For those who followed the debate over the Affordable Care Act when it was still in its infancy, there were plenty of substantive challenges surrounding overhauling the nation’s health care infrastructure. But there was also a political problem: The reform law known as “Obamacare” was not at all popular at the time.
It was difficult to imagine 14 years ago that two-thirds of the public would express support for the ACA, but Democratic leaders who swore that its popularity would grow over time were correct. Consider the results of the latest KFF Health Tracking Poll, released last week:
[T]wo-thirds (66%) of the public now have favorable views of the ACA, the highest level of support recorded in KFF polls since the law’s enactment in 2010. Favorable views of the ACA have been on the rise since 2017 during an unsuccessful attempt by Congressional Republicans to repeal the law during President Trump’s first term.
Not surprisingly, as the number of Americans with favorable views of the Affordable Care Act reaches new heights, unfavorable views have collapsed: Around this time 11 years ago, the KFF Health Tracking Poll found a 53% majority disliked the ACA. Now, that number has dropped to 30%, an all-time low.
For health care advocates, that’s the good news. The bad news is that Republican officials are moving forward with plans to gut the law in ways that would hurt consumers and ACA beneficiaries. The editorial board of The Washington Post summarized the GOP efforts well:
The legislation would erect multiple barriers to receiving the subsidized ACA coverage at the law’s core. It would shorten enrollment periods, restrict access for many immigrants living legally in the country and add burdensome paperwork that would make it hard for people to remain on the plans they already have. ... Sick people, who have the greatest need for health care coverage, will be the ones most likely to go to the trouble to navigate the bureaucracy, while healthy people might be more inclined to give up. Then, with fewer healthy people in the risk pools, premiums would rise for everyone.
The Post’s editors added that these changes don’t appear to be designed to address any specific problems with the status quo, noting that the revisions in the Republicans’ domestic policy megabill “provide no benefits to offset the damage they would do.”
And that damage would be considerable. The nonpartisan Congressional Budget Office found 16 million Americans would lose their health care coverage if the GOP’s inaptly named One Big Beautiful Bill Act passes, and nearly half of that total would result from measures designed to undermine the ACA.
In the first year of Donald Trump’s first term, Republicans also went after the ACA, and the political blowback was enormous: The effort inspired progressive activists to get more engaged, put the GOP on the defensive and pushed the president’s approval rating sharply lower. The political damage lingered and did real harm to Republicans in the 2018 midterms.
It would probably be wise for Democrats to focus their messaging accordingly. The Republicans’ megabill is, for all intents and purposes, an anti-health care bill that would take coverage from millions of American families.
This post updates our related earlier coverage.