John Shinkle/POLITICO POLITICO-Harvard poll: Republicans can't move beyond Obamacare repeal

Republicans can’t agree on what their party should do next on health care — but they do know they don’t want Obamacare.

While 60 percent of Americans want Republicans either to work with Democrats to fix the Affordable Care Act or move on, just as many Republicans want their party to repeal the health care law entirely or try again on a replacement plan, according to a new POLITICO-Harvard T.H. Chan School of Public Health poll.


The survey, taken days after House Republicans yanked their unpopular repeal bill from the floor last month but before the latest attempts to revive it, reveals the GOP is split on the contours of a replacement plan. But they are united in their disdain for Obamacare after seven years of promises to dismantle the health care law. And that helps explain why President Donald Trump is again pushing the repeal effort even as congressional leaders warn they don’t want to rush the legislation.

“[Republicans] want to be able to say Obamacare as it was no longer exists, but they’re not at all agreed upon what the replacement should be,” said Bob Blendon, a Harvard expert on health care policy and public opinion who designed the poll with POLITICO.

Democrats right now are more energized than Republicans when it comes to health care — a notable reversal from previous years when Republicans rode a wave of anti-Obamacare sentiment to take full control of Washington. Registered voters said the GOP’s repeal effort made them more likely to vote for a Democrat in 2018 (36 percent) than a Republican (24 percent).

Just 35 percent of Republicans think their party’s bill, the American Health Care Act, would lower premiums as the party promised — only 17 percent of Americans believed it would. Still, nearly two-thirds of Republicans preferred the GOP health bill over Obamacare, while 60 percent of the general public said they’d rather keep Obamacare.

The survey found strong disagreements about how much financial support Republicans should provide in their health care plan. A plurality of Americans, 42 percent, said the replacement should provide financial assistance to as many people as Obamacare does, while 34 percent said the plan should “provide access to coverage” but without any financial assistance. Among Republicans, though, 50 percent said the GOP plan shouldn’t provide any subsidies — more than double the percentage who said the replacement plan should give financial assistance to as many people as Obamacare does.

A majority of Americans, including about two-thirds of Democrats and 55 percent of independents, said they would prefer the government require health insurers to offer plans with more comprehensive coverage, even though it would mean higher premiums. By comparison, that idea was supported by 26 percent of Republicans, who were about twice as likely — 54 percent — to say insurers should be able to sell cheaper plans offering fewer benefits.

The GOP plan would generally provide less financial assistance to help people purchase insurance in the individual market while also scaling back Medicaid. Conservatives, particularly those in the House Freedom Caucus, are pushing for deeper cuts to Obamacare’s coverage mandates, which they say drive up the cost of insurance. But more moderate Rebublicans are nervous they would face voter backlash for deep coverage losses resulting from the GOP health plan.

Leaders of the Republican factions brokered an amendment over the recent two-week congressional recess meant to ease concerns from conservatives and moderates. Republican leaders say they’re closer to passing a bill in the House, but the White House is acknowledging it likely won’t get done by the 100-day mark of Trump’s presidency on Saturday.

"I think we want to make sure that we’ve got the votes and we’re headed in the right direction before putting some kind of artificial deadline," White House press secretary Sean Spicer said Monday.

Most Americans — 56 percent — have heard about the raucous town hall protests opposing Obamacare repeal over the past few months. But they’re doing little to actually change minds about the health law: Just 12 percent said the protests gave them a more favorable view of the ACA, while 9 percent said the demonstrations hardened their opposition to the law.

Even if the repeal effort stalls, top HHS officials have indicated they will allow states to pursue major changes to Medicaid eligibility. The POLITICO-Harvard poll found that while just about four in 10 Americans support requiring Medicaid beneficiaries to make copays when they receive care, 67 percent support requiring able-bodied, childless adults to work to receive Medicaid benefits.

The POLITICO-Harvard poll was conducted by SSRS, an independent research company, from March 22 to March 26. A second survey was conducted from March 29 to April 2 after Republicans pulled their repeal bill. The first survey used cellphones and landlines among a nationally representative sample of 1,019 U.S. adults, and a similar methodology was used for a second survey of 1,017 adults.

