A survey released today by the California HealthCare Foundation (CHCF) and Field Research Corporation finds that a majority of Californians are concerned that state and local budget problems will translate into major cutbacks in health care programs and services such as hospital emergency rooms and Medi-Cal, and a majority are willing to support several targeted tax increases to maintain current levels of service.
The survey comes in the midst of budget crises at the state and county levels. In Sacramento, the stalemate over the state budget — now nearly a month overdue — is over the magnitude of spending cuts and whether tax increases should be part of the budget-balancing solution. Proposed cuts would reduce the number of people covered by Medi-Cal and cut state payments to physicians, nursing homes, and other providers. Because the federal government matches state spending for Medi-Cal, the proposed state cuts also mean that California would lose these federal funds.
Many counties around the state are cutting their budgets, including funding for hospitals and clinics that provide health care services — from immunizations and prenatal care to emergency services.
Among the findings of the survey:
- Californians were most concerned about cutbacks in the area of hospital emergency rooms and trauma centers. Of those surveyed, 94 percent said they are either very concerned (70 percent) or somewhat concerned (24 percent) about cutbacks to hospital emergency rooms and trauma centers. This compares to just 6 percent who report being "not too" or "not at all" concerned about such setbacks.
- At least three in four Californians were also concerned that budget problems would lead to major cutbacks in health care programs for low-income Californians and the disabled, such as Medi-Cal (89 percent), immunizations and pre-natal care (85 percent), staffing for nursing homes (84 percent), and public health and bioterrorism preparedness (74 percent).
- Majorities of both parties were concerned about major cutbacks in each of the five areas of health care, although concern was greater among Democrats than Republicans. Larger proportions of residents of Southern California than Northern California were very concerned about cutbacks to hospital emergency rooms and trauma centers, staffing for nursing homes, and public health and bioterrorism preparedness.
- Californians' concerns were directly related to a willingness to pay higher taxes. Two-thirds (67 percent) of those surveyed said they would be willing to pay higher taxes to state and local governments to maintain current levels of emergency and trauma care. Half or more of those surveyed also supported paying higher taxes if these funds were used to maintain programs like Medi-Cal (60 percent), immunizations and pre-natal care (57 percent), and staffing for nursing homes (50 percent). Less than half of respondents supported higher taxes to maintain public health and bioterrorism preparedness (43 percent). In each case, support for raising taxes was greater among Democrats than Republicans.
- When respondents were asked about specific options for raising taxes to avoid cutbacks in health programs and services, large majorities favored increasing taxes on beer, wine and alcohol by five cents per serving (81 percent), and increasing taxes on cigarettes by 50 cents per pack (75 percent). More than two in three Republicans and Democrats favored both of these options. By contrast, only 36 percent of those surveyed favored an option to assess property owners an additional annual tax of three cents per square foot for improvements to buildings on developed property, while 60 percent were opposed.
The survey also found that there is a growing level of concern among insured Californians about the continuation of their or another family member's health insurance coverage. Statewide, 60 percent of those currently with health insurance coverage report being very concerned that there could be a time in the near future when they or someone close to them will be without health insurance. This compares to 44 percent who said this in September 2000, the last time this question was posed. In addition, 26 percent of Californians in this survey responded that there is someone close to them for whom they feel financially responsible who has been without health insurance in the past two years. This is up from 21 percent who reported this in September 2000.
Survey results are available through the link below.
About This Survey
The results in this report are derived from a statewide survey of California adults conducted by Field Research Corporation for the California HealthCare Foundation. The survey was administered by telephone from July 1 -13, 2003, in English and Spanish to 1,500 Californians. Sampling was conducted by means of random digit dialing, which selects telephone exchanges within all area codes serving California in proportion to the population. From each exchange a random sample of telephone numbers was created by adding random digits to the telephone exchange selected, permitting access to both listed and unlisted telephones. After the completion of interviewing, the survey results were weighted slightly to estimates of the state's population by region, gender, age, and political party. Results from the overall sample have sampling error of +/- 2.6 percentage points at the 95 percent confidence level. Results from subgroups of the overall sample have somewhat larger sampling error ranges.
Field Research Corporation is an independent market and opinion research organization with headquarters in San Francisco.