State University of New York at Albany.
IDinsight.
J Health Polit Policy Law. 2022 Feb 1;47(1):1-25. doi: 10.1215/03616878-9417428.
The United States is the only high-income country that relies on employer-sponsored health coverage to insure a majority of its population. Millions of Americans lost employer-sponsored health insurance during the COVID-19-induced economic downturn. We examine public opinion toward universal health coverage policies in this context.
Through a survey of 1,211 Americans in June 2020, we examine the influence of health insurance loss on support for Medicare for All (M4A) and the Affordable Care Act (ACA) in two ways. First, we examine associations between pandemic-related health insurance loss and M4A support. Second, we experimentally prime some respondents with a vignette of a sympathetic person who lost employer-sponsored coverage during COVID-19.
We find that directly experiencing recent health insurance loss is strongly associated (10 pp, p < 0.01) with greater M4A support and with more favorable views of extending the ACA (19.3 pp, p < 0.01). Experimental exposure to the vignette increases M4A support by 6 pp (p = 0.05).
In the context of the COVID-19 pandemic, situational framings can induce modest change in support for M4A. However, real-world health insurance losses are associated with larger differences in support for M4A and with greater support for existing safety net policies such as the ACA.
美国是唯一一个依靠雇主提供的医疗保险来为大多数人口提供保险的高收入国家。在 COVID-19 引发的经济衰退期间，数以百万计的美国人失去了雇主提供的医疗保险。在这种情况下，我们研究了公众对全民医疗保险政策的看法。
通过 2020 年 6 月对 1211 名美国人的调查，我们从两个方面考察了医疗保险损失对全民医疗保险（M4A）和《平价医疗法案》（ACA）支持的影响。首先，我们考察了与大流行相关的医疗保险损失与 M4A 支持之间的关联。其次，我们通过一个在 COVID-19 期间失去雇主提供的医疗保险的同情者的小插曲来对一些受访者进行实验性提示。
我们发现，直接经历最近的医疗保险损失与更大的 M4A 支持以及对扩大 ACA 的更有利看法密切相关（10 个百分点，p<0.01）。实验性地接触该小插曲会使 M4A 的支持率增加 6 个百分点（p=0.05）。
在 COVID-19 大流行的背景下，情境框架可以在一定程度上改变对 M4A 的支持。然而，现实世界中的医疗保险损失与对 M4A 的更大支持以及对现有安全网政策（如 ACA）的更大支持之间存在显著差异。
