Gallup Survey: Most Americans Want Changes to Affordable Care Act

Only 14% think act should stay “as is”

Americans’ assessments of the Patient Protection and Affordable Care Act (PPACA) remained relatively unchanged after the November 8 election, with more continuing to disapprove (53%) than approve (42%) of the act, according to a new Gallup survey. The vast majority of Americans want to see the law changed, the survey findings showed. This includes the 37% who want it repealed and replaced, along with 43% of Americans who want the law kept, but with major changes.

In its annual November Healthcare update, Gallup asked Americans who approved of the PPACA whether they would like it kept in place “as is” or kept but with significant changes. Similarly, Americans who disapproved of the PPACA were asked whether they wanted to keep it but with significant changes or repeal and replace it.

Putting the responses to these two questions together, an overall total of 43% of Americans––a group that includes some who approved of it initially (28%) and some who disapproved (15%)––wanted to change the PPACA significantly without repealing it. That is a slightly larger percentage than the 37% who disapproved and wished to see it repealed and replaced. Fourteen percent of Americans approved of the PPACA and wished to keep it “as is.”

Since Gallup began regularly tracking Americans' overall evaluations of the PPACA four years ago, approval has exceeded disapproval only once, in November 2012, shortly after President Barack Obama's re-election. Since then, disapproval has averaged 52%, while approval has averaged 42%.

Attitudes toward the PPACA continue to be highly partisan, Gallup found. The act, which was passed into law in 2010 despite “no” votes from all 178 Republican members of the House, became a point of contention between Donald Trump and Hillary Clinton during the election. Not surprisingly, rank-and-file Democrats have consistently been much more likely to approve of the PPACA than Republicans, Gallup noted. In the new poll, 7% of Republicans said they approved of the PPACA compared with 76% of Democrats.

Seventy-one percent of Republicans disapproved of the law and wanted to repeal it, essentially in line with Trump’s campaign promise, the Gallup findings showed. Few Democrats wanted to see the PPACA repealed and replaced. Instead, 59% of Democrats, including those who either approved or disapproved of the act in general, wanted to keep it with significant changes, mirroring Clinton's campaign platform position. Twenty-six percent of Democrats approved of the PPACA and wanted to keep it “as is.”

Shortly after his election earlier this month, Trump moderated his campaign promise to repeal the PPACA, saying in an interview that he would attempt to keep two popular provisions: banning insurers from excluding people with pre-existing conditions and allowing young people to stay on their parents' insurance until the age of 26.

“It appears that, to avoid disruption, Republicans may attempt to vote to defund the [PP]ACA, but in a way that such an action would not be triggered until after the 2018 midterm elections, thus allowing Congress to attempt to change significant parts of it in the meantime,” Gallup reported.

Results for the poll were based on telephone interviews conducted November 9–13, 2016, with a random sample of 1,019 adults (18 years of age and older) living in all 50 U.S. states and the District of Columbia.

Source: Gallup; November 28, 2016.