The Future Private Option Debate: Messaging Will Matter

Feb 9, 2015

With state lawmakers and Gov. Asa Hutchinson having deflected the rancorous debate regarding the Private Option we’ve seen in recent years, the issue still has a long way to go in terms of public opinion.

Hutchinson and legislative leaders have successfully secured future funding the Private Option and created a task force of 16 lawmakers to provide recommendations for a future program that may enact larger health care reforms.

Our latest Talk Business & Politics-Hendrix College survey, conducted in collaboration with Little Rock-based Impact Management Group, tested three different approaches to characterizing the health coverage debate. All three questions produced differing results.

These questions were asked during the height of this year’s legislative debate among 1,079 registered Arkansas voters via landline and Internet surveys.

Q: In the current legislative session, the General Assembly is considering whether to continue the “Private Option.” In this Arkansas program, federal Medicaid dollars are used to provide private insurance to low-income Arkansans through health care exchanges. Should the legislature vote to continue this “private option” after this current year?

Yes 46%
No 32%
Don’t Know 22%

Q: In the current legislative session, the General Assembly is considering whether to continue the “Private Option” program through which federal Medicaid dollars are used to provide private insurance to low-income Arkansans through health care exchanges. As a component of Obamacare, the “Private Option” is entirely funded through federal dollars for two additional years; ultimately, Arkansas will pay 10% of the cost of the program. Some argue that, no matter its benefits, the program contributes to federal deficit spending. Should the legislature vote to continue the program?

Yes 39%
No 42%
Don’t Know 19%

Q: In the current legislative session, the General Assembly is considering whether to continue the “Private Option” program through which federal Medicaid dollars are used to provide private insurance to over 200,000 low-income Arkansans through health care exchanges. In addition to the individuals covered, the federal dollars received through the program have important benefits for the state budget and the budgets of hospitals across the state have also benefited through the program. Should the legislature vote to continue the program?

Yes 49%
No 29%
Don’t Know 22%

“As lawmakers decide the future fate of the Private Option and larger health care reform, understanding the messaging battle to come will be as much of a factor as the policy details,” said Roby Brock, Talk Business & Politics Executive Editor.

ANALYSIS

Dr. Jay Barth, professor of political science at Hendrix College, offered his thoughts on the survey results.

Despite the peaceful extension of the “private option” Medicaid expansion brought about by Governor Asa Hutchinson’s proposal to extend the program for two years while a task force examines reform options, the program remains the source of intense policy debate in Arkansas. Our survey of Arkansas voters on their views of the private option shows that it remains a divisive issue in the state.

Our first question on the private option closely tracks our questions in recent years, allowing us to gauge change in the Arkansas electorate on the issue. A healthy plurality of Arkansans (46%) support the program’s continuation while about a third of the electorate (32%) oppose its extension. These numbers track almost exactly the numbers in our survey one year ago indicating that the impact of the program in signing up Arkansans for health coverage has had little impact on its popularity. Healthy percentages of Democrats support the program (65% approval), but the program continues to divide the Republican Party in Arkansas as it has recent GOP primary elections (35% approve; 37% disapprove). The program is particularly popular among younger voters (a majority of those 18-34 favor) and African-Americans (69% approve).

We also framed the question about the extension of the private option in two different ways. Opponents tend to emphasize its links to Obamacare and also highlight its ramifications for federal budget deficits while proponents emphasize the positive budgetary impacts of the program for the state and for Arkansas hospitals as well as the significant increase in health insurance in Arkansas compared to other states.

Indeed, our experiment with the power of survey question wording showed that these two frames are effective in moving voters towards and away from the program’s extension, respectively. The opposition frame shifts opinion (of the same survey respondents) into a plurality opposition (41%-38% oppose) while the proponents’ frame moves respondents into a majority supportive of the program. As the task force continues the debate over the private option in the months ahead, those who win the framing of the program may well win the battle over the private option in the Arkansas electorate.

Clint Reed, partner with Impact Management Group, offered his analysis.

The messages we tested show the simple, yet defined fault lines among the different demographics when talking about healthcare.

This is one issue that even the slightest messaging nuance can change the outcome of the research. When voters hear the benefits of the private option (i.e., increased health coverage to low income Arkansans or how it helps budget needs) they are overall in favor of the program.

However, as soon as the word “Obama” is associated with the program, it immediately changes the numbers. It’s really remarkable how impactful that one word is.

This just reinforces how unpopular Obama’s presidency has become and how introducing the phrase “Obamacare” into the debate could potentially change the outcome.

METHODOLOGY

This survey was conducted by Impact Management Group in collaboration with Talk Business & Politics and Hendrix College on Jan. 29 to Feb. 1, 2015. The poll, which has a margin of error of +/-2.98%, was completed using IVR survey technology and Internet respondents among 1,079 registered voters in Arkansas.

Approximately 14% of the voters in our sample were contacted via the Internet. Generally standard weighting to the poll results based on age, gender, race and Congressional Districts.

Age (weighted according to 2014 statewide vote)

12% Between the ages of 18-34
24% Between the ages of 35 and 49
39% Between the ages of 50 and 64 25% 65 or older

Ethnicity (weighted according to 2014 statewide vote)

12% African American
83% Caucasian
3% Other

Party Identification (unweighted)

24% Democratic
43% Republican
27% Independent
7% Other

Gender (weighted)

48% Male
52% Female

Congressional Districts (weighted)

25% CD1
25% CD2
25% CD3
25% CD4

All media outlets are welcome to reprint, reproduce, or rebroadcast information from this poll with proper attribution to Talk Business & Politics, Hendrix College and Impact Management Group. For interviews, contact Talk Business & Politics Editor-in-Chief Roby Brock by email at roby@talkbusiness.net, Dr. Jay Barth by email at barth@hendrix.edu, or Clint Reed at creed@impactmanagement.com.