Support for repealing the Affordable Care Act dropped significantly among Republicans immediately after the November election, according to a new poll. The data also reveal that, although a large majority of Trump voters say they view President Obama's health care law negatively, they like many of its provisions.
According to the data, collected by the Kaiser Family Foundation, 69 percent of Republicans supported repealing President Obama's signature health care law in October; a month later, only about half supported a full repeal.
“This is a new thing, first time we've seen it,” said the foundation's president, Drew Altman. He cautioned against reading too much into a single data point and said his organization would ask the same question next month, to see if the pattern holds. “We had a great debate over whether to even report it, because all of a sudden there it was — and it was quite significant.”
The results are surprising because President-elect Donald Trump's promise to repeal and replace the health-care law has been one of his clearest policy positions, reinforced by the announcement this week that he had chosen one of its fiercest critics to head the Department of Health and Human Services.
The drop doesn't mean people flipped to favoring the law; instead, there was an increase in the number of Republicans who thought scaling back the law was a good idea.
The poll also revealed an apparent contradiction in Trump voters' feelings about the law. According to the poll, 81 percent had unfavorable opinions about the Affordable Care Act and half wanted to see it repealed. But when Trump voters were asked how they viewed specific provisions, many were popular.
For example, more than two-thirds of Trump voters said they liked the health insurance exchanges where people can shop for insurance, the financial help the law provides to low- and moderate-income families to help pay for insurance, the elimination of out-of-pocket costs for preventive medical care and the ability of young adults to stay on their parents' health plan. A majority were in favor of the ban on insurers denying coverage to people with pre-existing medical conditions.
“The caution here for repealers is that, at the end of the day, people will care more about their insurance, their access to care and their economic security than they will about the ACA,” Altman said. “So what actually happens and is done to people’s coverage will trump their political dislike of the ACA.”
Finally, the poll examined how people might react to particular changes that could occur if the health law were to be repealed and replaced. For example, among those in favor of repealing the law, 38 percent changed their minds after hearing that it would mean people with pre-existing medical conditions could be denied insurance. Nearly a fifth changed their mind after hearing that 20 million people, who gained insurance through the expansion of Medicaid and by buying insurance on the exchanges set up by the law, would lose coverage.
Overall, the data show that Americans remain stubbornly divided on the future of the health care law. About half the public want to see the law remain as is or be expanded; 43 percent want to see it repealed or scaled back.
The debate over the future of the health law has been divisive. But Altman noted that if Trump's health care team also attempts significant changes to Medicare and Medicaid, it could make current-day controversies seem mild.
“If people think the ACA is a big debate, they haven’t seen anything,” he said.