1. 202.776.9066 | www.lakeresearch.com | November 6, 2008 Health Care and The 2008 Elections Celinda Lake

2. 2 Key Points The 2008 election delivered a substantial mandate for real change. Barack Obamas central argument in the closing days of the campaign was that it was time to turn to the page on the last 8 years and try something new. The margin of victory underscores that the voters are ready for change. The results of the presidential and congressional elections completes the wave that started in 2006. Four years ago, voters wanted change, but felt cross-pressured by the 9/11 dynamic. In 2006, terrorism was not enough to offset weak job approval rating for President Bush and the Congress. And in 2007 voters completed their repudiation of conservative Republican ideas. Health care reform is a key element of the change that voters demand. Consistently over the past year and a half, voters have expressed concern over rising costs and limited access and expressed an appetite for a larger government role. The economy dominated this election as a voting issue. All other issues took a back seat to the economic crisis. The health care issue was the top personal economic issue. The weak state of the economy presents a challenge to health care reform, but also an opportunity. While many politicians will instinctively seek to pull back on spending, health care is one of the key components of voters economic anxiety. Advocates need to drive this point home to policy makers.

3. 3 The vast majority of voters are insured. However, some key constituencies viewed health care as a voting issue. 90% of voters in 2008 had some members of their household covered, 79% had everyone covered.* Of those, 79% were swing voters. Currently, 91% of voters report having some sort of insurance coverage, and 66% had coverage for every member of their families in the last 3 years.** Core health care voters supporting progressive reforms include Democrats, Democratic women, and African-Americans. Older women and seniors are the most attentive voters on this issue. They need to be reassured that reforms will not adversely affect the quality of their health care. *SEIU/AHC polling by Lake Research Partners, November 2006. ** LRP Poll for The Partnership to Fight Chronic Disease. October 4-9, 2008. 1500 Likely Voters (795 Women).

4. 4 The economy dominated this election. Obama won by being the most trusted voice on the economy. He also appealed to voters specifically concerned about health care. Issue (%)ObamaMcCain Economy (63%)53%44% Iraq (10%)59%39% Health Care (9%)73%26% Terrorism (9%)13%86% Energy Policy (7%)50%46% Source: CNN 2008 Exit Polls. 17,836 Interviews

5. 5 Even after the collapse of Bear Stearns, Lehman Brothers and AIG, health care was the top personal economic concern in voters everyday lives for both men and women. LRP Poll for The Partnership to Fight Chronic Disease. October 4-9, 2008. 1500 Likely Voters (795 Women). Now Im going to read you some problems you and your family may face. Please listen carefully, then tell me which ONE of these you personally worry the most about? … Now from the same list, please tell me which ONE of these you personally worry about second most?

6. 6 Leading up to the election, eighty-two percent of voters viewed health care as extremely or very important to their vote for president. Source: Fox News Poll. 10/20-21/2008. 1,100 Registered Voters. (How important will each of the following issues be to your vote for president (in 2008)?...Extremely important, very important, somewhat important, not at all important)...Health care

7. 7 For the past year leading up to the election, we saw no lessening in the public appetite for progressive reformeven if it meant raising taxes. FavorOppose September 2007 February 2008 64% 27% 69% 28% Do you favor or oppose providing access to affordable, quality health care for all Americans even if it mean raising your taxes? Do you feel strongly or not strongly about that choice?* October 2008 31% 64% * Asked of half of sample.

8. 8 Similarly, voters have consistently been more than willing to accept a strong federal government role in making sure all Americans have access to affordable, quality health care. FavorOppose September 2007 February 2008 69% 66%28% 23% Do you favor or oppose providing access to affordable, quality health care for all Americans even if it mean a major role for the federal government? Do you feel strongly or not strongly about that choice? 30%64% October 2008

9. 9 The week before the election, Obama had established clear advantages on health care, jobs, and the economy. GWU Battleground Tracking. October 23,26-29, 2008.

10. 10 Both Obama and McCain voters believe that reducing the cost of health care is the top priority for reform. However, Obama voters are much more likely to be concerned about access as well. Source: Kaiser Family Foundation Poll. N=1622 Registered Voters. 9/2008.

11. 11 The fundamental disagreement between the two camps comes in who is most responsible for making sure that Americans have access to quality, affordable health care. Source: Kaiser Family Foundation Poll. N=1622 Registered Voters. 9/2008. Who should have the most responsibility for making sure Americans receive health insurance coverage?

12. 12 Two thirds of all voters were worried about health care costs, and these voters broke hard for Obama. Source: CNN 2008 Exit Polls. 17,836 Interviews Worried About Health Care (66%) Not Worried about Health Care (33%)

13. 202.776.9066 | www.lakeresearch.com | November 6, 2008 Health Care and The 2008 Elections Celinda Lake