Attitudes toward Changing the Health Care Law

An AP-NORC Poll conducted in April 2019 looks at perceptions of the Affordable Care Act and Americans’ preferences for possible changes.

In the wake of President Donald Trump’s renewed effort to repeal and replace the Affordable Care Act (ACA), many Americans would prefer that President Obama’s signature legislation remain in place, albeit with changes.

Forty percent of the public trust the Democratic party to handle health care compared with 23% who trust the Republicans.  The 17-point gap is a much larger than the differences between the public’s trust of either party handling the economy, immigration or foreign policy.

Fifteen percent say the ACA should be kept in its current form, while 42% want the law preserved but with changes. Forty percent want the ACA repealed, which includes 22% who say the law should be repealed in its entirety and 18% who want only parts of the law repealed.

Democrats strongly support the ACA, as well as possible alternatives including a single payer system and a government backed insurance choice. While Republicans disagree with the ACA and a single payer plan, there is less opposition to a possible plan that offers government health insurance for purchase instead of private insurance.

There is also a disagreement between Republicans and Democrats regarding Washington’s duty to provide its citizens with healthcare insurance.  Overall, 57% consider it the responsibility of the federal government to make sure all Americans have health care coverage, including 80% of Democrats and only 31% of Republicans.  Forty-one percent say the government is not obliged to ensure everyone has health insurance, including 67% of Republicans and only 19% of Democrats.

However, there is bipartisan support for some aspects of the ACA.  In addition to most Democrats, a majority of Republicans and independents back a prohibition of denials for pre-existing conditions, allowing people under 26 to remain on their parents’ insurance, and subsidies for those who cannot afford private insurance but are unable to receive Medicaid. The requirement of employers to offer insurance or face a fine is supported by 69% of Democrats and 46% percent of Republicans. The individual mandate does not get much support from either side of the aisle: only 35% of Democrats and 12% of Republicans favor it.

The nationwide poll was conducted April 11-14, 2019, using the AmeriSpeak® Panel, the probability-based panel of NORC at the University of Chicago. Online and telephone interviews using landlines and cell phones were conducted with 1,108 adults. The margin of sampling error is plus or minus 4.1 percentage points.