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SEPTEMBER 15, 2014 MEMORANDUM TO: INTERESTED PARTIES FROM: DAVID FLAHERTY, MAGELLAN STRATEGIES RE: UTAH MEDICAID EXPANSION SURVEY SUMMARY ________________________________________________________________________ This memorandum is a summary of a 500n live interview landline and cell phone survey of registered voters in Utah. The survey was fielded on September 8 and 9, and has a margin of error of +/- 4.38% at the 95% confidence level. The focus of this research was to measure voter opinion of four different Medicaid expansion proposals being considered by Governor Gary Herbert and the Utah Legislature. The four proposals presented in the survey include the Traditional Medicaid Expansion Proposal, the Partial Expansion Proposal, the Healthy Utah Proposal, and a “Do Not Expand Medicaid Right Now” Proposal. The full topline results of the survey are also included in this document. Survey Instrument Design The survey questions were designed to first measure voter awareness and interest in the Medicaid expansion issue and then inform respondents how the Utah Medicaid expansion debate came about. Respondents were then read information about each of the four Medicaid expansion proposals in stand-alone question format in random order, and then asked to choose which proposal they believed was the best and should be implemented. Except where otherwise cited, cost and enrollment figures for each proposal were obtained from materials produced for Utah legislators by the Office of the Legislative Fiscal Analyst or the Office of Legislative Research and General Counsel. Summary of Findings The survey finds that Utah registered voters are reluctant to favor any of the four Medicaid expansion proposals currently being considered by Governor Herbert and the state legislature. Of the four Medicaid expansion proposals that were tested in the survey, no individual proposal received 50% support among respondents. After explaining the details of each proposal in a stand-alone question format, on average 30% of respondents were unsure if they favored or opposed the proposals. Of the four proposals, the “Do Not Expand Medicaid Right Now” proposal had the highest percentage of voters favoring a proposal with 45% and the lowest percentage opposing a proposal at 26%.

Sutherland Institute Utah Medicare Expansion Survey Summary 091514

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The survey finds that Utah registered voters are reluctant to favor any of the four Medicaid expansion proposals currently being considered by Governor Herbert and the state legislature. Of the four Medicaid expansion proposals that were tested in the survey, no individual proposal received 50% support among respondents. After explaining the details of each proposal in a stand-alone question format, on average 30% of respondents were unsure if they favored or opposed the proposals. Of the four proposals, the “Do Not Expand Medicaid Right Now” proposal had the highest percentage of voters favoring a proposal with 45% and the lowest percentage opposing a proposal at 26%. The Healthy Utah Proposal was favored by 32% of respondents, opposed by 40% of respondents, and 28% were unsure or did not have an opinion of the proposal. The Traditional Medicaid Expansion and Partial Medicaid Expansion proposals were the least favored proposals by voters, with only 21% and 19% favoring them respectively. A near majority of 49% and 48% of voters oppose the Traditional and Partial Medicaid Expansion proposals, respectively. After respondents were informed about the details of each proposal and then asked to choose which one they believed was the best proposal that should be implemented, a plurality of 31% chose the “Do Not Expand Medicaid Right Now” proposal. Seventeen percent chose the Healthy Utah Proposal, 15% chose the Traditional Medicaid Expansion Proposal, and 10% chose the Partial Medicaid Expansion Proposal. One in five respondents, or 20%, were unsure or did not know which proposal was the best and should be implemented, and 7% did not like any of the proposals.

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Page 1: Sutherland Institute Utah Medicare Expansion Survey Summary 091514

!SEPTEMBER 15, 2014 MEMORANDUM TO: INTERESTED PARTIES FROM: DAVID FLAHERTY, MAGELLAN STRATEGIES RE: UTAH MEDICAID EXPANSION SURVEY SUMMARY ________________________________________________________________________ This memorandum is a summary of a 500n live interview landline and cell phone survey of registered voters in Utah. The survey was fielded on September 8 and 9, and has a margin of error of +/- 4.38% at the 95% confidence level. The focus of this research was to measure voter opinion of four different Medicaid expansion proposals being considered by Governor Gary Herbert and the Utah Legislature. The four proposals presented in the survey include the Traditional Medicaid Expansion Proposal, the Partial Expansion Proposal, the Healthy Utah Proposal, and a “Do Not Expand Medicaid Right Now” Proposal. The full topline results of the survey are also included in this document. Survey Instrument Design The survey questions were designed to first measure voter awareness and interest in the Medicaid expansion issue and then inform respondents how the Utah Medicaid expansion debate came about. Respondents were then read information about each of the four Medicaid expansion proposals in stand-alone question format in random order, and then asked to choose which proposal they believed was the best and should be implemented. Except where otherwise cited, cost and enrollment figures for each proposal were obtained from materials produced for Utah legislators by the Office of the Legislative Fiscal Analyst or the Office of Legislative Research and General Counsel. Summary of Findings The survey finds that Utah registered voters are reluctant to favor any of the four Medicaid expansion proposals currently being considered by Governor Herbert and the state legislature. Of the four Medicaid expansion proposals that were tested in the survey, no individual proposal received 50% support among respondents. After explaining the details of each proposal in a stand-alone question format, on average 30% of respondents were unsure if they favored or opposed the proposals. Of the four proposals, the “Do Not Expand Medicaid Right Now” proposal had the highest percentage of voters favoring a proposal with 45% and the lowest percentage opposing a proposal at 26%.

Page 2: Sutherland Institute Utah Medicare Expansion Survey Summary 091514

Sutherland Institute-Magellan Strategies Utah Medicaid Expansion Proposal Survey Summary September 15th, 2014

Magellan Strategies |1685 Boxelder Street, Suite 300 | Louisville, CO 80027

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2

The Healthy Utah Proposal was favored by 32% of respondents, opposed by 40% of respondents, and 28% were unsure or did not have an opinion of the proposal. The Traditional Medicaid Expansion and Partial Medicaid Expansion proposals were the least favored proposals by voters, with only 21% and 19% favoring them respectively. A near majority of 49% and 48% of voters oppose the Traditional and Partial Medicaid Expansion proposals, respectively. After respondents were informed about the details of each proposal and then asked to choose which one they believed was the best proposal that should be implemented, a plurality of 31% chose the “Do Not Expand Medicaid Right Now” proposal. Seventeen percent chose the Healthy Utah Proposal, 15% chose the Traditional Medicaid Expansion Proposal, and 10% chose the Partial Medicaid Expansion Proposal. One in five respondents, or 20%, were unsure or did not know which proposal was the best and should be implemented, and 7% did not like any of the proposals. Utah Voter Interest and Awareness of Medicaid Expansion Proposals Among all voters, 31% responded as being either extremely interested (11%), or very interested (20%) in the debate surrounding the expansion of Medicaid in Utah, and a plurality of 49% responded as being somewhat interested. Eighteen percent of registered voters responded as not being interested at all. Awareness of the Medicaid expansion debate is strong among all voters, with 76% of respondents having seen, read or heard at least a little information about the Medicaid expansion debate. Among all voters, 10% have seen, read or heard a lot of information, 31% some information, and 35% a little bit of information about the Medicaid expansion proposals. Only 24% of Utah voters have not seen any information at all about the Medicaid expansion proposals. Voter Opinion of Traditional Medicaid Expansion Proposal The Traditional Medicaid Expansion Proposal question was presented to respondents with the following information. “One proposal is referred to as the Traditional Medicaid Expansion Proposal. This proposal would expand Utah’s traditional Medicaid program to individuals at 138 percent of the federal poverty level as required by Obamacare. It would allow more than 160,000 individuals in Utah to obtain Medicaid coverage, although the actual number of qualifying individuals may be significantly higher, based on unexpectedly high enrollment in other states that have expanded Medicaid.i Some of the individuals that would be covered under this proposal currently have private health insurance, while others do not. It is estimated that just over 63 percent of working age adults in this group are single, and 61 percent do not have children.ii By 2021, this plan is estimated to cost $60 million in state tax dollars, with the remaining cost of $640 million paid for with funding from the federal

Page 3: Sutherland Institute Utah Medicare Expansion Survey Summary 091514

Sutherland Institute-Magellan Strategies Utah Medicaid Expansion Proposal Survey Summary September 15th, 2014

Magellan Strategies |1685 Boxelder Street, Suite 300 | Louisville, CO 80027

MagellanStrategies.com | 303-861-8585

3

government. If federal funding were cut in the future, Utah lawmakers would have to decide whether to pay more state tax dollars to continue health coverage or cut Medicaid health benefits.” “After hearing the information about this proposal, would you say you strongly favor, somewhat favor, somewhat oppose, strongly oppose or are you undecided about this proposal?” Among all voters, 49% oppose the Traditional Medicaid Expansion proposal, 21% favor the proposal, and 30% were unsure or did not have an opinion of the proposal. Voter Opinion of Traditional Medicaid Expansion Proposal by Voter Subgroup All

Voters

Men

Wom All Rep

Cons. Rep

Mod Rep

All Ind

Cons. Ind

Mod Ind

All Dem

Total Favor 21% 21% 22% 9% 5% 19% 29% 14% 40% 45% Total Oppose 49% 55% 45% 60% 66% 52% 45% 59% 38% 18% No Opinion 30% 24% 33% 31% 29% 29% 26% 27% 22% 37%

Voter Opinion of Traditional Medicaid Expansion Proposal by Voter Subgroup All

Voters CD 01

CD 02

CD 03

CD 04

30K Less

31K 70K

71K 100K

101K More

Age 65+

Total Favor 21% 19% 21% 28% 18% 25% 23% 24% 20% 20% Total Oppose 49% 52% 46% 47% 52% 50% 48% 55% 48% 54% No Opinion 30% 29% 33% 25% 30% 25% 29% 21% 32% 26%

Voter Opinion of Partial Medicaid Expansion Proposal The Partial Medicaid Expansion Proposal question was presented to respondents with the following information. “One proposal is referred to as the Partial Medicaid Expansion proposal. This proposal would subsidize private health coverage for anyone making less than 100 percent of the federal poverty level, which is estimated to be at least 70,000 individuals. It is estimated that 66 percent of the working age adults in this group are single, and 66 percent do not have children.iii By 2021, this plan is estimated to cost $25 million in state tax dollars if the federal government approves a more generous federal funding option for this proposal, with the remaining cost of $275 million paid for with funding from the federal government. If the federal government turns down the more generous federal funding option, approximately $75 million in state tax dollars would be required and federal funding would go down to approximately $225 million.iv In either case, if federal funding were cut in the future, Utah lawmakers would have to decide whether to pay more state tax dollars to continue health coverage or cut Medicaid health benefits.”

Page 4: Sutherland Institute Utah Medicare Expansion Survey Summary 091514

Sutherland Institute-Magellan Strategies Utah Medicaid Expansion Proposal Survey Summary September 15th, 2014

Magellan Strategies |1685 Boxelder Street, Suite 300 | Louisville, CO 80027

MagellanStrategies.com | 303-861-8585

4

“After hearing the information about this proposal, would you say you strongly favor, somewhat favor, somewhat oppose, strongly oppose or are you undecided about this proposal?” Voter Opinion of the Partial Medicaid Expansion Proposal by Voter Subgroup All

Voters

Men

Wom All Rep

Cons. Rep

Mod Rep

All Ind

Cons. Ind

Mod Ind

All Dem

Total Favor 19% 19% 19% 15% 12% 21% 22% 6% 38% 31% Total Oppose 48% 52% 44% 51% 54% 46% 49% 57% 37% 31% No Opinion 33% 29% 37% 34% 34% 33% 29% 37% 25% 38%

Voter Opinion of the Partial Medicaid Expansion Proposal by Voter Subgroup All

Voters CD 01

CD 02

CD 03

CD 04

30K Less

31K 70K

71K 100K

101K More

Age 65+

Total Favor 19% 22% 17% 22% 16% 29% 26% 15% 19% 16% Total Oppose 48% 45% 50% 48% 48% 42% 49% 52% 50% 50% No Opinion 33% 33% 33% 30% 36% 29% 25% 33% 31% 34%

Voter Opinion of the Healthy Utah Expansion Proposal The Healthy Utah Expansion Proposal question was presented to respondents with the following information. “One proposal is referred to as The Healthy Utah proposal. This proposal would expand Utah’s Medicaid program by using Medicaid funding to subsidize the purchase of private health insurance for individuals who do not currently qualify for Medicaid and make less than 138 percent of the federal poverty level, as required by Obamacare. It would subsidize health insurance premiums for more than 160,000 individuals whose insurance would cover similar health services as traditional Medicaid. The actual number of qualifying individuals may be significantly higher based on unexpectedly high enrollment in other states that have expanded Medicaid.v” “Some of these individuals currently have private insurance, while others do not. It is estimated that just over 63 percent of working age adults in this group are single, and 61 percent of them are without children.vi By 2021, this plan is estimated to cost $40 million in state tax dollars, with the remaining cost of approximately $360 million paid for with funding from the federal government.vii If federal funding were cut in the future, Utah lawmakers would have to decide whether to pay more state tax dollars to continue insurance subsidies or cut Medicaid health benefits.”

“After hearing information about this proposal, would you say you strongly favor, somewhat favor, somewhat oppose, strongly oppose or are you undecided about this proposal?”

Page 5: Sutherland Institute Utah Medicare Expansion Survey Summary 091514

Sutherland Institute-Magellan Strategies Utah Medicaid Expansion Proposal Survey Summary September 15th, 2014

Magellan Strategies |1685 Boxelder Street, Suite 300 | Louisville, CO 80027

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5

Voter Opinion of the Healthy Utah Proposal by Voter Subgroup* All

Voters

Men

Wom All Rep

Cons. Rep

Mod Rep

All Ind

Cons. Ind

Mod Ind

All Dem

Total Favor 32% 28% 36% 28% 24% 37% 36% 30% 43% 39% Total Oppose 40% 46% 34% 45% 49% 38% 36% 42% 31% 30% No Opinion 28% 26% 30% 27% 27% 25% 28% 28% 26% 31%

Voter Opinion of the Healthy Utah Proposal by Voter Subgroup* All

Voters CD 01

CD 02

CD 03

CD 04

30K Less

31K 70K

71K 100K

101K More

Age 65+

Total Favor 32% 31% 30% 37% 31% 43% 38% 21% 34% 24% Total Oppose 40% 40% 47% 34% 38% 42% 35% 51% 38% 45% No Opinion 28% 29% 23% 29% 31% 15% 28% 29% 28% 31%

Voter Opinion of the “Do Not Expand Medicaid Right Now” Proposal The “Do Not Expand Medicaid Right Now” proposal question was presented to respondents with the following information. “One proposal is to not expand Medicaid right now. This proposal would temporarily leave Utah’s Medicaid program as it is today while lawmakers seek to create new, targeted policies or programs that provide health coverage or services to the most vulnerable individuals who do not currently qualify for Medicaid, such as the medically frail, or individuals whose income is too high to qualify for Medicaid, but is significantly lower than the federal poverty line. These policies or programs would be funded by state tax dollars and may involve some federal funding. Until the new policies or programs are determined, it is unknown how many individuals would qualify for these benefits or services or how much they would cost. When Obamacare allows states to apply for greater Medicaid flexibility in 2017, or if the federal government offers new Medicaid flexibility provisions, such as Medicaid block grants to states, the state would then seek to significantly reform its Medicaid program in a way that best meets the needs of Utah residents.” “After hearing information about this proposal, would you say you strongly favor, somewhat favor, somewhat oppose, strongly oppose or are you undecided about this proposal?” Voter Opinion of the Do Not Expand Medicaid Now Proposal by Voter Subgroup* All

Voters

Men

Wom All Rep

Cons. Rep

Mod Rep

All Ind

Cons. Ind

Mod Ind

All Dem

Total Favor 45% 46% 43% 50% 51% 47% 42% 47% 46% 24% Total Oppose 26% 32% 21% 19% 17% 24% 30% 22% 29% 42% No Opinion 29% 22% 36% 31% 32% 29% 28% 31% 25% 34%

Page 6: Sutherland Institute Utah Medicare Expansion Survey Summary 091514

Sutherland Institute-Magellan Strategies Utah Medicaid Expansion Proposal Survey Summary September 15th, 2014

Magellan Strategies |1685 Boxelder Street, Suite 300 | Louisville, CO 80027

MagellanStrategies.com | 303-861-8585

6

Voter Opinion of the Do Not Expand Medicaid Now Proposal by Voter Subgroup* All

Voters CD 01

CD 02

CD 03

CD 04

30K Less

31K 70K

71K 100K

101K More

Age 65+

Total Favor 45% 40% 45% 44% 49% 38% 49% 46% 46% 36% Total Oppose 26% 30% 28% 31% 13% 29% 23% 32% 25% 27% No Opinion 29% 30% 27% 25% 38% 33% 28% 22% 29% 37%

Voter Opinion of Best Proposal That Should Be Implemented After hearing information about the four different proposals, respondents were asked which one they thought was the best and should be implemented. Voter Opinion of Best Proposal That Should Be Implemented by Voter Subgroup* All

Voters

Men

Wom All Rep

Cons. Rep

Mod Rep

All Ind

Cons. Ind

Mod Ind

All Dem

Don’t Expand 31% 34% 29% 42% 47% 30% 25% 31% 22% 11% Unsure/DK 20% 13% 25% 19% 20% 18% 22% 26% 19% 17% Healthy Utah 17% 14% 19% 17% 13% 26% 15% 16% 13% 19% Trad. Med. 15% 17% 14% 7% 6% 9% 19% 7% 29% 41% Partial Med. 10% 11% 9% 10% 8% 13% 10% 8% 13% 8% Don’t Like Any 7% 11% 4% 5% 6% 4% 9% 12% 4% 4%

Voter Opinion of Best Proposal That Should Be Implemented by Voter Subgroup* All

Voters CD 01

CD 02

CD 03

CD 04

30K Less

31K 70K

71K 100K

101K More

Age 65+

Don’t Expand 31% 30% 32% 30% 33% 25% 30% 36% 34% 28% Unsure/DK 20% 13% 22% 21% 25% 22% 22% 16% 13% 26% Healthy Utah 17% 15% 14% 21% 17% 17% 18% 17% 18% 10% Trad. Med. 15% 16% 21% 13% 12% 11% 16% 19% 19% 13% Partial Med. 10% 15% 5% 11% 6% 15% 9% 6% 12% 9% Don’t Like Any 7% 11% 6% 4% 7% 10% 5% 6% 4% 14%

Conclusion The focus of this research project was to inform Utah registered voters about the facts of four different Medicaid expansion proposals and measure their opinion of each proposal. Great care was taken when researching the facts presented about each proposal, including estimated costs and individuals covered by each proposal, so respondents could provide their opinions based on that information. What we find from the survey data is that Utah voters do not favor any one proposal overwhelmingly. Combined, the Healthy Utah, Traditional and Partial Medicaid expansion plans are supported by 42% of Utah voters. The “Don’t Expand Now” and voters that are unsure about any proposal combined is 51% of all registered voters. If we add the 7% of voters that don’t like any of the proposals to the “Don’t Expand Now”/unsure group of voters, 58% of registered voters prefer not to implement any of the other three plans.

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Sutherland Institute-Magellan Strategies Utah Medicaid Expansion Proposal Survey Summary September 15th, 2014

Magellan Strategies |1685 Boxelder Street, Suite 300 | Louisville, CO 80027

MagellanStrategies.com | 303-861-8585

7

Survey Commissioned By This survey was commissioned by Sutherland Institute. Survey Methodology This survey was conducted by live dialing to a landline and cell phone sample. The sample was randomly drawn from a Utah voter file. The results were weighted based upon voting registration numbers, which are included in this document. Any questions regarding the methodology of this survey should be directed to David Flaherty of Magellan Strategies at [email protected] or 303-861-8585. Utah Voter Registration Demographics The following are demographics compiled from a statewide voter file obtained from the Utah Lt. Governor’s office. Gender Female – 54% Male – 46% Party Republican, 44% Unaffiliated and Other Party, 44% Democrat, 10% Age Range 18 to 29, 18% 30 to 44, 31% 45 to 54, 16% 55 to 64, 16% 65+, 19% Region CD-01, 26% CD-02, 25% CD-03, 26% CD-04, 23% Hispanic Origin Quotas The Utah voter file does not indicate the Hispanic origin or race of each individual voter. To determine a reliable estimate of the Hispanic percentage of registered voters Magellan Strategies used data from the Pew Research Hispanic Trends Project. Pew Research estimated that 123,000 Hispanic individuals, or 7% of

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Sutherland Institute-Magellan Strategies Utah Medicaid Expansion Proposal Survey Summary September 15th, 2014

Magellan Strategies |1685 Boxelder Street, Suite 300 | Louisville, CO 80027

MagellanStrategies.com | 303-861-8585

8

registered voters were eligible to vote in the 2012 general election. To review their methodology please visit their website at http://ow.ly/BqeOb. About Magellan Strategies Magellan Strategies is a full-service survey research firm offering quantitative, qualitative, and predictive data modeling services to political candidates, campaigns and policy organizations across the country. !!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!i!For!examples,!see!Gosia!Wozniacka,!“Medicaid!enrollees!strain!oregon,”!Associated*Press,!http://bigstory.ap.org/article/apnewsbreakAmedicaidAenrolleesAstrainAoregon;!and!Karen!Bouffard,!“Enrollment!in!Michigan!Medicaid!expansion!exceeds!322K,”!The*Detroit*News,!http://www.detroitnews.com/article/20140711/BIZ/307110028;!and!Jennifer!Haberkorn,!“Enrollment!in!Medicaid,!children’s!health!program!grows!by!3!million,”!Politico,!http://www.politico.com/story/2014/04/medicaidAchipAenrollmentAgrowthA105383.html.!!ii!Norman!J.!Waitzman!et.!al,!“Who!would!be!newly!eligible!for!coverage!under!the!Healthy!Utah!Plan,!or!Full!Medicaid!Expansion?,”!presentation!to!the!Utah!Legislature’s!Health!Reform!Task!Force,!http://le.utah.gov/interim/2014/pdf/00003826.pdf.!!iii!Ibid.*!iv!Estimate!based!on!moving!from!a!90/10!federal!match!rate!to!a!70/30!federal!match!rate.!!v!See!footnote!1.!!vi!See!footnote!2.!!vii!For!state!tax!dollar!figure,!see!“Healthy!Utah!Plan!Overview,”!Utah!Department!of!Health,!http://le.utah.gov/interim/2014/pdf/00003836.pdf.!Federal!funding!estimate!was!calculated!based!on!a!90/10!federal!match!rate.!

Page 9: Sutherland Institute Utah Medicare Expansion Survey Summary 091514

!!!!!Utah Medicaid Expansion Survey Topline Results Magellan Strategies are pleased to present the topline results for a 500n live landline and cell phone survey of registered voters in the state of Utah. The interviews were conducted September 8th and 9th, 2014. This survey has a margin of error of +/- 4.38% at the 95 percent confidence interval. The survey results were slightly weighted based upon the voter registration demographics of Utah.

T1. Are you male or female? Female .................................................................... 54% Male ....................................................................... 46%

T2. Are you registered to vote in the state of Utah as a Republican, a Democrat, an independent voter, with some other party, or are you not registered to vote? Republican .............................................................. 44% Democrat ................................................................ 10% Independent ............................................................ 42% Some other party ....................................................... 4%

Thinking now about the issue of Medicaid expansion in Utah… T3. How interested would you say you are in the debate surrounding expansion of Medicaid in Utah? Would you say that you are extremely interested, very interested, somewhat interested or not interested at all? Extremely interested ................................................ 11% Very interested ........................................................ 20% Somewhat interested ............................................... 49% Not interested at all ................................................. 18% Don’t know or refused .............................................. 2%

Page 10: Sutherland Institute Utah Medicare Expansion Survey Summary 091514

Magellan ID#: UTMED-090814 Utah Medicaid Expansion Survey Topline Results Field Dates: 9/8/14 – 9/9/14, MoE +/- 4.38%, 500n

Magellan Strategies | 1685 Boxelder St. Suite 300 | Louisville, CO 80027

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T4. How much information have you seen, read or heard about the expansion of Medicaid in Utah? Would you say have seen, read or heard a lot of information, some information, a little bit of information or no information at all? A lot of information ................................................. 10% Some information .................................................... 31% A little bit of information ......................................... 35% No information at all ............................................... 24% Don’t know or refused .............................................. 0%

As you may know, a provision of the Affordable Care Act, also known as “Obamacare,” required states to expand Medicaid to anyone making less than 138 percent of the federal poverty level, which in 2014 is $23,850 dollars for a family of four. But in a 2010 ruling, the U.S. Supreme Court said that the Medicaid expansion provision of “Obamacare” could not be forced on states, and must be an “opt-in” program. Because Obamacare’s Medicaid expansion provision is optional for states, Governor Herbert and the state legislature are currently evaluating several different Medicaid expansion proposals, including:

A “Traditional Medicaid Expansion Proposal”, An alternative Medicaid expansion proposal called the “Healthy Utah Proposal”, A “Partial Medicaid Expansion Proposal”, And finally a proposal to not expand Medicaid at all for now.

I am now going to read to you some information about each proposal. After hearing the information about each plan I would like you to tell me if you strongly favor, somewhat favor, somewhat oppose, or strongly oppose that plan. If you are undecided or unsure there is an option for that as well. Let’s get started. T5. One proposal is referred to as the TRADITIONAL MEDICAID EXPANSION PROPOSAL. This proposal would expand Utah’s traditional Medicaid program to individuals at 138 percent of the federal poverty level as required by Obamacare. It would allow more than 160,000 individuals in Utah to obtain Medicaid coverage, although the actual number of qualifying individuals may be significantly higher, based on unexpectedly high enrollment in other states that have expanded Medicaid. Some of the individuals that would be covered under this proposal currently have private health insurance, while others do not. It is estimated that just over 63 percent of working age adults in this group are single, and 61 percent do not have children. By 2021, this plan is estimated to cost $60 million in state tax dollars, with the remaining cost of $640 million paid for with funding from the federal government. If federal funding were cut in the future, Utah lawmakers would have to decide whether to pay more state tax dollars to continue health coverage or cut Medicaid health benefits.

Page 11: Sutherland Institute Utah Medicare Expansion Survey Summary 091514

Magellan ID#: UTMED-090814 Utah Medicaid Expansion Survey Topline Results Field Dates: 9/8/14 – 9/9/14, MoE +/- 4.38%, 500n

Magellan Strategies | 1685 Boxelder St. Suite 300 | Louisville, CO 80027

www.MagellanStrategies.com | (303) 861-8585

3

After hearing information about this proposal, would you say you strongly favor, somewhat favor, somewhat oppose, strongly oppose or are you undecided about this proposal? Total Favor .............................................................. 21% Total Oppose .......................................................... 49% Unsure or don’t know ............................................ 30% Refused ..................................................................... 0% Strongly favor ............................................................ 7% Somewhat favor ..................................................... 14% Strongly oppose ...................................................... 25% Somewhat oppose ................................................... 24%

T6. One proposal is referred to as the PARTIAL MEDICAID EXPANSION proposal. This proposal would subsidize private health coverage for anyone making less than 100 percent of the federal poverty level, which is estimated to be at least 70,000 individuals. It is estimated that 66 percent of the working age adults in this group are single, and 66 percent do not have children. By 2021, this plan is estimated to cost $25 million in state tax dollars if the federal government approves a more generous federal funding option for this proposal, with the remaining cost of $275 million paid for with funding from the federal government. If the federal government turns down the more generous federal funding option, approximately $75 million in state tax dollars would be required and federal funding would go down to approximately $225 million. In either case, if federal funding were cut in the future, Utah lawmakers would have to decide whether to pay more state tax dollars to continue health coverage or cut Medicaid health benefits. After hearing information about this proposal, would you say you strongly favor, somewhat favor, somewhat oppose, strongly oppose or are you undecided about this proposal? Total Favor .............................................................. 19% Total Oppose .......................................................... 48% Unsure or don’t know ............................................ 33% Refused ..................................................................... 0% Strongly favor ............................................................ 2% Somewhat favor ..................................................... 17% Strongly oppose ...................................................... 23% Somewhat oppose ................................................... 25%

Page 12: Sutherland Institute Utah Medicare Expansion Survey Summary 091514

Magellan ID#: UTMED-090814 Utah Medicaid Expansion Survey Topline Results Field Dates: 9/8/14 – 9/9/14, MoE +/- 4.38%, 500n

Magellan Strategies | 1685 Boxelder St. Suite 300 | Louisville, CO 80027

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4

T7. One proposal is referred to as THE HEALTHY UTAH proposal. This proposal would expand Utah’s Medicaid program by using Medicaid funding to subsidize the purchase of private health insurance for individuals who do not currently qualify for Medicaid and make less than 138 percent of the federal poverty level, as required by Obamacare. It would subsidize health insurance premiums for more than 160,000 individuals whose insurance would cover similar health services as traditional Medicaid. The actual number of qualifying individuals may be significantly higher based on unexpectedly high enrollment in other states that have expanded Medicaid. Some of these individuals currently have private insurance, while others do not. It is estimated that just over 63 percent of working age adults in this group are single, and 61 percent of them are without children. By 2021, this plan is estimated to cost $40 million in state tax dollars, with the remaining cost of approximately $360 million paid for with funding from the federal government. If federal funding were cut in the future, Utah lawmakers would have to decide whether to pay more state tax dollars to continue insurance subsidies or cut Medicaid health benefits. After hearing information about this proposal, would you say you strongly favor, somewhat favor, somewhat oppose, strongly oppose or are you undecided about this proposal? Total Favor .............................................................. 32% Total Oppose .......................................................... 40% Unsure or don’t know ............................................ 28% Refused ..................................................................... 0% Strongly favor ............................................................ 5% Somewhat favor ..................................................... 27% Strongly oppose ...................................................... 18% Somewhat oppose ................................................... 22%

T8. One proposal is to NOT EXPAND MEDICAID RIGHT NOW. This proposal would temporarily leave Utah’s Medicaid program as it is today while lawmakers seek to create new, targeted policies or programs that provide health coverage or services to the most vulnerable individuals who do not currently qualify for Medicaid, such as the medically frail, or individuals whose income is too high to qualify for Medicaid, but is significantly lower than the federal poverty line. These policies or programs would be funded by state tax dollars and may involve some federal funding. Until the new policies or programs are determined, it is unknown how many individuals would qualify for these benefits or services or how much they would cost. When Obamacare allows states to apply for greater Medicaid flexibility in 2017, or if the federal government offers new Medicaid flexibility provisions, such as Medicaid block grants to states, the state would then seek to

Page 13: Sutherland Institute Utah Medicare Expansion Survey Summary 091514

Magellan ID#: UTMED-090814 Utah Medicaid Expansion Survey Topline Results Field Dates: 9/8/14 – 9/9/14, MoE +/- 4.38%, 500n

Magellan Strategies | 1685 Boxelder St. Suite 300 | Louisville, CO 80027

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significantly reform its Medicaid program in a way that best meets the needs of Utah residents. After hearing information about this proposal, would you say you strongly favor, somewhat favor, somewhat oppose, strongly oppose or are you undecided about this proposal? Total Favor .............................................................. 45% Total Oppose .......................................................... 26% Unsure or don’t know ............................................ 29% Refused ..................................................................... 0% Strongly favor .......................................................... 13% Somewhat favor ..................................................... 32% Strongly oppose ...................................................... 16% Somewhat oppose ................................................... 10%

T9. Now that you have heard some information about the different proposals and options, which one, if any, do you think is the best proposal or option that should be implemented? Do Not Expand Medicaid Right Now proposal ........ 31% Healthy Utah proposal ........................................... 17% Traditional Medicaid Expansion proposal ................ 15% Partial Medicaid Expansion proposal ....................... 10% Don’t like any of the proposals ................................. 7% Unsure or don’t know ............................................. 20% Refused ..................................................................... 0%

T10. Generally speaking, are you more likely or less likely to vote for a candidate for public office that supports expanding Medicaid in Utah? More likely .............................................................. 34% Less likely ............................................................... 42% Unsure or no opinion .............................................. 24% Refused ..................................................................... 0%

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Magellan ID#: UTMED-090814 Utah Medicaid Expansion Survey Topline Results Field Dates: 9/8/14 – 9/9/14, MoE +/- 4.38%, 500n

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T11. Among the following options, which best describes how you pay for your most of your own healthcare expenses? Employer provided healthcare plan ......................... 58% Pay own healthcare not selected from exchange ..... 15% Medicare, the federal program for seniors ................. 9% Pay own healthcare selected from exchange ............. 5% Uninsured and no healthcare plan ........................... 4% Medicaid, the state program for the poor ................... 1% Some other option ..................................................... 7% Refused .................................................................... 1%

T12. On most political issues, do you consider yourself to be conservative, moderate or liberal? Conservative ........................................................... 49% Moderate ................................................................ 38% Liberal ..................................................................... 10% Unsure or refused ..................................................... 3%

And now I have a few questions for statistical purposes only… T13. Is there anyone currently living in your household that is age 18 or younger? Yes .......................................................................... 44% No .......................................................................... 56% Don’t know or refused ............................................. 0%

T14. Are you married, widowed, separated, divorced, single and never been married, or unmarried and living with a partner? Married ................................................................... 77% Single and have never been married ....................... 15% Widowed .................................................................. 3% Divorced ................................................................... 3% Unmarried and living with a partner ......................... 1% Separated .................................................................. 1% No opinion ............................................................... 0%

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Magellan ID#: UTMED-090814 Utah Medicaid Expansion Survey Topline Results Field Dates: 9/8/14 – 9/9/14, MoE +/- 4.38%, 500n

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T15. What is the highest level of education that you have completed? High school graduate or less ................................... 10% Associate or technical degree .................................. 13% Completed some college ......................................... 27% Completed Bachelor’s 4-year college degree ........... 30% Completed some graduate school ............................. 5% Completed graduate degree .................................... 15% Unsure or refused ...................................................... 0%

T16. Which of the following age groups applies to you? Are you between the ages of 18 and 29, 30 and 44, 45 and 54, 55 and 64, or are you 65 or older? 18-29 ...................................................................... 18% 30-44 ...................................................................... 31% 45-54 ...................................................................... 16% 55-64 ...................................................................... 16% 65+ ......................................................................... 19% Refused ..................................................................... 0%

T17. For statistical purposes only is your ethnicity Hispanic or non-Hispanic? Hispanic ................................................................... 7% Non-Hispanic ......................................................... 92% Don’t know or refused .............................................. 1%

T18. For statistical purposes only what is your race? Are you white, black or African American, Asian, Pacific Islander or do you belong to some other racial group? White ...................................................................... 94% Black or African American ........................................ 0% Asian ......................................................................... 0% Pacific Islander .......................................................... 0% Some other group ...................................................... 5% Refused ..................................................................... 1%

Page 16: Sutherland Institute Utah Medicare Expansion Survey Summary 091514

Magellan ID#: UTMED-090814 Utah Medicaid Expansion Survey Topline Results Field Dates: 9/8/14 – 9/9/14, MoE +/- 4.38%, 500n

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T19. Which of the following best describes your current employment status? Employed full time .................................................. 43% Employed part time ................................................. 16% Unemployed or temporarily out of work ................... 4% Retired .................................................................... 18% Homemaker ............................................................ 13% Student ...................................................................... 5% Unsure or refused ...................................................... 1%

T20. Again for statistical purposes only, what was the total income of everyone in your household last year before taxes? $20,000 or less ......................................................... 7% $21,000 to $30,000 .................................................. 6% $31,000 to $50,000 ................................................ 13% $51,000 to $70,000 ................................................ 17% $71,000 to $100,000 .............................................. 20% $101,000 to $125,000 ............................................ 12% $126,000 or more ................................................... 13% Unsure or refused .................................................... 12%

Survey Methodology This live interview telephone survey was conducted using both landline and cell phone sample. The sample used for this survey was randomly drawn from a statewide Utah voter file. The survey response data was weighted based upon the voter registration demographics of Utah. The interviews were conducted on September 8th and 9th, 2014. Three attempts were made to interview each household in the sample. This survey has a margin of error of 4.38% at the 95 percent confidence interval. Any questions regarding the survey methodology should be directed to David Flaherty, at 303-861-8585 or [email protected].

Utah Voter Registration Demographics The following are demographics compiled from a statewide voter file from the Utah Lt. Governor’s office. Gender Female – 54% Male – 46%

Page 17: Sutherland Institute Utah Medicare Expansion Survey Summary 091514

Magellan ID#: UTMED-090814 Utah Medicaid Expansion Survey Topline Results Field Dates: 9/8/14 – 9/9/14, MoE +/- 4.38%, 500n

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Party Republican, 44% Unaffiliated and Other Party, 44% Democrat, 10% Age Range 18 to 29, 18% 30 to 44, 31% 45 to 54, 16% 55 to 64, 16% 65+, 19% Region CD-01, 26% CD-02, 25% CD-03, 26% CD-04, 23% Hispanic Origin Quotas The Utah voter file does not indicate the Hispanic origin or race of each individual voter. To determine a reliable estimate of the Hispanic percentage of registered voters we used data from the Pew Research Hispanic Trends Project. Their data estimated that 123,000 Hispanic individuals, or 7% of registered voters were eligible to vote in the 2012 general election. To review their methodology please visit their website at http://ow.ly/BqeOb.