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A woman walks past a polling place sign.

Women age 50 and over are saying they plan to vote in large numbers in Iowa and nationally and there’s no issue they care about more than health care, according to a Harris Poll conducted for AARP and released first to Iowa Capital Dispatch.

This group of women may be a key demographic in the 2020 elections, says Nancy LeaMond, executive vice president and chief advocacy and engagement officer for AARP, a national advocacy organization for older Americans. Nationally, 95 percent of 50-plus women say they plan to vote in the 2020 elections.

“Older women plan to turn out in force this election year, and polling shows that most haven’t made up their minds about who they’re voting for,” LeaMond said. “A big factor in their decision will likely be what candidates will do to lower health care costs. Candidates would be wise to focus on this pressing, top-of-mind issue and continue talking about their plans to cut high drug prices.”

In Iowa, 60 percent of Democratic 50-plus women say they will probably or definitely attend the Iowa caucuses on Feb. 3, the poll shows. That compares to about 16 percent of the overall electorate that participated in the 2016 caucuses, according to Electionproject.org.

The national poll, which was taken in December, also found seven out of 10 women age 50-plus were still undecided in the presidential race, LeaMond said. “This isn’t just Democrats looking at that enormous field wandering through Iowa,” she said. “These are all (50-plus) women voters. … And we think they are a swayable group as we move through there.”

In the Iowa caucus race, former vice president Joe Biden and former South Bend Mayor Pete Buttigieg were tied with 25 percent each among 50-plus Democratic women. Sen. Elizabeth Warren and Sen. Bernie Sanders were tied with 9 percent each. Sen. Amy Klobuchar had 7 percent; Tom Steyer had 4 percent; Andrew Yang had 3 percent and all other candidates had 1 percent or less. Thirteen percent were undecided.

It’s important to note that this poll was taken Dec. 5-25, so the landscape may have shifted.

Number one issue for older women: Health care

Health care was heavy on the minds of 50-plus women in Iowa, with 48 percent listing it as one of their three top issues. Immigration was in second place with 26 percent and terrorism/national security had 25 percent. Environment/climate change was cited by 22 percent.

“It’s almost impossible to overstate how important health-care costs are – to voters generally but especially to women,” LeaMond said. In Iowa and elsewhere, “health care costs are above jobs, the economy, all of these other issues.”

Iowa Democrats in the poll were supportive of “Medicare-for-all,” which as defined by Sanders and Warren would replace private health insurance. However, Democrats in the poll were even more supportive of proposals that make government-run health insurance optional.

A majority (52 percent) of Democratic 50-plus women in Iowa said they support Medicare-for-all, based on what they’ve heard or read about the program. Thirty percent were opposed and 18 percent didn’t know or were unsure. That compares to 35 percent overall support of Medicare-for-all among Iowa women age 50-plus, with 49 percent in opposition.

Iowa Democratic women age 50-plus were split on the prospect of replacing the current system with a government-run health-care system, with 43 percent in favor and 42 percent opposed. But 84 percent of Democrats favored “giving people the option to switch their insurance to a government-run health care system.”

Ethics and trustworthiness are key traits

LeaMond also highlighted the values that over-50 women are considering as they choose their leaders. Asked about a list of over 20 leadership traits, Iowa Democratic women said it was most important that a leader is ethical (47 percent) and trusted (44 percent).

“… The values that women voters are looking at in terms of honesty, ethical practices, we think are going to be very important as women go to the polls,” she said.