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Illustration: Sarah Grillo/Axios

There's a big disconnect between the health care debates that dominate Washington, the campaigns and the politically active — where all of the talk is about sweeping changes like "Medicare for All" or health care block grants — and what the voters are actually thinking about.

The big picture: In our focus groups with independent, Republican and Democratic voters in several swing states and districts, the voters were only dimly aware of candidates’ and elected officials’ health proposals. They did not see them as relevant to their own struggles paying their medical bills or navigating the health system.

Details: We conducted six focus groups in three states (Texas, Florida and Pennsylvania), facilitated by Liz Hamel, the Kaiser Family Foundation’s director of Polling and Survey Research. Each one had 8–10 people who vote regularly and said health care will be important in their presidential vote in 2020.

The highlights:

  • These voters are not tuned into the details — or even the broad outlines — of the health policy debates going on in Washington and the campaign, even though they say health care will be at least somewhat important to their vote.
  • Many had never heard the term “Medicare for All,” and very few had heard about Medicare or Medicaid buy-in proposals, or Medicaid and Affordable Care Act state block grant plans like the one included in President Trump’s proposed budget.
  • When asked what they knew about Medicare for All, few offered any description beyond “everyone gets Medicare,” and almost no one associated the term with a single-payer system or national health plan.
  • When asked about ACA repeal, participants almost universally felt that Republicans did not have a plan to replace the law.
  • When voters in the groups were read even basic descriptions of some proposals to expand government coverage, many thought they sounded complicated and like a lot of red tape.
  • They also worried about how such plans might strain the current system and threaten their own ability to keep seeing providers they like and trust.

Between the lines: Most voters in these groups don’t seem to see the current health reform proposals on either side of the aisle as solutions to their top problems: paying for care or navigating the health insurance system and red tape.

  • That, combined with a general distrust of politicians, can make these voters wary of any plan that sounds just a little too good to be true to them.

The bottom line: For most voters, the debate will be more meaningful when they see stark differences on health between the Democratic nominee and President Trump in the general election. Then they may be able to focus more on what the differences on health reform mean for the country and their daily lives.

Go deeper

26 mins ago - Health

The Obamacare wars end in a whimper

Illustration: Shoshana Gordon/Axios

Existential threats to the Affordable Care Act just aren’t what they used to be.

The big picture: The anti-Obamacare fire on the right may not be fully extinguished — it still throws off some smoke and a few sparks every once in a while — but it has petered out into irrelevance, dismissed as a distraction even by some of the same conservatives who helped to stoke it in the first place.

Health care ruling saves Republicans from themselves

Illustration: Aïda Amer/Axios

The Supreme Court saved the health care system from imploding Thursday by dismissing a Republican challenge to the Affordable Care Act. But it also saved the GOP itself from another round of intraparty chaos.

Why it matters: Most GOP lawmakers privately admit (and some will even say publicly) they don't want to deal with health care again. The issue generally isn't a good one for them with voters — as they learned the hard way after they failed to repeal the ACA in 2017.

9 hours ago - Economy & Business

Fed chief's second-term audition

Jerome Powell during a virtual news conference. Photo: Daniel Acker/Bloomberg via Getty Images

Federal Reserve Chairman Jerome Powell faces a long, hot summer audition for a second term, with senators watching and weighing his response to potential signs of inflation.

Why it matters: The financial system's chief is one of the most powerful in the world. President Biden hasn’t given any public indication whether he’ll renominate Powell, but Democrats close to the administration say there's a chance he'll make an announcement by Labor Day — well before Powell’s term ends next February.