Make health insurance exchange top priority: survey

Governors and state legislatures should make establishing a health insurance exchange the No. 1 item on their healthcare agenda this year, a majority of Americans said in a survey from the Kaiser Family Foundation, Robert Wood Johnson Foundation and Harvard School of Public Health.

In the survey, conducted Jan. 3-9, respondents identified the top healthcare priorities at the state and federal levels. It found that 55% said creating an insurance exchange should lead the list for state officials. According to Kaiser, so far 18 states have indicated they will run their own exchanges, while seven have said they will operate an exchange with the federal government. The exchange option in the survey was the only one of seven possibilities in which a majority of those surveyed identified it as a top priority. For instance, 39% said the main priority should be supporting women's access to family planning and other reproductive services, while 37% identified increasing state regulation of health insurance premiums.

Meanwhile, a majority of Americans—52%—said states should expand their Medicaid programs, as opposed to 42% who said the program should be kept as it is today. Predictably, those results followed political party lines on the issue, with 66% of Republicans favoring the status quo and 75% of Democrat respondents preferring Medicaid expansion.

And as the new 113th Congress prepares to dive into some thorny budget battles on Capitol Hill, they should not make major reductions to Medicare, according to 58% of respondents. Medicare was second only to public education in the list of federal programs and services that the public said should not be cut as part of deficit-reduction negotiations.

Survey participants also had a chance to evaluate a list of 15 federal healthcare program areas—not including Medicare, Medicaid and the Patient Protection and Affordable Care Act—to determine which of those they deemed most important for federal spending this year. Of those, five were identified by a majority of respondents as the top priorities: funding for veterans' healthcare (60%); addressing health problems related to natural or man-made disasters (59%); bolstering research to find cures and treatments for major disease threats; preventing infectious diseases, including providing vaccinations (52%); and preventing chronic illnesses (51%).

“When asked if federal spending on improving health and preventing illness saves the nation money in the long run, two-thirds of the public (67%) says it does,” according to the report. “Not surprisingly, those who hold this belief are significantly more likely to prioritize spending on things like vaccinations and screening tests, as well as providing funds to state public health departments and hospitals that treat the uninsured.”