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5 Opinion Shifts on the Affordable Care Act


Support for the ACA has grown, but more Republicans want to fix it than before, which may explain why Congress and President Donald Trump keep looking for a deal.

Two polls this week—from Gallup and the Kaiser Family Foundation—show that public opinion on the Affordable Care Act (ACA) has shifted markedly since Election Day, with more Americans than ever supporting the law. The Kaiser Health Tracking Poll, in particular, revealed the public’s sigh of relief that the Republican alternative, the American Health Care Act (AHCA), failed to gain enough support to clear the House of Representatives.

Here are 5 key shifts in public opinion on the ACA:

1. Polls show record levels of support for the ACA.

The Gallup poll found 55% of Americans support the ACA, a flip from November 2016 when 42% approved and 53% disapproved. Gallup reported this was the first time a majority of Americans supported the ACA since the polling group began asking about support in 2012.

The Kaiser poll, which has been asking about public support for the ACA since 2010, found that 49% had a favorable view of the ACA in March compared with 44% who disapproved; favorable and unfavorable views were both at 46% in April, representing the strongest support for the ACA across a 2-month stretch since polling began.

2. More Americans than ever have an opinion on the ACA.

The Kaiser poll has consistently tracked people who have “no opinion” of the ACA, which may indicate they don’t understand what the law does. The percentage of Americans who reported no opinion was above 20% in early 2013, in the months before policies were first sold on the marketplace exchanges. But polls reported in March and April show this number has fallen below 10%. The number took a sharp dip when details of the AHCA were unveiled, which allowed the public to compare the ACA with an alternative.

3. Partisan divide on the ACA remains, but it’s less clear cut.

The strongest support for the ACA still comes from Democrats, and the strongest criticism still comes from Republicans. A Kaiser poll from February 2016 found that 34% of Republicans wanted to replace the ACA, and 26% wanted a repeal with no replacement. Only 21% of Republicans wanted to build upon the ACA. This month, the Kaiser poll found that 51% of Republicans believe President Donald Trump and Congress should do what they can to make the ACA work.

4. Independents are leading the shift in public opinion.

Over the years, the Kaiser poll’s fluctuations in public approval of the ACA have almost always centered on how independents view the law at a given moment. Similarly, the Gallup poll finds that a recent shift in opinion among independents has fueled the increase in support. Only 40% of independents supported the law in November 2016, while 57% of independents supported the law in the poll reported this week.

5. More Republicans now want to fix healthcare compared with before.

While not precisely the same, questions asked in the February 2016 Kaiser poll and the most recent one suggest that now that they have a member of their party in the White House, Republicans are more energized to deal with healthcare. Last year’s poll asked respondents whether they wanted to continue debating healthcare or move on to other issues; 40% of Republicans at that time said they were tired of hearing about healthcare.

In the new poll, only 22% of Republicans said they want Congress to stop working on healthcare. By contrast, 59% of Democrats were tired of the healthcare debate in February 2016, while 70% now want Congress to move on. Views among Republicans—who are more likely to vote in primaries—may explain why Trump and Congress have kept trying to reach a deal, even though the majority of Americans support the ACA.

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