Americans are sharply divided on revoking Obamacare’s mandate that individuals obtain health insurance coverage, according to a new CNN/ORC Poll, a change that’s a key provision of a newly released Republican plan to repeal and replace the 2010 law.
The survey, conducted before the details of the GOP plan were released Monday, also finds mixed views on several other provisions included in the new proposal. The public is broadly opposed to reductions in funding for Medicaid, though there is near-universal support for maintaining the protections afforded to those with pre-existing conditions under the Affordable Care Act.
Overall, 50% oppose removing the requirement to obtain coverage or pay a penalty, while 48% favor it.
A broad majority, 87%, support maintaining Obamacare’s protections for those with pre-existing conditions, and 61% are opposed to a replacement bill that would curb funding for the expansion of the Medicaid program implemented under the ACA.
Shifting tax credits from an income-based system to one that’s driven by age, another idea incorporated in the new proposal, also divides the public, with 46% in favor and 50% opposed. And a new provision, mentioned by President Donald Trump in his address to Congress last week, to allow insurers to sell coverage in any state regardless of where they are licensed generates greater support, with 66% in favor and 31% opposed.
The partisan divide on replacement provisions is sharpest on Medicaid funding, with 74% of Democrats opposed to curbs on federal funds for the program and 49% of Republicans in favor.
Some prominent Republicans, including four senators, have signaled their unwillingness to support a bill that results in cuts to the Medicaid program. The GOP proposal unveiled on Monday would restructure the program so that states receive a set amount of money from the federal government every year — changes experts warn could result in millions of people losing access to insurance they received under the Affordable Care Act
There’s also a significant partisan gap on the individual mandate, with 60% of Democrats opposed to removing it and 55% of Republicans in favor.
There’s agreement across party lines on maintaining protections for those with pre-existing conditions (more than 8 in 10 of any party favor that) and on allowing insurers to sell their products in any state (74% of Republicans, 65% of independents and 61% of Democrats back that).
More broadly, the share of Americans who say that Congress and the Trump administration should only repeal the Affordable Care Act if replacements can be enacted at the same time has grown.
Overall, 59% say the White House and Republicans in Congress should only repeal parts of the bill when they are able to replace them, up four points from 55% in January. That shift is driven largely by changes among Republicans, from 58% in support of repeal only with replacement in January to 66% now.
Public still split on law
Impressions of Obamacare itself remain mixed, with 46% saying they favor it and 49% opposed, though that is a more positive reaction to the law than any CNN/ORC polling prior to January.
Still, the poll suggests the changes brought by Obamacare haven’t improved overall satisfaction with the cost or quality of care in the U.S.
On basic measures of quality and cost, Americans are less satisfied with health care in the United States now than they were in 2009, before the law was put into place. Considering the quality of care they receive, 78% are satisfied, down from 82% in March 2009. Likewise, satisfaction with insurance coverage has dipped from 73% to 68% in that time.
A majority, 53%, now express dissatisfaction with the price they pay for health care, up from 48% in 2009, and just 14% are satisfied with the total cost of care in the US, down from 23% in that year. Recent studies have shown that the cost of insurance premiums — both employer-provided and purchased on the exchanges created by Obamacare — have risen sharply, with average deductibles also increasing rapidly.
Satisfaction with these elements of the health care system are closely tied to views of Obamacare itself. Among those who favor the law, 88% are satisfied with their quality of care, 78% with their insurance coverage and 52% with their total out-of-pocket costs. Those figures drop to 68%, 58% and 39%, respectively, among those who oppose the ACA.
In findings from the same poll released earlier this week, Trump’s approval rating for handling health care tilted negative: 53% disapproved and 43% approved.
The CNN/ORC poll was conducted by telephone from March 1-4 among a random national sample of 1,025 adults. Results for the full sample have a margin of sampling error of plus or minus 3 percentage points. It is larger for subgroups.