Almost half of the public, 49 percent, holds favorable views of the ACA, while 42 percent have negative views, which are among the law's most positive ratings tracked in polls by the nonpartisan Kaiser Family Foundation in the years since the law's passage.
The survey was conducted May 16-22, after the House passed its health-care bill on May 4. The results underscore the challenge facing the Senate when it returns to work next week and continues debating the House bill or crafting an alternative.
Its work was made harder by a recent Congressional Budget Office report that concluded that the House legislation would result in 23 million more uninsured people by 2026 than under the current law. The poll was before the report's release.
Some senators want to soften parts of the House bill, especially provisions that would allow insurers in individual states to charge higher premiums to consumers with costly medical conditions. Others, however, want to hew to a tough line on state flexibility, as well as Medicaid spending reductions and other issues. With a narrow 52-member majority, Senate Majority Leader Mitch McConnell (R-Ky.) has little room to maneuver among the disparate factions in his own party.
In the face of public unease over the repeal-and-replace effort, Republican lawmakers and Trump administration officials argue that the ACA is collapsing on its own and, in the process, pushing up premiums and deductibles to unsustainable levels. Democrats counter that it is the Republicans who have long undermined the law and continue to do so.
The Kaiser poll is a stark reflection of those partisan differences. It shows that about two-thirds of Republicans are favorable toward the House bill, while 78 percent of Democrats view the ACA positively. Independents are more favorable toward the ACA than the AHCA, by 48 to 30 percent.
The survey also finds that nearly half of Americans say the quality of their health care and their ability to get insurance coverage will stay about the same if the House bill is adopted. At the same time, the public is increasingly pessimistic about these issues as well as potential cost. A 45 percent plurality of adults say that the Republican bill would push up health-care costs for their families, compared with about 28 percent in December.
The poll also asked people whether several different components of the AHCA made them more or less likely to support it. Some of the highest “less likely” responses were on changes made to ensure House passage, such as allowing states to let health-care companies cut back on benefits they cover so they can sell cheaper plans. For most of the AHCA's reforms tested by the Kaiser poll, more said each made them less likely to support the law than more likely.
Parts of the GOP bill at least as many people are “more likely” to support as "less likely" included allowing states to require adults without disabilities to be working or searching for work to qualify for Medicaid coverage and providing federal funding for states to cover people with preexisting conditions through separate high-risk pools.
The poll was conducted among a random national sample of 1,205 adults; overall results carry a three-point margin of sampling error.