Amid Primary Debate about Universal Coverage, Most Democrats Now Want to Expand the Affordable Care Act, Leading to Somewhat Less Favorable Views of the Law Itself

Voters Rank Health Care Fourth As Issue for Presidential Candidates to Discuss

With the Democratic presidential primary featuring a debate about how to get to universal health coverage in the United States, the latest Kaiser Health Tracking Poll finds most Democrats want Congress to expand the Affordable Care Act, contributing to a widening gap between unfavorable and favorable views of the health reform law.

Overall the poll finds that this month 49 percent of the public have an unfavorable of the law while 38 percent have a favorable one. The 11 percentage-point gap compares to a 6-point gap in March, but the movement was among Democrats who are now less likely to hold favorable views (63% this month compared to 69% in March) and more likely to hold unfavorable ones (25% compared to 19%).

The public overall remains split on what they want Congress to do next with the law.  About as many people say they want the entire law repealed (32%) as say they want to expand what the law does (30%), while fewer say they want the law implemented as is (14%) or scaled back (11%).

While most Republicans (56%) say they want Congress to repeal the law entirely, most Democrats (51%) say they want to expand what the law does – a share that has increased 13 percentage points over the past year. Even among Democrats who do not hold a favorable view of the ACA, twice as many want Congress to expand the law (40%) than repeal it (19%), suggesting this goal is contributing to the somewhat less favorable views Democrats now hold about the law.

As the 2016 presidential election contest marches on, voters rank health care fourth as the issue they most want the candidates to discuss on the trail. When asked to name the issues they are most interested in hearing the candidates discuss, by far the largest share cite the economy/jobs (30%), followed by national security (21%), immigration (17%), and health care (15%). Further down the list are social issues (10%), education (8%), and foreign policy (8%).

The economy is the most cited issue regardless of party. Democratic voters are more likely to mention health care than independents or Republicans. In addition, Republican and independent voters are more likely than Democrats to mention national security and immigration.

When asked specifically what health care issues voters would most like to hear the presidential candidates discuss, the Affordable Care Act (37%) and health care costs (36%) top the list, followed by expanding coverage for the uninsured (26%) and Medicare (10%).

Nearly half of Republican voters (45%) mention the Affordable Care Act, many of whom explicitly mention repealing or opposing it. Slightly more Democratic voters mention expanding coverage for the uninsured and health care costs than the Affordable Care Act, while equal shares of independents mention the Affordable Care Act and health care costs. 

Designed and analyzed by public opinion researchers at the Kaiser Family Foundation, the poll was conducted from April 12-19 among a nationally representative random digit dial telephone sample of 1,201 adults. Interviews were conducted in English and Spanish by landline (420) and cell phone (781). The margin of sampling error is plus or minus 3 percentage points for the full sample. For results based on subgroups, the margin of sampling error may be higher.