A new high of 57% of Americans now approve of the Affordable Care Act as enhanced subsidies are set to expire at the end of this month. The approval rate has increased by 3% since last year, according to the latest West Health-Gallup Health and Healthcare Survey.
“Approval of the ACA has gradually increased over the past five years, but this year’s record high is largely fueled by a sharp rise in support among political independents,” the survey report said. “With lawmakers postponing a decision on the subsidies during the recent government shutdown and the December 31 deadline for action fast approaching, the ACA has again become a central point of partisan contention.”
Opinions continue to differ sharply by party, with 91% of Democrats, 63% of independents and 15% of Republicans approving. Although Democratic and Republicans ratings are roughly in line with last year’s figures, independents’ rating has jumped 10 points to a record high.
- The majority of Republicans (62%) disapprove and support repealing the law.
- A 49% plurality of Democrats approve and support keeping it the way it is, while 38% support it but with significant changes.
- Independents are divided between approving and keeping it as is (24%) and approving but making significant changes (34%).
Regardless of their level of support, many Americans would like to see changes made to the ACA.
“Public opinion remains fractured over what should happen next,” the report said. “Even among ACA supporters, Americans diverge between keeping the law largely intact and seeking major changes, while opponents overwhelmingly endorse repealing the law. These divisions mirror broader national debates that are likely to intensify as Congress prepares to vote on the subsidies.”
One-quarter of adults approve of the ACA and prefer to keep it as it is; 28% approve of it but would like to see significant changes; 9% disapprove and favor making significant changes, and 25% disapprove of the law and think it should be repealed. Those who disapprove are much more likely to say they prefer it to be repealed and replaced (72%) than kept in place but with significant changes (24%). This 48 point gap in preferences for the ACA among those who disapprove of it is the largest on record.
Meanwhile, Americans’ views on the federal government’s responsibility to cover the cost of care for uninsured patients reveal both broad agreement and sharp limits. Most adults favor federal funding for hospitals treating the uninsured, but support drops considerably when the question involves patients living in the United States illegally.
“Taken together, Americans’ record-high approval of the ACA, their divergent preferences for its future and their conditional support for funding care for the uninsured highlight a health policy environment defined by partisan polarization,” the report said.
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