TO: Patriot Majority USA and Priorities USA

FROM: Geoff Garin

DATE: May 16 2017
The Impact of the AHCA Vote on
RE: Republican House Members

Summary

Between May 8 and 10, 2017, Garin-Hart-Yang Research surveyed a representative cross section of 750 voters across
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15 districts of Republican House members who supported the passage of the American Health Care Act. Eight of the
districts were won by Donald Trump last November, and seven were carried by Hillary Clinton.

The findings of this research are clear and stark:

The AHCA is disliked by voters, and opposition to the legislation is extremely strong among voters who
know the most about it.

Constituents who already are aware that their representatives voted for the AHCA hold those
representatives in low regard and are much less likely to support them for reelection.

The political toll on Republicans who voted for the bill is very likely to grow even larger as more constituents
become aware of how their representatives voted.

The bottom line: if you are a Republican, the key takeaway from this research is that you want voters to know
as little as possible about the AHCA and to forget about it as soon as possible. But for Democrats and other
progressives, the survey highlights the importance of educating voters and making sure they always
remember that their GOP representatives supported passing this bill.

Discussion of Key Findings

Among all voters in the 15 districts, 38% express a favorable opinion of the Republican health care bill, while 53%
express an unfavorable opinion. There is virtually no intensity among those who are favorable to the bill, with a mere
8% saying they are very favorable. More than two-thirds of those who are negative to the bill feel strongly about it, with
37% saying they are very unfavorable.

Forty-five percent of voters across the 15 districts say they have heard a lot about the GOP bill, and there is a powerful
relationship between knowing a lot about the AHCA and having an intensely negative opinion of it. Among
the 45% who say they know a lot, only 34% are favorable to the bill (11% very favorable, 23% somewhat favorable),
while 65% are unfavorable to the billincluding a majority of 53% who are very unfavorable. Independent voters
who have heard a lot about the AHCA are unfavorable to it by a whopping margin of 70% to 27%. Independents
who have heard less about the bill so far are unfavorable to it by 49% to 32%.

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The 15 districts included in the survey are: AZ-02, CA-25, CA-45, CA-49, FL-18, IA-01, IA-03, IL-06, ME-02, MN-02, MN-03, NY-01, NY-
19, TX-07, VA-02
We find a similar relationship with other key segments of the electorate, including seniors and non-college educated
white women, both of whom are key swing voting blocs for the 2018 mid-term elections:

AGE 65+ WHITE NON-COLLEGE

WOMEN
View of bill: HEARD HEARD HEARD HEARD
A LOT LESS A LOT LESS
FAVORABLE 39% 43% 35% 39%
UNFAVORABLE 59% 38% 65% 44%

At the time we conducted the survey, 56% of voters in these 15 districts were aware of the fact that their representative
voted for the GOP bill. Those who know that their representatives voted for the bill are highly critical of them on a
host of baseline measurements asked early in the surveyfar more so than those who are not yet aware of which side
their representative took. For example:

Voters who know that their representative voted yes on the bill voice disapproval of his/her overall job
performance by 55% to 40%. By comparison, those who do not yet know how their representative voted
give him/her a net positive job approval rating by 54% to 20%.

Voters who know that their representative voted yes on the bill say by 52% to 40% that they would prefer
to elect a Democrat next year rather than reelect their Republican incumbent. Those who are not yet
aware of the health care vote currently prefer to reelect the incumbent, by 56% to 27%.

Independents who know how their representatives voted want to replace them next year by 48% to 33%. Independents
who as yet are unaware of how their representatives voted favor reelecting them by 43% to 21%.

There is compelling evidence from the survey that the health care vote is the central driver of these high negatives
among constituents who know that their representative voted yes on the bill.

We asked respondents to describe their reactions to what they have seen and heard recently about their
representative, prior to asking any questions in the survey about health care or the AHCA. Among those who later in
the survey indicated their awareness that the representative voted yes on the bill, 21% say recent news had made
them more favorable to their representative, and 54% say recent news had made them less favorable. When we
asked those who had become less favorable to volunteer what they had seen or heard recently about their
representative, the bulk of the most specific responses focused on the health care bill:

His/her vote on health care bill, to repeal

ACA/Obamacare 21%
Disagree with his/her views, ideas, stands on
issues 16%
He/she voted for Trumpcare, for the new health
care bill/AHCA 14%
Not going to town hall meetings, not meeting the
people 8%
Not listening to the people, doesnt care about
people 9%
Not doing a good job, not a good representative 7%
For constituents who are not yet aware that their representatives voted for the GOP bill, the survey results
show that many of them are likely to turn against their incumbents if and when they hear more about this
issue.

We read respondents a lengthy statement in support of the AHCA, as well as several criticisms of the bill. After hearing
both, we told respondents their representatives voted for the bill and asked them how they felt about it. Overall, 35%
say hearing more about the issue makes them more favorable to their representative, while 54% say that hearing more
makes them less favorable. The favorable reaction comes primarily from self-identified Republicans (70% more
favorable, 16% less favorable), but independents react negatively by a very wide margin (25% more favorable, 61%
less favorable). Most importantly, the responses indicate a significant potential for taking votes away from
Republican supporters of the AHCA. Voters who initially are undecided about reelecting their representatives react
negatively to hearing more about the bill and how their incumbents voted on it by a wide margin of 15% more favorable
and 66% less favorable. Moreover, 20% of those who initially are inclined to reelect their representatives react
negatively to them after hearing more about the issue.

The volunteered responses from those who react negatively to hearing more about what their representatives voted
for are indicative of why this issue can be so deeply problematical for Republican incumbents. The takeaways from
voters are harsh and often personal:

Not for the people/candidate not concerned for us/doesnt

listen to us 17%
Concerns about changes in pre-existing conditions 11%
Voted along party lines, he/she is not an independent thinker 10%
Bill is too negative/affects everyone, bad/horrible/terrible bill 9%
Tax cuts for the rich, tax benefits to the rich 8%
Premiums will increase, health insurance will be too expensive 6%
Against his/her decision to repeal ACA/Obamacare 6%
Disagree with his/her views, with the way he/she voted 6%
Lack of concern for the elderly, senior citizens 5%
Too many people, families, wont have coverage 5%
Representative has no care, no concern for the people 5%

Two-thirds of voters say each of the following provisions gives them big concerns about the Republican health care
legislation:

Under the Republican bill, insurance companies could go back to charging people much higher premiums if
they have a pre-existing medical condition
The Republican bill includes a provision AARP calls an "age tax," that allows insurance companies to charge
people over the age of 50 premiums that are five times higher than younger people
Under the Republican bill, insurance companies could go back to putting annual and lifetime limits on health
care coverage
The Republican bill takes $117 billion dollars out of Medicare to give a tax cut to the top two percent of
incomesreducing the money Medicare needs to pay for the health care of seniors
The Republican bill cuts Medicaid by $880 billion dollarscuts that will reduce funding for nursing home care,
care for people with disabilities, mental health care, and drug treatment
Women voters react especially strongly to the fact that, under the Republican bill, women could be charged more than
men for their insurance because insurance companies would no longer be required to include pregnancy, child birth,
or prescription birth control as part of basic health insurance; 71% say this gives them big concerns about the
Republican bill, including 61% who say it gives them very big concerns.

A key problem for Republican congressional supporters of the AHCA is that the validators in opposition to the bill are
far more credible than the two elected officials most closely identified with the legislation, Donald Trump and Paul
Ryan, as the responses to the following question show:

Donald Trump and congressional Republican leaders like Paul Ryan say that people with pre-existing medical
conditions will be able to get affordable health insurance under their bill, but the American Medical Association,
the American Cancer Society, the American Heart Association, and AARP all say that the Republican bill will
put people with pre-existing conditions at serious risk. Who are you more likely to believe about the impact the
Republican bill will have on people with pre-existing conditionsDonald Trump and Paul Ryan, or the
American Medical Association, the American Cancer Society, the American Heart Association, and AARP?

More likely to believe Trump 25%

and Ryan
More likely to believe 61%
AMA/ACS/AHA/AARP
Both equally/neither 9%
Not sure 5%