New Poll Shows Virginians Support Certificate of Public Need, Want a Fair Balance Billing Fix that Doesn’t Favor Insurers, and Express Concerns Over the Financial Burdens of High-Deductible Insurance Plans

January 21, 2020

Statewide Survey Conducted by Mason-Dixon Polling & Strategy Shows a Nearly 4-to-1 Margin of Support for Maintaining Virginia’s Certificate of Public Need Program, a Majority of Virginians (52 Percent) are Worried About Balance Billing Proposals that Favor Insurers and Don’t Address Provider Concerns, and Reveals that Many People Have Deferred Medical Treatment Due to Concerns About High-Deductible Insurance Costs

RICHMOND, VA – The results of a recent statewide public opinion poll show that more than half (53 percent) of Virginians say the Commonwealth’s Certificate of Public Need (COPN) program should be maintained, compared with just 14 percent who believe the program should be undone. The margin of COPN support among Virginia voters is nearly 4-to-1 in favor of protecting the program as is. Overall, nearly two-thirds of Virginians (62 percent) express support for the current health care delivery system with COPN in place. These findings are consistent with results from a June 2019 statewide poll in which 55 percent of Virginians said they support preserving COPN, compared to just 13 percent in opposition to the program.

Mason-Dixon Polling & Strategy conducted the poll, which is the latest in a series of surveys commissioned by the Virginia Hospital & Healthcare Association (VHHA) to help identify health care issues of concern to Virginians and to inform the Association’s approach to developing corresponding public policy solutions.

The poll also found that a majority (52 percent) of Virginians are worried about balance billing legislative proposals, such as one that has been considered in the U.S. Congress, that includes insurance rate-setting provisions which could harm patient access to care and impact health care providers by giving health insurance companies greater authority over health care service reimbursements. Balance billing occurs when a patient receives an unexpected medical bill after receiving health care treatment from an out-of-network provider. These situations sometimes arise in connection to emergency medical treatment. A coalition of patient and consumer advocates, physicians, and hospitals supported legislation during the 2019 Virginia General Assembly session to protect patients from balance billing in emergency situations. It passed the Virginia Senate unanimously but stalled in the House of Delegates due to objections from special interest groups. When Virginians were polled in June 2019 on the issue of balance bills connected to medical emergencies, a majority (51 percent) said insurance companies should be held financially responsible for out-of-network situations, compared to just 19 percent who said the doctor or health care facility should bear the cost.

The December 2019 Mason-Dixon poll also surveyed Virginians about high-deductible insurance plans that require families to pay more in out-of-pocket costs for care. Nearly four in 10 Virginians (39 percent) say they have high-deductible insurance plans, a finding consistent with national research done by the U.S. Centers for Disease Control and Prevention indicating 40 percent of Americans have such coverage. High-deductible plans have become more commonplace in recent years as health insurance premiums have contemporaneously risen at a rate faster than wage growth. Among those Virginians with high-deductible insurance coverage, more than four in 10 (44 percent) said that in the past two years they have either delayed needed medical treatment or surgery, failed to fully pay a medical bill, requested financial assistance from a health care provider, or put off buying prescription medication because of the costs associated with these plans.

“The hospital community is committed to the goal of making Virginia the healthiest state in nation, and  the Commonwealth has made great bipartisan strides towards that in recent years by improving the health care delivery system and enhancing Virginians’ access to care,” said VHHA President and CEO Sean T. Connaughton. “There are, however, many other important reforms that can be made to support public health and well-being. Among them is identifying policy solutions that make health insurance more affordable for Virginia employers facing rising insurance premiums, and for families so they can access medical care when they need it without worrying about the financial impact it could have on their households.”

The poll of 625 registered Virginia voters was conducted Dec. 12-16, 2019 and featured live landline and cell phone interviews with Virginians from all regions of the Commonwealth representing a wide array of ethnic, gender, age, and political diversity reflecting the distinctive demographics of the Commonwealth.

About VHHA: The Virginia Hospital & Healthcare Association is an alliance of 110 hospitals and 27 health delivery systems that develops and advocates for sound health care policy in the Commonwealth. Its mission is to achieve excellence in both health care and health. Its vision is through the power of collaboration to be recognized as a driving force behind making Virginia the healthiest state in the nation. Connect with VHHA through Facebook, Twitter, YouTube, LinkedIn, Instagram, and


Julian Walker
Vice President of Communications
(804) 297-3193 office
(804) 304-7402 mobile