From Medicare to medical costs, more voters trust Democratic presidential candidate Hillary Clinton to do a better job on health care issues facing the nation, according to a poll out Thursday. But they’re not holding out hope for big improvements.

The survey from the nonpartisan Kaiser Family Foundation also found that the future of Medicare and overall access and affordability are the top health care issues for voters. Neither of those is getting much attention in a campaign that has been dominated by questions of character and temperament.

On the basic pocketbook question, the poll found that 36 percent of voters feared their own access to affordable care would get worse if Republican Donald Trump is elected, versus 24 percent who worried their own situations would worsen under Clinton. Just over half said a Clinton presidency would not make much difference to their own personal access, while 37 percent felt the same way about Trump.

“Even though Hillary Clinton is trusted by more of the public on these issues, they have pretty low expectations that things will get better, no matter who wins,” said Kaiser polling chief Mollyann Brodie. (The foundation is not associated with health insurer Kaiser Permanente.)

Clinton has played a prominent role on health care issues for more than 20 years, since she emerged on the national scene as the leader of the failed effort to pass a bill providing health care for all in her husband’s first presidential term. She’s a candidate of continuity, expressing strong support for Medicare, Medicaid, and President Barack Obama’s health care law. She’s proposed incremental improvements but no sweeping changes.

Trump’s views on health care seem fluid. He has said he wouldn’t cut Medicare and he won’t stand for people “dying on the street,” but his health care plan is basically a collection of Republican talking points. He’d repeal “Obamacare,” and he has expressed support for a House GOP plan to limit Medicaid spending and turn the program for low-income people over to the states.

Both candidates have said they’d authorize Medicare to negotiate drug prices. That puts Trump at odds with most Republicans, who see Medicare negotiations as nothing more than the government dictating prices.

Republican policy experts say they expect House Speaker Paul Ryan of Wisconsin to take the GOP lead on health care if Trump is elected. Ryan favors a major overhaul of Medicare for future retirees, gradually replacing open-ended government coverage with a limited payment that beneficiaries could use for a range of insurance options.

Women’s access to reproductive health accounted for the biggest trust gap between Clinton and Trump. Sixty-four percent of voters — and 71 percent of women voters — said they trusted Clinton to do a better job. The numbers for Trump were 28 percent and 20 percent, respectively.

On the future of Medicare, 53 percent of voters said they trusted Clinton, compared to 38 percent trusting Trump. Interestingly, voters age 65 and older were much more closely divided, with 47 percent saying they trusted Clinton and 44 percent trusting Trump.

The split on Medicaid was 54 percent trusting Clinton and 37 percent trusting Trump. On the overall access and affordability of health care, 52 percent trusted Clinton, compared with 39 percent saying Trump would do better.

Clinton led by double-digit margins on most issues, but the closest split — 9 percentage points — was on the fate of the Obama health care law. Fifty percent said they trusted Clinton, compared with 41 percent for Trump. The public remains divided over the 2010 health overhaul, with 42 percent holding an unfavorable view, and 40 percent favoring it.

The Kaiser foundation poll was conducted from Aug. 18-24 among a nationally representative random digit dial telephone sample of adults that included 1,020 registered voters. The margin of sampling error is plus or minus 4 percentage points for registered voters.

(AP)