Voters want — and expect — President-elect Donald Trump and the GOP-controlled Congress to repeal the 2010 health care law, according to a new POLITICO/Morning Consult poll released Tuesday, but they are skeptical of repeal without a plan to replace Obamacare and some of its most popular elements.
A majority of voters disapprove of the law, which is teetering on life support as Trump prepares for his inauguration next week and Republicans signal that repealing Obamacare is their top priority. Only 41 percent of voters surveyed approve of the law, while a 52-percent majority disapproves. More self-identified Democrats disapprove of the law (23 percent) than Republicans who approve (16 percent), and independents tilt strongly against it (36 percent approve, versus 54 percent disapprove).
On a list of six initiatives for Trump and congressional Republicans, repealing the health-care law ranks as the most important, with 26 percent of all voters, including 41 percent of Republicans, calling it their top priority
And voters are counting on changes to the law. A combined majority wants the law repealed in part (32 percent) or completely (27 percent). Fewer than a quarter of voters want the law expanded (24 percent), and only 11 percent want the law kept as-is.
A combined 73 percent of voters say it’s either “very” or “somewhat” likely Trump and congressional Republicans repeal the law, while only 13 percent say it’s “not too likely” Obamacare is repealed and 4 percent say it isn’t likely at all.
But the popularity of some of Obamacare’s components makes the issue a hornet’s nest for Republicans in the absence of a plan for the nation’s health care system moving forward. With just 10 days to go until the GOP controls all of Washington’s policy-making levers, the impending repeal of the law has vexed the party, despite making striking Obamacare from the U.S. Code a centerpiece of its campaign platform for the past six years.
Only 28 percent of voters say the law should be repealed “even if there is no current plan for replacing” it. Fully 61 percent say the law “should not be repealed until there is a new plan for replacing the law.”
Congressional Republicans are united in their desire to repeal the law. Outgoing President Barack Obama’s most significant legislative achievement, the health care law has led to a dramatic reduction in the number of Americans without health insurance, but it has failed to deliver on promises to slow the growth of health-care costs for most Americans.
Republicans are less unified, however, in what to do after repealing the law. Some want to replace the law’s provisions immediately with GOP-aligned alternatives — and don’t want to repeal the law until a replacement is ready — while others want to repeal the law upon Trump’s inauguration and work on new health-care policies in the year ahead.
One major complication to any replacement: Trump and some Republicans have pledged to consider some of the more-popular elements of the health-care law in a post-Obamacare framework, and the POLITICO/Morning Consult poll shows voters want to keep large parts of the law.
Testing eight separate elements of the law, more voters want to keep each of the eight provisions than want to repeal them, in some cases by overwhelming margins.
Nearly two-thirds of voters, 66 percent, favor keeping a provision that prohibits insurance companies from denying coverage to patients with pre-existing conditions. Sixty-three percent of voters want to keep the requirement that insurance companies allow policyholders to keep their children on their plans until age 26. Fifty-six percent think subsidies for low-income Americans to buy insurance should stay, and the same percentage wants to keep federal funding for states to expand their Medicaid programs.
A 55-percent majority also wants to keep the requirement that businesses and companies with more than 50 full-time employees offer health insurance to those employees, while only 27 percent want that provision repealed. Many Republicans say that requirement has led businesses to slash jobs and hours to avoid hitting that threshold.
And 53 percent of voters want to keep requiring insurance companies to cover prescription birth control, while just three-in-10 want that requirement repealed. (The Supreme Court ruled in 2014 that employers may exclude contraceptive coverage for their employees if it violates the employers’ religious beliefs.)
Pluralities of voters also want to keep two other provisions of the law, though by narrower margins: 46 percent want to keep the elimination of lifetime and annual limits on health reimbursement to individuals, while 32 percent want that repealed. And 33 percent of voters want to repeal the long-derided medical-device tax, compared to 37 percent who want to keep it.
The most-popular elements of the law are also well-regarded by Republicans. Sixty-three percent of Republicans want Trump and Congress to keep the prohibition on denying coverage to those with pre-existing conditions, and 56 percent want to retain requiring insurance companies to allow the children of policyholders to stay on their plans until age 26.
While other provisions of the law are less popular with GOP voters, those voters are not overwhelmingly in favor of repealing them. Only 40 percent of Republicans want to repeal the 50-employee requirement, slightly fewer than the 44 percent who want to keep it. Just 38 percent want to repeal the subsidies for low-income Americans to buy insurance, compared to 43 percent who want to keep the subsidies. Forty-one percent want to repeal Medicaid expansion funds, while 40 percent want to retain those funds as part of the law.
“The Affordable Care Act has a branding problem: Voters don’t like the law when looked at as a whole but are actually big fans of many of its key components,” said Kyle Dropp, Morning Consult chief research officer and co-founder. “That creates a significant challenge for Republicans. They have to put forth a replacement plan that maintains some of Obamacare’s popular components, but avoids the pitfalls that have plagued the broader health care law.”
While voters are wary of repealing the law without a replacement, only 18 percent are “very concerned” that repealing the law could cause them to lose their health insurance, while 16 percent are “somewhat concerned.” Forty-six percent of Democrats are very or somewhat concerned about losing their coverage, compared to 26 percent of Republicans and 29 percent of independents.
A combined majority of voters are “not too concerned” (21 percent) or “not at all concerned” (35 percent) about losing their coverage if Obamacare is repealed.
The POLITICO/Morning Consult poll was conducted January 5-7, surveying 1,988 registered voters. The margin of error is plus or minus 2 percentage points.
Morning Consult is a nonpartisan media and technology company that provides data-driven research and insights on politics, policy and business strategy.