Americans' Views of Healthcare Law Improve

PRINCETON, N.J. -- Shortly after the Supreme Court in late June turned back a second legal challenge to the 2010 Affordable Care Act, Americans' approval of the law rose to 47%, the highest level since 2012. Still, Americans are as likely to disapprove as to approve of the law.

The results are based on a July 1-5 Gallup poll. On June 25, the Supreme Court issued its decision in the case of King v. Burwell. At issue in the case was the Affordable Care Act's provision for tax credits to subsidize individuals' health plans purchased through insurance "exchanges." The law stated that only those who purchased insurance through exchanges established by states were eligible for subsidies.

Currently, 16 states have their own exchanges, with individuals in other states having to purchase insurance through federally run exchanges. The Supreme Court ruled that while the language plainly reads that only those in states with state-run exchanges are eligible for the tax credits, the law intended for people to get subsidized coverage through a state-run exchange or the federal exchange.

Support for ACA Typically Has Not Been High in the Past

A majority of Americans have typically disapproved of the Affordable Care Act, also known as "Obamacare," since late 2012 when Gallup began asking this version of the question. Opinion of the law before it was passed and immediately after its passage in March 2010 has never been highly positive.

Recent low points in Americans' support for the law came in late 2013 and early 2014, when 38% approved after companies dropped millions of Americans from their insurance plans because the plans did not meet the law's minimum coverage requirements. Those actions clearly contradicted President Barack Obama's pledge that those who liked their insurance plan would be able to keep it under the new law. Approval registered a similarly low 37% last fall after Republicans' strong showing in the midterm elections.

But approval of the law has now increased 10 percentage points in two subsequent polls, rising to 44% in April and now 47% after the court's decision.

Since November, approval of the ACA has increased among all key demographic groups, with the changes for each group generally within a few points of the overall 10-point increase.

As has been the case throughout the law's history, the differences are the greatest among political subgroups, with 83% of Democrats and 14% of Republicans approving. Support for the ACA is higher among nonwhites than whites, younger adults than older adults, and college graduates than college nongraduates.

Majority of Americans Say ACA Has Not Had an Effect on Them Personally

More than five years after the law's passage, many but not all of its provisions have been implemented. Fifty-five percent of Americans currently say the ACA has so far not affected them or their family. This percentage has declined over time as more of the law's provisions have rolled out, including the first two opportunities for Americans to buy health insurance through government exchanges in late 2013/early 2014 and late 2014/early 2015. More Americans say the law has hurt them and their family (25%) than say it has helped them and their family (18%), a pattern that has persisted since Gallup first asked the question in 2012.

As would be expected, Americans who say the law has helped their family overwhelmingly approve of it, and the vast majority of those who say the law has hurt their family disapprove of it. Those who say the law has not affected them are more likely to approve (51%) than disapprove (44%) of it.

To some degree, those relationships reflect the partisan evaluations of the law. Republicans -- who widely disapprove of the ACA -- are much more likely to say it has hurt their family (40%) than helped it (7%). And Democrats -- most of whom approve of the law -- are much more likely to say it has helped their family (30%) than hurt it (9%). Whether these reports of the law's effect are accurate assessments or just a broader expression of support for or opposition to the law is unclear.

Implications

Americans' views of the ACA have improved in recent months, but because they were more negative about it previously, now they are merely divided in their assessments of it. The Supreme Court's decision may have helped boost Americans' views of the law, giving it further legitimacy.

Additionally, changes in Americans' party affiliation since last fall could be a factor in the public's more upbeat assessment of the ACA. Americans also view Obama more positively now than they did last fall, and given his close association with the law, more positive opinions of him may translate to more positive opinions about Obamacare.

The Supreme Court's decision makes the future of the law slightly more certain, pending further legislative challenges from Republicans in Congress or legal challenges in court. If Americans elect a Republican president and a Republican-controlled Congress in 2016, this could imperil the ACA. But Republicans would likely need a large enough majority in the Senate to overcome a potential Democratic filibuster if they tried to roll back major provisions of the law or repeal it altogether.

Survey Methods

Results for this Gallup poll are based on telephone interviews conducted July 1-3 and 5, 2015, on the Gallup U.S. Daily survey, with a random sample of 2,013 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. All reported margins of sampling error include computed design effects for weighting.

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.

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