Nearly one in four Californians (23%) say they know someone who has died of COVID-19

Nearly 9 in 10 (86%) say it is important for the governor and lawmakers to work on making sure there are enough doctors, nurses, and other health care providers

52% of Californians have skipped or delayed care in the last 12 months primarily due to COVID-19 or cost; many say the delays have made their health condition worse

Californians say controlling the spread of COVID-19 and making health care more affordable are the two most important priorities facing the state in 2021 — tied with improving public education and ahead of addressing homelessness, promoting jobs, and taking on a range of other issues, according to a newly released statewide survey conducted by the California Health Care Foundation and NORC at the University of Chicago. More Californians — 63% — say addressing the COVID-19 crisis is “extremely important” than any other priority in the three years CHCF has conducted this annual survey. Half (50%) prioritize making health care more affordable.

The 2021 CHCF California Health Policy Survey, conducted between November 19, 2020, and January 12, 2021, among a representative sample of 1,541 adults age 18 or older, also captured Californians’ views on getting vaccinated, accessing health care, equity issues in the health system, and the rising cost of care.

The survey found 23% of Californians say they know someone who has died of COVID-19, with larger numbers among Black (32%), Latinx (27%), and Asian Californians (26%), compared to 17% of White residents.

Nearly three in four of those surveyed (71%) say they “definitely” or “probably” will be vaccinated once the COVID-19 vaccine becomes available to them. A total of 13% say they will “probably not” be vaccinated, and 16% say they will “definitely not” get the vaccine. (The survey began fielding in mid-November, before the US Food and Drug Administration issued Emergency Use Authorizations for both the Pfizer and Moderna vaccines.)

In addition to asking about broad policy priorities and vaccine attitudes, the survey also asked about specific health care policy priorities. Californians put addressing COVID-19 at the top of this list too, with 59% saying that ensuring state and county public health departments have the resources they need to control the spread of COVID-19 is “extremely important.” Nearly half (49%) say making sure there are enough doctors, nurses, and other health care providers is “extremely important.” A total of 45% say making sure people with mental health problems can get the treatment they need is “extremely important.”

As was the case at the beginning of the pandemic, just over half of Californians (52%) report that they or a family member skipped or postponed health care in the last 12 months — mostly due to issues related to COVID-19. Half of Californians (51%) also say they took at least one action to delay or skip care because of cost in the last 12 months. Of those who cut back on care due to cost, 41% say the steps they took because of cost made their health condition worse.

“COVID-19 has definitively shaped the views of Californians over the last year, and addressing the pandemic has become Californians’ top policy priority by far. Still, ongoing issues like the high cost of health care, the number of health care providers, and access to mental health care remain top of mind for many,” says Kristof Stremikis, director of Market Analysis and Insight at the California Health Care Foundation. “Health equity is also a concern. Significant numbers of Californians say it is harder for Black and Latinx people to get the care they need compared to White people. A strong majority of people who see racial and ethnic inequities in health care believe that that federal and state governments have the biggest responsibility to help solve the problem.”

Other key findings from the survey include:

• Equity remains a top concern. Just over half of Californians (51%) say it is “harder” or “much harder” for Black people to get the health care they need when they are sick compared to White people. A similar number (49%) report that it is “harder” or “much harder” for Latinx people.
• Cost of care is a lingering issue. The high cost of care was the cause of 51% of Californians delaying, skipping, or cutting back on care in the last 12 months — with 41% of those who cut back on care saying it made their health condition worse. Six in 10 Californians are “very” or “somewhat” worried about unexpected medical bills (62%) and out-of-pocket costs (60%). Some 54% of Californians are worried about affording treatment for COVID-19, with one-third of Latinx (34%), Black (33%), and Asian Californians (29%) saying they are “very worried” about affording treatment, compared to 17% of White Californians.
• Expanding coverage continues to be popular. Some 64% of Californians favor increasing financial assistance to make coverage more affordable for those purchasing insurance through Affordable Care Act marketplaces like Covered California. Also, 64% favor creating a national “public option” — a government–administered health plan that would compete with private health plans and give people the option to enroll in it if they prefer. Six in 10 (60%) favor lowering the age people are able to enroll in Medicare from 65 to 60. Less than half of Californians (43%) favor a single-payer system. One in four (25%) strongly oppose such a policy.

The 2021 CHCF California Health Policy Survey full report shows data broken down by race/ethnicity, income, political party, and region. Also available are the “topline” (key results and a complete question list) and all of the charts found in the report.

About the California Health Care Foundation