Americans' Approval of ACA Holds Steady

WASHINGTON, D.C. -- On the eve of its 10-year anniversary, the Affordable Care Act (ACA) -- signed into law by President Barack Obama on March 23, 2010 -- is supported by the slight majority of Americans, 52%. This has occurred only twice previously in Gallup polling on the ACA since 2012, both times in the early days of Donald Trump's presidency. Since Trump has been in office, the public has either tilted in favor of the ACA or been closely split. By contrast, from 2012 to 2016, attitudes more often tilted against the law.

The low points in public support for the ACA, also known as "Obamacare," were seen from late 2013 through late 2014, as the healthcare exchanges were being rolled out and opponents were calling for its repeal. The latest reading is from a Gallup poll conducted Feb. 17-28 and is just shy of the record-high 55% approval in 2017.

Views of ACA Diverge Along Partisan Lines

Americans' views of the ACA remain starkly divided by party. In fact, a record-high percentage of Democrats (94%) now approve of the Affordable Care Act, while Republicans' approval (11%) remains low and mostly unchanged over the past several years.

After initially approving of the ACA in 2012, independents soured on the legislation within its first year, and their support remained low through 2016, including during the ACA's least popular days. Since last year, support among this group has been back to 50% or better and is holding steady.

The Pros and Cons of the ACA

Americans have mixed views of the specific impact the ACA has had on a variety of aspects of their own healthcare plans over the past decade.

On the positive side:

• 78% of Americans say they did not have to change their primary doctor.
• The same percentage (78%) report that they did not have to give up a medical plan they liked because of its noncompliance with the ACA.
• 28% say the ACA allowed them to obtain health insurance after not having it previously.
• 22% were able to keep or add an adult child on their plan, a key benefit mandated by the ACA that took effect in 2010.
• 20% say they have gotten coverage for a preexisting medical condition that wasn't covered before the law was passed.

At the same time, some of the perceived challenges or negative impacts of the ACA include:

• 61% do not think they have access to more services in their plan since the law's enactment.
• 53% of Americans report that their premiums have increased since the law was passed.

	Yes	No	No opinion
	%	%	%
You had more medical services covered in your plan than in the past	36	61	2
You obtained health insurance coverage when you didn't have it before	28	70	1
You kept or added an adult child up to age 26 on your health plan	22	78	--
You obtained coverage for a preexisting medical condition when you didn't have it before	20	79	1
Your health insurance premiums went down	17	80	3
Your health insurance premiums went up	53	44	3
You had to change to a different primary doctor	21	78	1
You had to give up a medical plan you liked because it didn't comply with the law's requirements	21	78	1
Gallup, Feb. 17-28, 2020

Bottom Line

While a slight majority of Americans approve of the Affordable Care Act, scarcely improved over the mostly divided support seen since Trump took office, Democrats are more likely than ever to approve of the healthcare law. Thus, despite some Democratic presidential candidates' focus on "Medicare for all," these results indicate Democrats are in no hurry to abandon the ACA. While approval ratings and overall perceptions of the law's impact are important to track, another key metric often used to assess the success of "Obamacare" is the overall rate of Americans who are uninsured.

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