In Focus: Listening to Enrollees with Affordable Care Act Coverage Who Voted for Trump

As Republicans in Washington pursue efforts to repeal and replace the Affordable Care Act, what do enrollees in ACA marketplaces and state Medicaid expansions who voted for President Trump want in a health care plan? The Kaiser Family Foundation asked some of them in six focus groups convened in December in Michigan, Ohio, and Pennsylvania — three with Trump voters enrolled in the ACA marketplaces and three with Trump voters in Medicaid.

Focus group participants shared both positive experiences and concerns about their coverage through the ACA. They discussed a range of issues including access to care, high deductibles, surprise medical bills and the cost of prescription medications. Trump voters on Medicaid were particularly satisfied with their coverage. Some of what participants said mirrored broader public sentiments about the U.S. healthcare system overall.

Focus group participants also said they knew few details about what might come next. Concerned about losing coverage, they wanted repeal and replacement of the ACA to happen at the same time. Several key themes emerged about what they wanted in an ACA replacement plan: more affordable coverage with both lower premiums and deductibles, access to a broad range of doctors and hospitals, greater transparency about what their plan covers and what services would cost, continued coverage of pre-existing conditions and elimination of the individual mandate. They expressed skepticism that high deductible plans with savings accounts would be affordable options for them.

Read the focus group report and watch the companion video. Also available is a recent op-ed in The New York Times authored by KFF President and CEO Drew Altman, based on his observations of the focus groups.