PRINCETON, NJ -- With the open enrollment period for obtaining health insurance through a federal government exchange now over, Americans' views on the broader healthcare law remain more negative than positive. Currently, 43% approve and 54% disapprove of the law, commonly known as "Obamacare." The approval figure is a bit higher than Gallup's estimates since last November, but disapproval is essentially unchanged.
The March 31 deadline for obtaining health insurance through an exchange was a major milestone in the law's implementation. The White House reports more than 7 million Americans enrolled in health insurance plans. Gallup's tracking polling also shows a decline in the percentage of Americans without health insurance during the first quarter of this year.
Even so, Americans' generally negative views of the law have changed little over the past year as more and more of its provisions have gone into effect. For example, 45% of Americans expect the law to make the U.S. healthcare situation worse in the long run, compared with 37% who believe the law will make the situation better, with only minor variations on each percentage since June.
Americans' overall approval of the law and expectations for its long-term effects on the healthcare system continue to be strongly related to their party affiliation. A vast majority of Democrats, 79%, approve of the law, and 69% think it will make the healthcare situation better. In contrast, 87% of Republicans disapprove of the law, and 77% think it will make the healthcare situation worse.
Independents are more negative than positive toward the law. They disapprove of the law by 65% to 32%, and 53% believe the law will make the healthcare situation worse compared with 26% who say better.
Majority of Americans Unaffected by Law
Most Americans, 64%, say their own healthcare situation has so far not been affected by the provisions of the ACA law already in effect. This percentage has declined only slightly from 70% in February 2012 even as more of the law has since been implemented.
More Americans continue to say the law has hurt (18%) rather than helped them (15%), although that is a closer division than in past Gallup surveys.
Americans are more likely to think the law will affect their own healthcare situation in the long run, with 32% expecting it to make their situation worse and 24% saying better. Americans have always predicted the law would do more to harm than help their healthcare situation, but the current eight-percentage-point gap is the lowest yet.
The plurality, 42%, now expect the healthcare law will not make much difference to their healthcare situation either way. That is up from prior surveys and suggests that as more of the law has taken effect, Americans are more likely to see that it is not affecting them -- and has not made their situation worse.
These changes are a result of a shift in Republicans' views. Republicans are now more likely than in the prior survey to predict the law's long-term impact on their family will be negligible and less likely to believe it will be harmful. Perhaps with more of the law's provisions now in effect, and little evidence it has actually hurt their healthcare situation, Republicans' views may be more informed by their experience rather than their negative opinions about the law more generally.
Implications
Americans continue to evaluate the Affordable Care Act negatively, and their basic opinions of the law have been fairly stable over the past year. That may suggest Americans have already made up their mind about the law, for the most part reflecting their underlying political orientation, and the law's implementation is not going to influence how they feel about the law.
Yet there is some evidence that Americans' perceptions of how the law might affect their own situation both in the short-term and long-term are changing and becoming less negative. Those shifts would make sense if the law works as intended to bring more people into the health insurance system and to make it more affordable for those struggling to pay for it, while not materially affecting the healthcare of those who have it and can afford it.
Still, many of the provisions of the law have yet to go into effect, and the Obama administration has delayed the dates that many are scheduled to take effect, most notably the requirement that employers with at least 50 workers must offer full-time employees health insurance. That, too, has the potential to influence Americans' views about whether the law is beneficial, neutral, or harmful to their own situation.
Survey Methods
Results for this Gallup poll are based on telephone interviews conducted April 7-8, 2014, on the Gallup Daily tracking survey, with a random sample of 1,009 adults, aged 18 and older, living in all 50 U.S. states and the District of Columbia.
For results based on the total sample of national adults, the margin of sampling error is ±4 percentage points at the 95% confidence level.
Interviews are conducted with respondents on landline telephones and cellular phones, with interviews conducted in Spanish for respondents who are primarily Spanish-speaking. Each sample of national adults includes a minimum quota of 50% cellphone respondents and 50% landline respondents, with additional minimum quotas by time zone within region. Landline and cellular telephone numbers are selected using random-digit-dial methods. Landline respondents are chosen at random within each household on the basis of which member had the most recent birthday.
Samples are weighted to correct for unequal selection probability, nonresponse, and double coverage of landline and cell users in the two sampling frames. They are also weighted to match the national demographics of gender, age, race, Hispanic ethnicity, education, region, population density, and phone status (cellphone only/landline only/both, and cellphone mostly). Demographic weighting targets are based on the most recent Current Population Survey figures for the aged 18 and older U.S. population. Phone status targets are based on the most recent National Health Interview Survey. Population density targets are based on the most recent U.S. census. All reported margins of sampling error include the computed design effects for weighting.
In addition to sampling error, question wording and practical difficulties in conducting surveys can introduce error or bias into the findings of public opinion polls.
View survey methodology, complete question responses, and trends.
For more details on Gallup's polling methodology, visit www.gallup.com.
