The Most Trusted Institution in American Politics Is the Hospital Down the Road

In an electorate that is sour on nearly everything, one institution stands apart. A new national survey of 2,010 likely voters from Leadership for America Fund found that voters rate their local hospital at 67 percent favorable and 16 percent unfavorable, a net of plus 51.

Nothing else tested comes close. Voters rated their state government at net plus 14 and the federal Medicare and Medicaid agency at plus 11. Health insurers and Democrats in Congress were each at plus 5. Republicans in Congress were at minus 3. Sixty percent of the same voters said the country is on the wrong track.

Voters are not looking at Medicaid from a distance. Fifty-three percent said someone in their household has had Medicaid coverage now or in the past five years. Forty-two percent said they or someone in their household delayed care, skipped care, or had trouble paying a medical bill in the past year. Eighty percent reported at least one of six health system experiences the survey tracked, and 38 percent reported three or more.

The more voters have experienced, the more the issue matters to them. Among voters with no exposure, 69 percent said a candidate's position on hospital closures and Medicaid matters to their vote. Among the heavily exposed, it was 89 percent. Overall, 79 percent said it matters, with 44 percent calling it very important.

If the hospital closest to them closed or cut back, 80 percent said it would affect their family, and 41 percent said it would be a major impact. The specific consequences concern them most. Eighty percent are concerned that veterans and seniors would lose care close to home. Seventy-nine percent are concerned about longer ambulance and emergency room waits, and 78 percent about cancer and dialysis patients traveling farther.

Voters do not blame the hospitals. Only 14 percent said hospitals themselves would be most responsible for a closure, the smallest share among the actors tested, and 40 percent named the administration or Congress. A closer look at how voters think about local care shows how far the instinct runs. Fifty-seven percent said closures push up what they and their neighbors pay, and 57 percent agreed that you cannot lower the cost of living without lowering what families pay for health care.

The information gap is wide. Only 25 percent said they have seen, read, or heard anything about a hospital near them cutting back, even though 39 percent report a coverage disruption of their own or someone they know.

On who voters believe, trust follows the bedside. Seventy-three percent said they trust doctors and nurses at their local hospital to tell the truth about hospital funding where they live, and 69 percent said the same of a veterans organization. A national hospital association in Washington was at 43 percent.

The political question is what voters do with all of this. Seventy-one percent said they would be more likely to support a member of Congress who publicly pushes the administration to fix the Medicaid work requirement rule so cancer patients and seniors keep the coverage they were promised. Sixty-eight percent support congressional hearings. Sixty-two percent support limits on how far the administration can go in cutting hospital payments. Bloomberg Government, which first reported the survey, said the findings suggest voters dislike how the administration is carrying out the Medicaid changes, which could be another drag on Republicans in the midterms.