Voter Support for Policies Associated With Child Health as National Campaign Priorities.

Abstract

Importance: Policies that are associated with child health are rarely included in platforms of candidates for national political office. Candidates may underrecognize voter support for such priorities or perceive that such policy issues are not sufficiently divisive to appeal to partisan voters. Key policy questions associated with child health may be considered by the next Congress, including the consistency of Medicaid coverage across states and restoring the recently lapsed refundable child tax credit.

Objective: To examine voter support for candidates regarding policies that are associated with child health.

Design, setting, and participants: This nationally representative survey of registered US voters 18 years or older was conducted from March to April 2024 and included a survey-based randomized experiment to evaluate the association of message framing with voter support.

Exposures: Messages conveying distinct rationales for Medicaid reform and refundable child tax credit.

Main outcomes and measures: Likely or definite support for candidates.

Results: In this sample (unweighted N = 2014; 1015 women [51.0%]), most respondents indicated they would likely or definitely vote for candidates who expressed strong support for all tested policies: extreme risk protection order (79.5%), school threat assessment (73.1%), expanded childcare (69.6%), refundable child tax credit (66.6%), federalization of Medicaid (66.0%), paid parental leave (65.5%), free school meals (65.6%), safe firearm storage and enforcement (62.9%), preventing Medicaid disenrollment for children younger than 6 years (61.9%), universal free preschool (61.6%), and summer nutrition programs (57.9%). More women than men expressed support for all tested policies. Strong majorities of Democrat and Independent voters would support candidates who endorsed child-focused policies; fewer than 50% of Republican voters expressed such support, except for the extreme risk protection order and school threat assessment. Variations in framing language regarding consistent Medicaid coverage across states were not associated with amplified or diminished voter support. Framing the refundable child tax credit as benefiting "hard-working" vs "low-income" families garnered significantly more support among men (67.0% vs 59.0%), privately insured individuals (72.0% vs 64.4%), and Republicans (54.6% vs 43.0%; all P < .05).

Conclusions and relevance: The study results suggest that most voters favor candidates who strongly support policies that are associated with child health. Voter support differs substantively by gender and political party affiliation and may be associated with language choices in messaging about policy change.