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Despite Enrollment Success, Healthcare Law Still Unpopular

Despite Enrollment Success, Healthcare Law Still Unpopular

WASHINGTON, D.C. -- Although the Obama administration is boasting higher-than-expected enrollment for the Affordable Care Act, Americans' attitudes toward the healthcare law have changed only marginally since the open enrollment period ended for 2014. A steady 43% of Americans approve of the 2010 Affordable Care Act, also known as "Obamacare," while a majority continue to disapprove of it, roughly where sentiment was before the enrollment window officially closed on March 31.

Approval of the U.S. Healthcare Law

These data are based on interviews with 2,538 Americans in a May 21-25 Gallup poll.

At the moment, there appears to be a rare lull in media scrutiny and political acrimony toward the healthcare law. The opportunity to buy individual health insurance policies through federal or state-run exchanges officially came to a close on March 31, 2014. The number enrolled now exceeds 8 million, and the high tally gave the impression of a good finish to what had been a very bad start, plagued by a botched website launch in early October and then reports of canceled insurance policies due to new, Affordable Care Act-inspired regulatory standards.

Nonetheless, public opinion about the healthcare law has been relatively steady throughout this front-and-center saga, mostly immune to both the good and bad developments. Approval of the law fell to 38% in early January 2014, when the federal exchange website's glitches continued to plague the rollout of the marketplaces. Approval ratings improved slightly once the website was fixed and the public relations fiasco receded.

Net approval of the Affordable Care Act now stands at -8 points, reflective of the fact that more Americans disapprove than approve. This is the least negative tilt measured since the -3 recorded in late October 2013.

Fewer than four in 10 adults (37%) say the law will ultimately make the healthcare situation better in the U.S., consistent with past measures. A plurality of Americans (44%) say it will make things worse, and another 16% say it won't make much of a difference.

Long-Term Impact of Healthcare Law on the U.S.

Blacks Most Approving of Law, Whites Least

Approval of the healthcare law is intimately tied to a person's politics, with 79% of Democrats approving versus 8% of Republicans. Race and ethnicity also play some role in approval of the Affordable Care Act. Non-Hispanic white Americans are, by far, the least supportive of the law, with 35% approving. By contrast, 76% of black Americans approve of the law, while less than a fifth disapprove. Meanwhile, 57% of Hispanics -- a group intently targeted by the law -- approve, and one-third disapprove.

The Obama administration made a concerted effort to try to enroll Hispanics, the least likely of the three major racial/ethnic groups to report having health insurance, with President Barack Obama appearing on two Spanish-language television networks earlier this year to discuss the issue.

Approval of the U.S. Healthcare Law, by Race

Black Americans are also most likely to see the law as making the healthcare situation in the U.S. better, with 64% saying so. Lesser shares of Hispanics (41%) and whites (31%) believe the law will improve the U.S. healthcare situation.

Long-Term Impact of Healthcare Law on the U.S., by Race


The past eight months have been eventful for the Affordable Care Act. The unresponsive federal health exchange website that blemished the start of the open enrollment period became a huge liability for the Obama administration and its signature domestic achievement, and matters only worsened once Americans began receiving notification letters of canceled policies. But the issues with the website were eventually resolved, and the number of people enrolled exceeded initial expectations, giving the law's supporters something of a happy ending.

Throughout this ordeal, public opinion has remained mostly static and oriented against the healthcare law, suggesting that most Americans have made up their minds on this issue and see no reason to revisit their opinion. This is likely a consequence of the polarizing effect of the law -- Republicans are solidly opposed, while the bulk of Democrats support it. It's uncertain what role this still unpopular law will play in the midterm elections; Americans say the economy and unemployment overshadow healthcare in terms of the most important problem facing the U.S. But many Republican candidates competing against Democratic incumbent senators in states such as North Carolina, Arkansas, and Louisiana are highlighting their opposition to the law. Some Democrats may try to embrace and defend it, while others may try to change the topic of discussion.

Survey Methods

Results for this Gallup poll are based on telephone interviews conducted May 21-25, 2014, on the Gallup Daily tracking survey, with a random sample of 2,538 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 ±3 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.

For more details on Gallup's polling methodology, visit

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