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Majority of the Public Say They Haven’t Been Affected By the Health Reform Law

Democrats More Likely to Say They Have Been Helped By the Law, Republicans More Likely to Say They Have Been Hurt

Republican Voters Want ACA Debate to Continue, Democrats Would Rather Hear Candidates Talk About Issues Like Jobs, Independents Are More Split

More than four years after the Affordable Care Act’s enactment and more than a month after the close of open enrollment, six in 10 Americans (60%) say the health reform law has not had an impact on them or their families, Kaiser’s May Tracking Poll finds.

Among those who say it has, Republicans are much more likely to say their families have been hurt by the law (37%) than helped (5%), while Democrats are more likely to say their families have been helped (26%) than hurt (8%).  Independents fall in between, though more say that their families have been hurt than helped.  This relationship between partisanship and reported impact of the law holds when controlling for other factors such as income, race/ethnicity, and insurance status.

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When those who say they’ve been helped or hurt by the law are asked about specifics, most of those who report being hurt say it has increased their health care costs (14% of the public overall), while the most common response among those who report being helped is that it has allowed someone in their family to get or keep coverage (5% of the public overall).

This month’s poll also takes an early look at registered voters’ views in advance of November’s congressional midterm elections. (As the election nears, our polling will look more closely at likely voters.)

The poll finds more registered voters (51%) say they are tired of hearing candidates talk about the health care law and want them to focus more on other issues like jobs than say it is important for candidates to continue to debate the health reform law (43%).  These averages mask a familiar partisan divide on the ACA, with a majority of Democratic voters (69%) saying they are tired of the debate and a majority of Republican voters (60%) saying they want it to continue. Independents are more split, with half (50%) saying they’d rather hear candidates talk about issues like jobs and 44 percent saying they want the ACA debate to continue.

Overall a majority of registered voters say they will consider a candidate’s position on the health care law as just one of many important factors to their vote.  About three in 10 voters (31%) say they would only vote for a candidate who shares their view on the health reform law.  This includes a somewhat larger share of those with an unfavorable view of the law (38%) than a favorable one (28%), suggesting the law may be more of a motivator for opponents than supporters. The share of voters who say they would only vote for a like-minded candidate on the health care law is similar to the share who say the same about government spending (33%), while slightly fewer say the same about job creation and immigration reform (22% each).

Other findings include:

  • The public’s overall perception of the law is unchanged over the past month, with 38 percent holding a favorable view of the law and 45 percent holding an unfavorable one.  As in the past, most Democrats view the law favorably, and most Republicans view it unfavorably. There is also an intensity gap on favorability, with nearly twice as many Republicans expressing a “very” unfavorable view as Democrats expressing a “very” favorable one (61% vs. 36%).
  • As in previous tracking polls, a majority of the public overall (59%), including majorities of Democrats and Independents, say they want their representative in Congress to work to improve the law, rather than repeal it and replace it with an alternative. Two thirds of Republicans favor repeal and replace. When those who favor the “improve” option are asked to say in their own words how they would like to see the law improved, one in five cite affordability of health care and lower costs (20%), while fewer say increasing help for specific groups such as seniors or the poor (11%) and expanding access and availability more generally (11%). Other specific improvements were suggested by small shares of the public.
  • This month’s Health Policy News Index finds the health law’s enrollment numbers were the most followed health policy story, with 58 percent of the public following it closely. This represents a 10 percentage point increase in the share closely following that story since March.   For comparison, 69% say they closely followed the kidnapping of school girls in Nigeria, and 65% the conflict between Ukraine and Russia.

The survey was designed and analyzed by public opinion researchers at the Kaiser Family Foundation and was conducted from May 13-19 among a nationally representative random digit dial telephone sample of 1,505 adults ages 18 and older (including 1,279 registered voters). Telephone interviews were conducted by landline (750) and cell phone (755) and were carried out in English and Spanish. The margin of sampling error is plus or minus 3 percentage points for the full sample and 3 percentage points for registered voters. For results based on subgroups, the margin of sampling error may be higher.