaud on March 30 were the featured guests in The Commonwealth Club of California’s continuing virtual series on the coronavirus outbreak.

Among the topics discussed were:

  • How does this epidemic compare to previous ones?
  • What goes into epidemiological models, how do they work and how reliable are they?
  • Who is at greatest risk for getting sick?
  • Was China’s approach to social distancing more effective?
  • When will we be able to relax social distancing measures?
  • When people recover will they have immunity?
  • What are Americans’ views on the epidemic?

Listen to the audio-only version.

Hospitals across the country clearly need additional resources as they struggle to treat the surge of COVID-19 patients and prepare for a spike in patient load.  The $100 billion fund was established to help hospitals ramp up quickly, in response to new demands, giving the Secretary of Health and Human Services broad discretion over how the $100 billion fund will be distributed, although it is not yet clear how these funds will be allocated. (more…)

A Look at the $100 Billion for Hospitals in the CARES Act

Authors: Karyn Schwartz and Tricia Neuman
Published: Mar 31, 2020

The $2 trillion Coronavirus Aid, Relief, and Economic Security (CARES) Act contains a vast array of spending provisions, including an additional $100 billion for the Public Health and Social Services Emergency Fund.  This new funding is designed to provide an influx of money to hospitals and other health care entities responding to the coronavirus pandemic. This $100 billion averages out to about $108,000 per hospital bed in the United States.

Hospitals across the country clearly need additional resources as they struggle to treat the surge of COVID-19 patients and prepare for a spike in patient load.  The $100 billion fund was established to help hospitals ramp up quickly, in response to new demands, giving the Secretary of Health and Human Services broad discretion over how the $100 billion fund will be distributed, although it is not yet clear how these funds will be allocated. (more…)

The $2 trillion Coronavirus Aid, Relief, and Economic Security (CARES) Act contains a vast array of spending provisions, including an additional $100 billion for the Public Health and Social Services Emergency Fund.  This new funding is designed to provide an influx of money to hospitals and other health care entities responding to the coronavirus pandemic. This $100 billion averages out to about $108,000 per hospital bed in the United States.

Hospitals across the country clearly need additional resources as they struggle to treat the surge of COVID-19 patients and prepare for a spike in patient load.  The $100 billion fund was established to help hospitals ramp up quickly, in response to new demands, giving the Secretary of Health and Human Services broad discretion over how the $100 billion fund will be distributed, although it is not yet clear how these funds will be allocated. (more…)

News Release

KHN Wins Five “Best in Business” Awards and Two Honorable Mentions from The Society for Advancing Business Editing and Writing (SABEW)

Published: Mar 30, 2020

KFF’s Kaiser Health News (KHN), an editorially independent news service focusing on health care and policy, has won five “Best in Business” awards from the Society for Advancing Business Editing and Writing (SABEW). The awards, announced today, recognize outstanding business journalism in 2019.

The five awards, all of which came in the division for medium size news organizations, include:

America’s Broken Health Care System, by Elisabeth Rosenthal, KHN Editor-in-Chief, winner in the Commentary/Opinion category. The judges wrote that Rosenthal “deftly uses the medical bills she received to guide readers through the maze of medical bureaucracy and deliver a clear exposition of how and why the nation’s health care system has become so beleaguered, unfair and inefficient.”

Hidden Harm, by Christina Jewett, winner in the government category and co-winner in the investigative reporting category.  The judges wrote that, “Jewett’s stories unearthed a Dr. Evil-scale cover-up of hidden FDA data on millions of medical device malfunctions, injuries and deaths. Her coverage forced the administration to open this vital data to both doctors who perform procedures as well as public scrutiny, and in the process, no doubt saved countless lives.”

University of Virginia Health System lawsuits, by Jay Hancock and Elizabeth Lucas, winner in the Health/Science category. The judges wrote that KHN “exposed how the center’s overly aggressive billing and collection policies were ruining people’s lives.”

In India’s burgeoning pain market, U.S. drugmakers stand to gain, by Sarah Varney, winner in the international reporting category. The judges wrote that “Varney uncovered a trend in India of sweeping importance: the relatively new cultural acceptance of pain medication and the pharmaceutical companies, largely chased away from places like the United States, that are looking to capitalize on the trend.”

KHN also earned two honorable mentions, including one in the economics category for No Mercy, a series by Sarah Jane Tribble that looks at what happens when the closure of a rural hospital disrupts a community, and another in the feature category, for Varney’s story about India’s market for pain medication.

For more on the awards, visit SABEW’s website.

KHN content is always available to news organizations to republish free of charge.

About The Henry J. Kaiser Family Foundation and Kaiser Health News:

Filling the need for trusted information on national health issues, KFF (the Henry J. Kaiser Family Foundation) is a nonprofit organization based in San Francisco, California.  KHN is an editorially independent program of KFF and is the nation’s leading and largest health and health policy newsroom, producing stories that run on kffhealthnews.org and are published by hundreds of news organizations across the country.

New KFF State Survey Data Provide a Benchmark for Measuring State Responses to COVID-19

Author: Samantha Artiga
Published: Mar 27, 2020

On March 26, we posted our 18th annual 50-state survey of Medicaid and CHIP eligibility, enrollment, renewal, and cost sharing policies. It continues to serve as the only comprehensive resource for information on these policies across states and provides information that has enabled tracking of state implementation of the Medicaid expansion and streamlined enrollment and renewal procedures under the ACA.

This year’s survey, which provides data on policies in place as of January 2020, now serves a new purpose by providing a benchmark against which we can measure state actions to respond to COVID-19 and the economic crisis. The survey findings document policies states must maintain in order to access temporary enhanced federal Medicaid funding as part of COVID-19 response efforts. The Families First Coronavirus Response Act provides states a temporary 6.2 percentage point increase in the federal Medicaid matching rate. To receive those enhanced funds, states cannot implement more restrictive eligibility policies than those in place as of January 1, 2020 and must provide continuous coverage to Medicaid enrollees through the emergency period. For example, states cannot reduce income eligibility limits or increase requirements to verify eligibility criteria.

The survey findings show that, as of January 2020, there is wide variation in state policies that affect individuals’ ability to access coverage and care. For example, more individuals can access Medicaid coverage in states that have implemented the ACA Medicaid expansion to low-income adults than in states that have not expanded, where poor adults continue to face a coverage gap. Largely because of the ACA, individuals can apply for Medicaid and CHIP online or via phone, and states can connect individuals to coverage quickly through real-time eligibility determinations and renewals using electronic data matches. Moreover, some states have taken up options that expedite access to coverage and facilitate continuity of coverage, such as presumptive eligibility and 12-month continuous eligibility for children. However, certain policies and processes may by contributing to coverage losses among eligible individuals. For example, some states conduct periodic data checks between renewal periods to identify potential changes that might affect eligibility, provide enrollees limited time (e.g., ten days) to respond to requests to verify ongoing eligibility, and only contact enrollees once by mail to request information before terminating coverage. Changes the federal government was pursuing as part of program integrity efforts prior to COVID-19 may have further increased coverage barriers for eligible individuals, but the Centers for Medicare and Medicaid Services (CMS) recently withdrew its planned regulatory changes that would have tightened eligibility requirements.

States can take a range of actions through Medicaid under current rules and waivers to enhance their response to COVID-19. They can take some of these actions quickly without federal approval. For example, they can allow self-attestation of eligibility criteria other than citizenship and immigration status and verify income post enrollment, which would make signup easier and faster. They also can provide greater flexibility to enroll individuals who have small differences between self-reported income and income available through data matches. Further, they can suspend or delay renewals and periodic data checks between renewals (as noted above, states must provide continuous coverage to Medicaid enrollees through the emergency period to receive enhanced federal funding). States can take other actions allowed under existing rules by submitting a state plan amendment (SPA). For example, states could expand eligibility, including implementing the ACA Medicaid expansion to low-income adults in states that have not yet expanded; adopt presumptive eligibility; or modify cost sharing requirements. Beyond these options, states can seek additional flexibility through Section 1135 and Section 1115 waivers. CMS has provided states SPA and waiver templates and checklists to facilitate implementation of changes to respond to COVID-19, and state Medicaid policies and processes already are evolving as states implement changes to expedite enrollment in coverage, keep enrollees covered, and facilitate access to services as part of COVID-19 response efforts.

State Medicaid and CHIP eligibility and enrollment policies will remain an important indicator to watch looking forward. As evidenced by previous recessions, states will likely see growing demand for Medicaid and CHIP as individuals lose jobs and incomes decrease amid the declining economy. The ability to connect these individuals to coverage quickly and to keep them connected to coverage over time will help ensure they can access care for COVID-19 and more broadly.