Healthcare ranks as top voter priority heading into election season

Nearly half of Americans don't know that the Republican tax cut bill repealed the Affordable Care Act requirement for nearly everyone to have health insurance, effective next year.

And people are more likely to say they favor cutting welfare and entitlement programs than that they favor cutting Medicaid and Medicare.

Those are some of the key findings of the January Kaiser Health Tracking Poll released Friday by the Kaiser Family Foundation.

Congressional Republicans have sent mixed messages about whether they will take another shot at cutting and restructuring Medicaid after their failed attempts last year. The Kaiser survey results suggest that if they do try it again, Republicans will use language describing Medicaid as a welfare or entitlement program, which has less support than Medicaid itself.

Thirty-two percent of respondents said they favor cutting welfare, and 27% said they back cutting entitlement programs. In contrast, just 12% supported cutting Medicaid, and a mere 7% favored cutting Medicare. Still, a plurality of respondents supported increasing spending on all four types of programs, with 47% backing higher spending on Medicaid and 46% favoring more Medicare spending.

The popularity of the two big public healthcare programs remains a big hurdle for Republicans seeking to roll back the government's role in healthcare and helped block their ACA repeal-and-replace efforts in 2017.

Those looking for a respite from healthcare politics may be disappointed during the hotly contested congressional election campaign coming up. Healthcare appears to remain a top-tier issue.

Voters rated healthcare slightly above the economy and jobs as the most important issue—29% vs. 27% and 24%, respectively. Healthcare ranked well above immigration and the conflict with North Korea.

Respondents in battleground states and congressional districts ranked healthcare even higher, with 34% saying it's the most important issue.

Democrats and Republicans differed sharply in their priorities. Two-thirds of Democrats cite the young immigrants known as the Dreamers as a top priority, ahead of healthcare issues including ACA stabilization (61%) and the opioid epidemic (54%).

Republicans are about as likely to consider President Donald Trump's proposed border wall as a top priority (43%) as they are to consider repealing the ACA (48%), the opioid epidemic (43%), stabilizing the ACA marketplaces (42%), and passing an infrastructure bill (41%).

Only 36% of the public was aware that Congress has repealed the tax penalty for not buying health insurance, while 46% incorrectly said the mandate penalty has not been repealed. The rest (18%) were unsure. The results were similar among people who are uninsured or buy their insurance in the individual market.

The low awareness of the mandate repeal could be good news for insurers and providers, since many consumers may think they still are required to buy coverage.

But there's plenty of time for people to learn about that repeal. Between now and November, Trump and Republicans running for Congress are likely to brag about it as a big step toward their long-standing promise of repealing the healthcare law.