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March 5, 2021

The Future of Health Policy in a Partisan United States: Insights From Public Opinion Polls

Author Affiliations
  • 1Harvard T.H. Chan School of Public Health, Boston, Massachusetts
  • 2The Commonwealth Fund, New York, New York
JAMA. 2021;325(13):1253-1254. doi:10.1001/jama.2021.1147

As a result of the 2020 election, Democrats now have control of 3 bodies of national government: the presidency and both houses of Congress. But their margins in the Senate and House of Representatives are slim, which likely means very close votes on major legislation. Over time, the voting patterns of elected officials have tipped more closely to the views of people who identify with their own political party than those of the public as a whole, emphasizing the importance of analyzing policy preferences by party. Since the mid-1990s, those who identify with the 2 political parties have grown further apart in their policy preferences. In 2019, average Democrats differed from average Republicans in their views across 30 policy-related issues about what government should do in the future by 39 percentage points, more than double the gap in 1994.1 What is not often recognized is how profoundly divided those who identify as Democrats and Republicans are on key issues of health care policy today, such as Medicaid spending and abortion.

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    2 Comments for this article
    Incremental Reform
    John Eresian, AB, MBA |
    The pubic supports full-throated federal support when it comes to war or vaccine development but only incremental support for universal healthcare coverage and federal price caps. So there goes any hope for near-term cost control.
    Credibility Gap
    Michael Mundorff, MBA, MHSA | Integrated healthcare system
    If “action to deal with the COVID-19 pandemic shows the least partisan differences” then someone should tell Republican members of Congress, who after urging “bipartisanship” unanimously opposed the March 2021 COVID relief legislation despite broad bipartisan support among the general population.

    Partisan politics appears to be less of a problem than partisan politicians.