A new poll from the Kaiser Family Foundation (KFF) shows the Affordable Care Act (ACA) with its highest approval rating yet from the public: 55 percent of Americans said they have a favorable opinion of the health care reform law, while opposition stood at 37 percent. KFF began tracking public opinion about the ACA in March 2010, when it was signed into law.

While the ACA has grown in popularity even while under attack from the Trump administration, much of the debate about health care on the 2020 campaign trail centers around Medicare for All proposals favored by some Democratic candidates. Other candidates have called for a more moderate position such as a government-run public option. The KFF poll found both of those concepts have majority support: Medicare for all has 52 percent support (down from a high of 57 percent in early 2019), while a public option scores higher: 66 percent of Americans support that idea.

Not surprisingly, the upcoming election seems to be driving more partisan views on health care: the KFF analysis said that health care has emerged as the biggest issue for those who identify as Democrats, while Republicans have rallied in opposition to the Medicare for All proposal.

"Republicans seem to be shifting their ire from the ACA to Medicare for All," said KFF President and CEO Drew Altman. "The gulf between Republicans and Democrats on health has never been wider."

Health care a top concern, opposition to ACA is muted

Democratic voters and independent voters said that health care is their top issue when deciding which candidate to support. The poll found 36 percent of Democrats and 30 percent of independent voters identified health care as the most important issue in this presidential election. Just 12 percent of Republicans said health care was their top issue, behind the economy (34 percent), immigration (19 percent), and foreign policy/national security (17 percent).

The poll analysis noted that Republicans have changed their focus from the ACA to Medicare for all as a political issue. KFF polls found that in 2016's presidential election, 29 percent of Republicans said opposing or repealing the ACA was their top health care issue. In the 2018 midterms that number had dropped to 18 percent. In this latest poll, only 3 percent of Republicans said opposing or repealing the ACA was their top health care priority.

Instead, Republican voters list high costs as the top health care issue (24 percent), followed by opposition to single payer/Medicare for all proposals (19 percent.)

Medicare for all vs. public option

Overall, voters who expressed support for a larger government role for health care insurance were more interested in the public option than in Medicare for all, the poll found.

"When voters who expressed support for both a national Medicare for All plan and a government-administered public option (40 percent of all registered voters) are asked which proposal they prefer, the public option retains its edge," the report said. "More than four in ten voters (44 percent) either only favor a public option (26 percent) or prefer it (18 percent) compared to one-fourth of voters (26 percent) who either only favor a national Medicare for All plan (7 percent) or prefer it over a public option (20 percent)," the report said.

The poll also found that a public option approach is supported over Medicare for all by Democratic voters by 51 percent to 39 percent; by independent voters by 45 percent to 24 percent, and by swing voters (voters who have not decided which party they will support in the election) by 49 percent to 25 percent.

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As election nears, ACA sees highest approval ratings to date

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