Drew Altman, Kaiser Family Foundation, Mollyann Brodie April 3, 2019
Data: Kaiser Health Tracking poll conducted Nov. 14-19, 2018 among 1,201 U.S. adults. Total margin of error is ±3.0 percentage points. Poll methodology; Chart: Chris Canipe
The only plausible explanation for President Trump's renewed
effort through the courts to do away with the Affordable Care Act, other than
muscle memory, is a desire to play to his base despite widely reported
misgivings in his own administration and among Republicans in Congress.
Reality check: But the
Republican base has more complicated views about the ACA than the activists who
show up at rallies and cheer when the president talks about repealing the law.
The polling is clear: Republicans don't like the ACA, but just like everyone
else, they like its benefits and will not want to lose them.
The big picture: About three quarters of
Republicans still have an unfavorable view of the ACA, and seven in 10 say
repealing the law is a top health priority for Congress — higher than other priorities
such as dealing with prescription drug costs. And yes, 7 in 10 Republicans
still want to see the Supreme Court overturn the law.
But as the chart shows, majorities of
Republicans like many elements of the ACA —especially closing the "donut
hole" in Medicare prescription drug coverage (80%), eliminating copayments
for preventive services (68%), keeping young adults under 26 on their parents'
plans (66%) and subsidies for low and middle-income households (63%).
- Nearly half of
Republicans want the Supreme Court to keep the protections for
pre-existing conditions (49%), and even more show
general support for the pre-existing conditions protections (58%).
- During the repeal and
replace debate in 2017, even Republicans were
nervous to hear that these sorts of things would go away. The 2020
campaign would drive home to the public, and to Republicans, what they
have to lose — and it would become especially real to them if the 5th
Circuit Court of Appeals upholds the ruling striking down the
ACA.
Maybe Republicans would forget about these lost benefits if they
could agree on a replacement plan they liked? But there isn't one, and many of
the ideas thought to be elements of one — such as cutting and block granting both
Medicaid and ACA subsidies — are non-starters with Democrats and moderate
Republicans on Capitol Hill. They're unpopular with the public, too.
The bottom line: It is widely
accepted that a renewed debate about repeal hands Democrats a powerful new
political opportunity. Deeper in the polling, it's also clear that’s it's more
of a mixed bag for Republicans than President Trump may realize.
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