President Donald Trump just promised a “phenomenal” new health care plan within the next two months. Earlier this year, he tweeted: “The Republican Party will become The Party of Health Care!” So, what can we expect?
As a public opinion researcher who has spent decades studying voters’ attitudes — and especially concerns that are more deeply held by women voters — Trump’s pronouncement strikes me as an opportunity for Republicans to expand their thinking about what constitutes health care. If they’re smart, they’ll marry this issue with another issue getting attention from Iowa’s two U.S. Senators and voters across the country: paid family and medical leave — the ability to use the health care you have and to be there for sick or injured loved ones. Sen. Grassley announced a new bipartisan working group of his Senate Finance Committee to focus on the issue, and Sen. Ernst has been a leading Republican voice in support of paid leave for new parents.
Let’s think about why Trump is determined to address health care, despite repeated failed attempts to overturn Obamacare. Voters are concerned about the costs of premiums and prescription drugs, but cost containment remains elusive. Views of the Affordable Care Act have been trending positive since the 2016 election and the law is as popular as it’s ever been.
This is a problem for Republicans heading into 2020. The issue is driving elections and voters are more likely to trust Democrats on the issue of health care.
Republicans need something to say about health care. Here’s where paid leave can come in. Health care and paid leave are acutely key issues for rural voters. And despite Iowa’s senators’ current focus only on paid leave for new parents, paid family and medical leave as a national policy is most popular when it is considered to be for everyone, whether they are caring for a new child, an ill or aging relative or their own serious health issue.
So what about defining health care more broadly, just as voters do? Voters’ concerns with health care go beyond coverage and cost. They extend to the toll acute or chronic health care conditions take on families and the conflict that serious health issues can create between keeping your job and caring for yourself or loved ones. This is an area where Republicans — if they allow themselves to think and legislate more expansively than they have — can realize success.
Many Americans — particularly those without college degrees, those working jobs with few benefits, or those living in rural areas where getting to a health care provider can take much of the day — have to make difficult choices between keeping a job and caring for loved ones or themselves.
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The Family and Medical Leave Act (FMLA) which was created 26 years ago provides for unpaid leave for some people when serious family or personal health issues arise, but it is not practical for many. Today, just 17 percent of workers have access to paid family leave through their jobs. Voters overwhelmingly think it’s time to update the FMLA with paid leave to better meet the needs of working people. And while Republicans have been floating proposals for paid maternity and paternity leave to care for new babies and adopted children, voters again overwhelmingly — want to see coverage that extends to personal or family members’ serious health situations that are common to everyone. In fact, paid leave only for new parents seems unfair to childless people or those who’ve long since exited their childbearing years — while a comprehensive paid leave plan benefits all.
In research we conducted with Perry Undem for the National Partnership for Women & Families, we found men to be as upset as women about not being able to be there for their spouse, child, or parent when they needed them. And while having paid time off for a new baby is a great idea for parents, there are so many other situations that cause people to drop out of the workforce or get fired because their families need them. It is better for people and for the economy if these people stay in the workforce.
A comprehensive paid family leave policy need not become a big government-funded program. In fact, the way voters prefer to pay for it is to have employees and employers share the cost through small payroll contributions. And voters in our survey — including Republicans and especially Republican women — say they are willing to contribute more than would be required to fully fund a national paid family and medical leave program that would provide all working people access to 12 weeks of paid family and medical leave.
If Republicans want to introduce “something phenomenal,” they can start by making it easier for people who work to take care of themselves and their families. A paid leave plan that covers all working people is an obvious way to do that.
• Christine Matthews is president of Bellwether Research in Alexandria, Va, which provides opinion research for policy, advocacy, corporate and political clients.