Abstract 4139550: Americans’ Views on Healthcare Coverage, Access, and Equity in the US: Implications for Cardiovascular Health

Background: Increased healthcare coverage and access leads to better cardiovascular outcomes. Policymakers are currently assessing strategies to expand coverage and access through government programs, but Americans’ views on health care remain poorly characterized. Methods: We used the 2022 General Social Survey (GSS) to assess perceptions of US healthcare coverage, access, and equity. We examined responses to 3 questions for all respondents, and stratified by age, income, and political affiliation: (1) whether the rich have easier access to health care, (2) whether it is unfair that those with higher incomes can afford better health care, and (3) whether respondents would be willing to pay higher taxes to improve the level of health care for all. GSS survey weights were used to generate nationally representative estimates. Results: Our analyses included 3544 survey respondents (weighted mean [SD] age, 47.1 [17.9] years). The majority of US adults agreed that the rich have easier access to health care (79.5%, [95% CI 75.7%, 83.3%]). Overall, more than half of Americans believe that differential access based on income is unfair (56.5% [52.0%, 60.9%]), with significant variation based on political party affiliation (Democrats 70.8% [62.4%, 79.2%]) vs Republicans 34.0% [25.9%, 42.1%], p < 0.001). In terms of expanding coverage, 10.7% [8.1%, 13.3%] of Americans were willing to pay higher taxes to improve the level of health care for all, with stronger support among Democrats than Republicans (20.3% [14.4%, 26.2%] vs 2.6% [0.6%, 4.5%], p < 0.001). We found no statistically significant variation in responses based on respondent age and income. Conclusions: In this national study, we find that Americans’ views on healthcare coverage, access, and equity are divided along partisan lines. Despite broad agreement that access is inequitable, only 1 in 10 Americans are willing to pay higher taxes to increase health care coverage nationwide. These results may inform policy priorities around expanding care coverage – including preventative screening, guideline-directed therapies, and in-hospital care for cardiometabolic conditions – with the goal of improving cardiovascular health in the US.