Todd Spangler

Detroit Free Press

WASHINGTON — Republicans may have a good reason for dragging their feet on a quick repeal of the Affordable Care Act, with a new poll showing few voters in Michigan want them to do so without a replacement already in place.

Only 8% of Michigan voters polled by EPIC-MRA of Lansing favor repealing the 2010 Affordable Care Act — also known as Obamacare — without a Republican-led Congress and President Donald Trump first putting in place a new plan that presumably would offer some, if not many, of the same coverage options and protections.

"Support among Michigan voters for a repeal of the ACA (without a replacement) is extraordinarily low," said Bernie Porn of EPIC-MRA, which surveyed 600 Michigan voters from Feb. 4-9. The poll has a margin of error of plus or minus 4 percentage points and was commissioned by the Michigan Health & Hospital Association, which represents dozens of community health care facilities across the state. EPIC-MRA also does polling for the Free Press and its media partners.

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While the vast majority of Michiganders want an ACA replacement in place before repeal, that's not to say most people want to keep Obamacare, however: According to the poll, 57% of voters surveyed support repealing it, "but not until a detailed replacement is enacted." Another 33% favored keeping the ACA; 2% were undecided or refused to answer.

It also goes without saying that those numbers could change drastically depending on the specifics of any replacement plan, which has yet to be developed and released to the public.

Ever since its passage, congressional Republicans and GOP presidential candidates, including Trump, have called for an immediate repeal of the ACA, which put in place state marketplaces for individuals without insurance to purchase coverage while also expanding Medicaid eligibility, prohibiting denial for preexisting conditions and allowing children to remain on parents' policies until age 26. It also mandated coverage for all Americans as a way to spread costs.

Since winning the White House and taking control of both chambers of Congress this year, however, Republicans have been slow to move on their promise to repeal Obamacare abruptly or without a replacement in place, wary of the impact it could have on constituents. The Congressional Budget Office recently estimated that a repeal could result in 18 million more uninsured individuals in the first year after elimination, growing to 27 million as Medicaid eligibility was restricted.

It's still not known what a replacement program would look like and what it would cover, though last month Trump said his plan would provide "insurance for everyone." Meanwhile, some Republican members in the U.S. House have been pushing for House Speaker Paul Ryan to move ahead with repeal even without a replacement ready to go.

Nearly 1 million people are covered by the Affordable Care Act in Michigan, including some 321,000 people who have purchased plans through the marketplace exchanges and more than 600,000 covered under Healthy Michigan, the state's Medicaid expansion program under the ACA.

Porn said that 61% of Democrats polled did not want the law repealed at all and that 79% of Republicans and 63% of self-described independent voters favored repeal but only with a replacement being in place first.

EPIC-MRA said the polling sample included 43% Democrats, 39% Republicans and 18% independents or others. Additional demographic information about the sample and results, which the Free Press typically reviews when writing about a poll's results, was not immediately available.

The poll also found that a large majority of Michiganders — 81% — believe the state or federal government should provide "a low-cost, comprehensive health insurance plan for adult residents earning $34,000 a year or less," essentially matching the Healthy Michigan program. That support included 67% of Republicans and 80% of independent voters.

"Michigan voters overwhelmingly agree that the state should offer low-income working men and women the type of insurance available" under Healthy Michigan, Porn said.

Seventy-eight percent of respondents also said lower-income residents should receive financial assistance from the state or federal government to purchase health plans for themselves and their families.

Contact Todd Spangler: 703-854-8947 or tspangler@freepress.com. Follow him on Twitter at @tsspangler.