Despite sharp partisan differences over the Affordable Care Act, Democrats and Republicans, including voters who backed President-elect Donald Trump, strongly support most of the law's key provisions, a new national poll indicates. And although most Trump voters still favor repealing the law, often called Obamacare, an increasing share of Americans overall opposes that approach, according to the poll, which was conducted in mid-November, following Trump's election.
Just a quarter of Americans say they want to scrap the law, down from nearly a third in October. By contrast, nearly half say they want the law expanded or implemented as it is.
Another 17 percent say they want the law scaled back. The new findings from the nonprofit Kaiser Family Foundation are the most extensive sample of public opinion about the health law since last month's election. And they underscore the challenge confronting the incoming Trump administration and congressional Republicans, who have pledged to roll back key parts of the 2010 health law early next year.
"While President-elect Donald Trump and Republican leaders in Congress work on a replacement to the Affordable Care Act, the new poll finds many of the law's specific provisions remain popular even among President-elect Trump's supporters, potentially complicating the path ahead," the survey's authors note.
More than 8 in 10 Americans say they like provisions in the law that eliminate out-of-pocket costs for many preventive services such as cancer screenings and that allow young adults to remain on their parents' health plans until they are 26.
Even the law's program for providing federal aid to states to help them expand their Medicaid programs for the poor is supported by 80 percent of Americans. The same strong majority supports the law's system of insurance marketplaces — such as HealthCare.gov — where people who don't get coverage through an employer can shop for health plans. And 80 percent of Americans favor the government subsidies provided through the law to help low- and moderate-income people buy health insurance on the marketplaces.
Congressional Republicans are working on a plan that would repeal the Medicaid expansion and the insurance subsidies for lower-income consumers.
Trump has pledged to act quickly to scrap the law. He and his congressional allies have promised to develop a replacement, but they have not indicated what that might include.
The repeal calls have been extremely popular with Republican voters. And even now, 81 percent of people who voted for Trump hold an unfavorable view of Obamacare, according to the Kaiser poll. Half say they want the entire law repealed.
This apparent paradox — in which Americans view the law unfavorably but overwhelmingly support most of its key provisions _ has characterized opinion about Obamacare for years, said Robert Blendon, an authority on public attitudes about health care at Harvard University. "It's long been clear that what is driving opposition to the law are the mandates," he said.
The law's requirement that Americans have health insurance or pay a tax penalty is by far the least popular part of Obamacare. And Republicans have exploited it as a potent symbol of what they have said is Obamacare's dangerous expansion of government.
That argument has resonated powerfully with conservative voters nationwide. Today, the insurance mandate is view favorably by just 35 percent of Americans. But that makes it the only one of 10 provisions of the health law that does not command majority support in the Kaiser poll.
Several Republican plans to replace the health law include an alternative mechanism to encourage healthy consumers to sign up for coverage that would penalize people who do not maintain continuous coverage.
Both conservative and liberal insurance experts say that any system that guarantees coverage to people, even if they are sick, must include some kind of penalty for not having coverage. That insurance guarantee is a key part of the health law. The Kaiser poll was conducted Nov. 15-21 among a nationwide sample of 1,202 adults.
The margin of error for the full sample was plus or minus 3 percentage points.