Despite political enmity stirred up by the Affordable Care Act, a large majority of Americans across the political spectrum support most of its provisions, according to a November poll conducted by the Kaiser Family Foundation. What's more, that support has increased since the presidential election.
More than 80 percent of the 1,202 nationally representative American adults Kaiser polled by phone last month supported ACA rules that include mandates to insurance companies to allow young adults to stay on their parents' plans, eliminate out-of-pocket costs of preventive services, and reduce the cost of medications for Medicare recipients. The least popular piece of the law, particularly among Republicans and Independents, is the requirement that Americans buy health insurance or else pay a fine to the government.
The survey comes on the heels of news that fewer people are struggling to pay their medical bills, according to a report released by the National Center for Health Statistics earlier this week. This is because more Americans are insured through the ACA, and because an expanding economy is finally employing more people and raising their incomes.
While Donald Trump promised repeatedly during his presidential campaign to repeal the health care law if elected – and Republican lawmakers have tried dozens of times to gut Obama’s 2010 law – fewer Americans support a complete repeal now that President-elect Trump is readying to take office in January.
According to the Kaiser poll, which has a plus or minus 3-point margin of error, only a quarter of responders said the week after the election that they wanted the law repealed, compared to 32 percent who wanted a repeal in October. Notably, many Republicans appear to have changed their minds: 52 percent of Republicans said after the election that the ACA should be repealed. In October, 69 percent were calling for a repeal.
While many Americans don’t want the law completely scrapped, some do want it scaled back (17 percent in November vs. 9 percent in October). At the same time, 30 percent want the law expanded, and 19 percent want it to stay as is.
It is becoming increasingly more likely that instead of a repeal, the law will be scaled down and revised under President Trump. The president-elect already has said that he will keep some of Obamacare’s most popular features, including the mandate that insurance companies cannot deny coverage to people with pre-existing medical conditions.
Generally, Republicans have said they want to transfer oversight and funding of health care to the states and get rid of the Obamacare state exchanges. As a replacement, the president-elect has called for tax-free health savings accounts that would allow people to save money for health-care costs, as well as deductions of health-care premiums from personal income taxes. Trump also has said he wants to allow insurance companies to sell plans across state lines to spur competition.
Obamacare has expanded Medicaid coverage and provided federal subsidies that have helped low-income people buy health coverage. Now, the rate of non-elderly adults without insurance dropped from 20.4 percent in 2013, the year before the law went into effect, to 8.6 percent this year, according to the US Department of Health and Human Services.
The federal government reports that 20 million more people have insurance under the ACA, though most people still get coverage through their employers. The law hasn't been a money saver for everyone: Partly because the nation’s biggest insurers, including Aetna and UnitedHealthcare, have pulled out of most state exchanges because too many sick customers made them less profitable, premiums for some ACA participants are expected to rise by 25 percent in 2017.