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March Kaiser Health Tracking Poll: The ACA at Two Years; The Individual Mandate and the Supreme Court

As the Patient Protection and Affordable Care Act (ACA) nears its second birthday, the latest Kaiser Health Tracking Poll finds that public opinion on the law remains evenly split (41 percent favorable, 40 percent unfavorable) with sharp divisions along partisan lines, much as it has been since the law was passed.

With the Supreme Court preparing to hear challenges to the law later this month, about half the public thinks the Court should strike down the individual mandate, which has been and continues to be the law’s least popular provision. The public is not yet paying close attention to the legal proceedings, and opinions on what the Court should do about the mandate mirror views on the law overall, with most (83 percent) of those who oppose the law wanting the Court to find the mandate unconstitutional, and half of those who favor the law preferring the opposite outcome. Still, most do not see the Court’s ruling as the final word on the ACA; six in ten say that if the Court finds the mandate unconstitutional, some parts of the law will still be implemented. Underlying these beliefs is the fact that less than a quarter of the public (23 percent) expresses a lot of confidence in the Supreme Court, and about half believe national politics (50 percent) and the justices’ own ideology (51 percent) will play a major role in the Court’s decision, similar to the 54 percent who expect legal analysis to play a major role. At this point, the public says the Court’s decision is unlikely to change their overall opinion on the ACA, with the vast majority of those with a favorable or unfavorable view of the law saying a ruling to uphold or strike down the mandate would not change how they feel about the law in general.

Meanwhile, the views of seniors—who have traditionally tilted more negative on the law—have trended more positively in recent months, and in March, seniors are just as likely to view the law favorably (44 percent) as unfavorably (42 percent). Finally, two years after passage, the ACA is not yet “real” for most Americans—six in ten say they don’t have enough information to understand how the law will impact them, and two thirds say the law has not yet affected their family in either a positive or negative way.

Also available is a new “Pulling It Together” analysis from Drew Altman which draws on the poll findings to examine the role the health reform law plays as a political symbol.

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