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This article concerns research conducted in partnership between West Health and 黑料网, a family of nonprofit and nonpartisan organizations focused on lowering healthcare costs for seniors and on the rising cost of healthcare in the U.S.

WASHINGTON, D.C. -- By a 52% to 39% margin, Americans trust Joe Biden over Donald Trump to lead the U.S. healthcare system most efficiently amid COVID-19. These data are based on a new study conducted by and 黑料网 in the two days immediately following the first presidential debate, but before President Trump was diagnosed . The results largely run along party lines with Biden supported by 95% of Democrats and Trump supported by 88% of Republicans. However, among independents, Biden is trusted (47%) over Trump (40%).

Trust in Biden is substantially higher among women (58% to 32%) and among young adults under the age of 30 (62% to 25%). Among those who watched the debate, the results were similar to the overall total, with Biden holding a 53% to 40% edge.

	Joe Biden	Donald Trump	Other candidate
	%	%	%
U.S. total	52	39	9
POLITICAL IDENTITY:
Democrat	95	3	2
Republican	5	88	7
Independent	47	40	13
GENDER:
Women	58	32	10
Men	46	48	7
AGE:
18-29	62	25	12
30-44	56	32	12
45-64	45	48	7
65+	48	46	4
West Health-黑料网 Post Debate National Healthcare Poll, Sep 30-Oct 1, 2020
黑料网 Panel

These results are based on a survey conducted by web from Sept. 30-Oct. 1, 2020 with 1,518 adults, ages 18+, living in all 50 U.S. states and the District of Columbia via the , a scientifically populated panel of about 100,000 adults nationwide.

Reducing Cost of Healthcare Matches Pandemic in Voting Importance

Survey respondents were also asked to evaluate the importance of three health-related issues in determining their vote for president in the 2020 U.S. election: managing the coronavirus pandemic, reducing healthcare costs and lowering drug costs. Of these, managing the coronavirus pandemic and reducing the cost of healthcare were both cited as the most important or among the most important issues by two-thirds of respondents, compared with 45% for lowering drug costs.

Democrats are considerably more inclined than Republicans to report high importance on the pandemic (94% to 41%) and on reducing the cost of healthcare (81% to 52%) in influencing their vote. Conversely, about one-quarter of Republicans place low importance on the pandemic, compared with 12% of independents and just 1% of Democrats.

Reducing the costs of drugs, though lower in importance than the other two issues, is also the least politically polarizing; Democrats are only modestly more likely to report its influence on their vote.

	U.S. total	Democrat	Republican	Independent
	%	%	%	%
MOST OR AMONG MOST IMPORTANT:
Managing the coronavirus pandemic	67	94	41	64
Reducing the cost of healthcare	66	81	52	62
Lowering the cost of drugs	45	49	41	44
LEAST OR AMONG LEAST IMPORTANT:
Managing the coronavirus pandemic	12	1	24	12
Reducing the cost of healthcare	6	2	8	8
Lowering the cost of drugs	12	12	12	11
West Health-黑料网 Post Debate National Healthcare Poll, Sep 30-Oct 1, 2020
黑料网 Panel

Black and Hispanic adults are somewhat more likely to place high importance on healthcare costs and managing the pandemic than are White adults. Black respondents assert a particularly high importance on managing the pandemic in their vote choice, reported by 88% compared with 71% among Hispanic respondents and 62% among White respondents.

Biden Trusted More to Ensure Racial Equality in Healthcare

A 54% majority also trusts Biden more to ensure racial equality in access to quality healthcare compared with 38% for Trump. While White adults are evenly split, an overwhelming majority of Black respondents trust Biden more (84% to 9%), while Hispanic respondents are twice as likely to better trust Biden (60% to 31%).

	Joe Biden	Donald Trump	Other candidate
	%	%	%
U.S. total	54	38	8
RACE/ETHNICITY:
White Americans	46	45	8
Black Americans	84	9	7
Hispanic Americans	60	31	9
GENDER:
Women	61	30	8
Men	46	46	9
AGE:
18-29	67	20	13
30-44	58	30	12
45-64	46	47	6
65+	49	47	4
West Health-黑料网 Post Debate National Heatlhcare Poll, Sep 30-Oct 1, 2020
黑料网 Panel

As with trust in managing the healthcare system amid the COVID-19 pandemic, Biden's leads in trust regarding equality in access to care are greatest among women (61% to 30%) and those aged 18-29 (67% to 20%). Among men and adults aged 45 and older, the two candidates are equally trusted.

Implications

Even before President Trump's diagnosis with COVID-19, which has had the effect of re-elevating the coronavirus issue in the national dialogue, managing the pandemic carried significant importance to U.S. adults in determining their vote for president. This is sensible given the impact of the pandemic on everyday life in the United States; out of the 128 countries worldwide with at least 5,000 confirmed cases of COVID-19, the U.S. has the and has suffered the highest overall death count globally with over total fatalities.

But the importance of U.S. healthcare more generally should not be understated as a major factor in influencing Americans' voting choice. Reigning in the cost of care is considered as important as the pandemic itself by U.S. adults, highlighting how this issue maintains a prevailing presence in voters' minds. And Biden's trust advantage in managing the healthcare system amid the pandemic underscores the intersection between the two issues.

The 2020 election season has also been characterized by racial strife and civil unrest, as well as the and the among Black and Hispanic persons. And despite the among these groups since the onset of the ACA's Health Insurance Marketplace, access to quality affordable care remains a critical issue for voters. Biden's trust advantage to manage this issue among Black and Hispanic adults likely contributes to support for his candidacy generally among these voter blocks.

Distinct differences are found between White and non-White Americans concerning healthcare worries amid the pandemic. For example, by a margin of nearly two to one, 58% of non-White adults in June reported that they were either "extremely concerned" or "concerned" about not being able to pay for the cost of care if diagnosed with COVID-19 compared with 32% among White respondents. And in April, 14% of U.S. adults, including 22% of non-White respondents, reported that they would avoid care for COVID symptoms due to concerns over costs.

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