New Healthcare Poll


TO: Interested Parties
FROM: Hart Research
DATE: September 18, 2018
RE: Battleground Survey of Latino Voters

On behalf of UnidosUS Action Fund, Hart Research Associates conducted a survey among 500 Latino likely voters in battleground CDs and states with a focus on the issue of healthcare and its role in this year's elections. The survey was conducted by phone from July 19 to 25, 2018, with 100 interviews each conducted in Arizona and Nevada and 300 interviews conducted in 12 competitive CDs: CA-10, CA-21, CA-25, CA-39, CO-06, FL-26, FL-27, NJ-02, PA-07, TX-07, TX-23, and VA-10 (approximately 25 interviews in each CD). The survey's margin of error is ±4.38 percentage points. This memo reports the survey's key results and message findings.

Latino voters are supporting Democratic congressional candidates in battleground races by large margins. President Trump's poor performance marks among these voters may be contributing to Republican candidates' low standing.

  • Latino voters look ready to provide substantial support to Democratic Senate candidates in two key Southwest battlegrounds. In Nevada, Latino voters prefer Democrat Jacky Rosen over GOP incumbent Dean Heller by a very strong 39-point margin (62% to 23%). In Arizona, Democrat Kyrsten Sinema enjoys an even larger 45-point edge (67% to 22%) over her Republican opponent Martha McSally among Latinos. With Latino voters comprising about 14% of the likely electorate in Nevada and 18% in Arizona, it is clear that the Latino vote could make the difference in these competitive races.
  • Similarly, in the competitive House races surveyed, Latinos indicate they will deliver substantial support to Democratic challengers. By an overwhelming ratio of three to one, Latinos report they will vote for the Democrat (69%) over the Republican (22%) in the U.S. House election in their district. Support for the Democrats is particularly high among women (+54) and voters who have not attended college (+63). A high turnout level in November would likely expand the Democratic margin, as those who are most certain to vote in November (70+ on Turnout Score) favor the Democrats by 16 points, while the margin is an overwhelming 57 points among those less certain to vote (Turnout Score below 70). With Latinos making up approximately 27% of the likely electorate in these districts, their voting decisions (and turnout level) could certainly play a critical role in determining partisan control of the House in 2019.

  • Donald Trump appears to be more of a liability than an asset for GOP candidates as they seek Latino support. Latino voters disapprove of the job being done by President Trump by a lopsided 40-point margin, with 64% saying they disapprove and just 24% saying approve. The proportion disapproving exceeds 60% in the House battleground CDs (62%), Nevada (65%), and Arizona (67%). We see a large gender gap regarding Donald Trump—72% of women disapprove, compared with 54% of men—but no significant generational difference. While Trump's support is famously high among whites with no college education, Latinos with just a high school degree or less education give Trump very low marks: 16% approve, 72% disapprove.
    • The president's most notable legislative achievement, the 2017 tax bill, is also viewed negatively. Just one in four (25%) Latinos have a favorable opinion of the law, while nearly half (46%) view it unfavorably. However, opinion of the tax bill is notably less negative among Latinos age 55 and over (28% favorable, 41% unfavorable), English-dominant voters (31%, 43%), and those with a four-year college degree (35%, 44%).

Healthcare will be a key issue for Latinos as they make their voting decisions this fall, especially female and older Latinos. This will likely benefit Democrats, as Latinos voice strong support for government healthcare programs—especially Medicaid and CHIP—and express more confidence in Democrats than Republicans to handle the issue.

  • Healthcare will be a top-tier voting issue for Latinos in 2018. While immigration (35%) emerges clearly in this survey as their top voting issue, education (25%) and healthcare (22%) are the next most frequently selected issues. Healthcare ranks ahead of such issues as jobs, taxes and government spending, and national security.

    • Latinos age 55 and older are much more likely than younger Latinos to cite healthcare as an important voting issue, with 31% selecting the issue (a virtual tie for top choice with immigration at 32%).

    • Women (28%) are nearly twice as likely as men (15%) to say healthcare will play an important role in determining their 2018 votes.

    • Healthcare will play a strong role in determining the votes of Latino Democrats (27%) and independents (23%), but not Republicans (8%).

  • Latinos generally embrace a strong role for the public sector in providing health coverage. Fully 81% have a favorable opinion of Medicaid, including 64% very favorable, while just 8% are unfavorable. Similarly, the Children's Health Insurance Program (CHIP) enjoys a favorable rating from 83% of Latinos, including 66% very favorable. Latino support for the Affordable Care Act is not as overwhelming, but they do hold a favorable opinion of the ACA by nearly two to one: 54% favorable to 29% unfavorable (14% are neutral).

  • Looking forward, Latino voters trust Democrats in Congress (49%) more than President Trump and Republicans in Congress (14%) to deal with the issue of healthcare, a 35-point advantage (30% trust both equally). This should give Democrats a significant edge as candidates of both parties seek support from Latino voters concerned about healthcare issues. Indeed, the Democrats' advantage on this measure expands to 57 points among Latinos who report healthcare will be one of their top voting issues.

    • Political independents trust Democrats over Republicans by 23 points.

    • Women (+43 points) and those age 55 and older (+41) express strong trust in Democrats.

  • Education also emerges as a key voting issue for some groups of Latino voters. Education is ranked second as a voting issue for Latinos under age 40 (34%), those with a four-year college degree (29%), moderates (27%), and those living in suburban areas (30%), and it is the number-one voting issue for Arizona Latinos (40%), independents (31%), and those undecided on their House vote (32%).

Positive healthcare campaign messages can be strong motivators for Latinos to vote Democratic this cycle. The survey identifies Democratic healthcare policy ideas that are popular among key persuasion audiences.

  • Among Latinos who are persuasion targets in this election, we find great enthusiasm in the survey for a proposal to make everyone, regardless of age, eligible to purchase affordable health insurance through Medicare if they choose to do so. Fully 56% of undecided voters, and 56% of independents, strongly support this proposal.

    • Support is slightly weaker, though still solid, for creating a national health insurance plan, like Medicare for All, under which everyone would receive their health insurance through the government. This is strongly supported by 54% of undecided voters and 53% of independents (support for this version of Medicare for All is much weaker among Republicans).

  • Latino persuasion targets also express support for increasing the amount of financial assistance available for those who purchase private health insurance under the Affordable Care Act, to make their insurance more affordable, strongly supported by 48% of undecided voters and 50% of independents.

    • Support among Republican Latinos is much milder (33% strong support).

  • Persuadable voters voice much less enthusiasm for a final proposal: Make all low-income children eligible for Medicaid health insurance, regardless of their immigration status. While 62% of all Latinos strongly support this idea, that is mostly a function of overwhelming support from Latinos already voting Democratic (72% strongly support) rather than undecided voters (42%).

    • This idea is very popular among Latinos who are least certain to turn out this year (70% strongly support).

The survey reveals that criticisms of a candidate's record on healthcare issues can also be powerful messages for persuadable Latino voters.

Five negative campaign messages emerge from the survey as the strongest in terms of reducing a candidate's likelihood of receiving support from undecided Latinos. Voting to charge older health consumers more for coverage ('age bands') is the single strongest criticism, but all of these could prove very effective. All five of these criticisms would apply to nearly all GOP congressional incumbents, and in every case at least 60% of undecided voters say this fact would make them much less likely to vote for a candidate.

  • Voted to allow insurance companies to charge people age 50 and older five times as much as young people for health insurance (74% much less likely)

  • Voted to give huge tax cuts to big pharmaceutical companies that continue to jack up the prices they charge for prescription medicines (66%)

  • Voted to allow insurance companies to deny coverage to people with preexisting medical conditions (64%)

  • Voted to cut Medicaid by hundreds of billions of dollars and take away Medicaid coverage from millions of people (61%)

  • Voted to give large tax cuts to millionaires and billionaires, paid for by eliminating health coverage for millions of Americans (60%)

Three other criticisms were convincing to a significant proportion of Latino voters, but prove somewhat less powerful than the messages cited above.

  • Voted to allow insurance companies to set limits on how much they will cover in a year, so people with very high medical expenses are not fully covered (57%)

  • Voted to allow insurance companies to sell health insurance plans that do not cover essential health benefits, such as maternity care and prescription drugs (57%)

  • Voted to increase out-of-pocket healthcare costs, such as co-pays and deductibles, for many individuals who purchase their own health insurance (55%)

Finally, two of the tested criticisms did not prove very convincing to persuadable Latino voters. These messages appear to be appreciably weaker than all the others included in the survey:

  • Favors making it harder for citizen children living in immigrant families to participate in health and nutrition programs (42%)

  • Voted to repeal the Affordable Care Act, also known as Obamacare (42%)

The relatively weak response to the final item—repealing the ACA—is notable. Several of the more effective negative messages refer to a candidate's vote to repeal the ACA, but do not reference ACA explicitly. That appears to be very significant in terms of delivering a persuasive campaign communication. It is considerably more persuasive to inform Latino voters about the concrete consequences that would follow repeal than to talk about 'ACA repeal' as an issue.

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