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July Kaiser Health Tracking Poll: A Focus On The Mandate and the Medicaid Expansion in the Aftermath of the Supreme Court Decision

This second July poll reports in further depth on public opinion about the Affordable Care Act (ACA) in the wake of the Supreme Court decision. The Supreme Court’s decision that the individual mandate was constitutional as a tax appears to have had little impact on opinion about the already largely unpopular requirement that most people have health coverage or potentially face a penalty. Sixty-six percent of the public view the mandate negatively when it is described as a “fine” and 61 percent do so when it is labeled a “tax.”

The idea of expanding Medicaid under the ACA to cover more low-income people is popular, with 67 percent of Americans supporting the concept and 30 percent opposing it. But the Court’s decision giving states the option to decide whether or not to expand Medicaid has created a new arena for ACA controversy and partisan disagreement. When people are asked whether their own state should expand its Medicaid program to cover more low-income people, with the federal government eventually paying 90 percent of the cost and the state 10 percent, 49 percent of people support expanding Medicaid in their own state while 43 percent say they prefer to keep their state’s status quo. As with most ACA-related controversies, the public splits sharply along partisan lines on whether their state should undertake the expansion.

Americans remain roughly divided on the ACA, with unfavorable views of the law in July slightly outweighing favorable views, 44 percent to 38 percent this month. When it comes to next steps, the share of Americans who favor repeal of the law (46 percent) matched the share this month who would like to keep the law or expand it (45 percent). Half of those who hope to see the law repealed also favor replacing it with a Republican alternative. With the November election approaching and the law a key point of contention between the president and his challenger, just over half of Americans say their mind is made up on the law, and won’t change. The law’s opponents are much more likely than its proponents to say their minds are firmly made up (69% vs. 47%). For more on the mandate and the Medicaid expansion, including evidence that opinions on these issues may be somewhat malleable, check out the full findings, chartpack, and topline here.

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