Survey Report

As the four-year anniversary of the Affordable Care Act approaches, the law remains unpopular with the public. Currently, 53% disapprove of the 2010 health care law while 41% approve of the law. Opinion of the measure is virtually unchanged since last September.

However, the new national survey by the Pew Research Center, conducted Feb. 27-March 16 among 3,335 adults, finds that when opponents of the health care law are asked about the law’s future, more want elected officials to try to make it work than to make it fail.

A majority of ACA opponents – representing 30% of the public overall – want politicians to do what they can to make the law work as well as possible, compared with 19% of the public that wants elected officials to do what they can to make it fail. These opinions are little changed from December, but in the September poll opponents were more evenly divided over how they wanted elected officials to deal with the law.

There continue to be deep partisan differences over the Affordable Care Act – 72% of Democrats approve of law compared with 37% of independents and just 8% of Republicans.

Among Democrats and independents, most who disapprove of the law want elected officials to try to make it work. Republicans are divided: 43% say elected officials should try to make the law fail, but nearly as many (40%) want them to try to make it work as well as possible.

Most Tea Party Republicans, however, say that elected officials should work to make the law fail. Nearly all Republicans and Republican leaners who agree with the Tea Party disapprove of the law (97%) and 60% want elected officials to try to make it fail. A large majority of non-Tea Party Republicans (81%) also oppose the law, but just 25% want politicians to try to make it fail.

Demographic Differences in Views of Health Care Law

The 2010 health care law is politically divisive, but the differences go well beyond party affiliation. Views of the law continue to vary widely across racial and ethnic groups. By nearly two-to-one (62%-33%) more whites disapprove than approve of the law. By contrast, 77% of blacks approve of the law, while just 18% disapprove.

Hispanics are evenly divided: 47% approve of the law, while 47% disapprove. Over most of the past four years, Hispanics have offered more support than opposition for the health care law. As recently as September, 2013, 61% of Hispanics approved of the law. Support for the ACA among Hispanics fell sharply in October of 2013 (to 47%) and has yet to recover.

Most men disapprove of the law (57%) while 39% say they approve. Women are more closely divided with 44% saying they approve and 50% saying they disapprove.

People younger than 30 do not view the law as negatively as do older Americans. About as many young people approve (50%) as disapprove (47%) of the health care law. Among older age groups, majorities disapprove. That marks a change from December, when younger people had about the same view of the health care law as older adults. (This survey was included as part of the “Millennials in Adulthood” report, released March 7).

College graduates take a more positive view of the law (50% approve, 47% disapprove) than those with only some college experience (40% approve, 54% disapprove) and those with no college experience (36% approve, 57% disapprove).

Those with family incomes of $30,000 a year or less are as likely to approve (45%) as disapprove (47%) of the health care law. By contrast, majorities of those in more affluent households disapprove of the law.

Broad Opposition to Health Care Law among Less Educated Whites

Overall, whites disapprove of the 2010 health care law by roughly two-one-one (62% disapprove, 33% approve). However, there are differences in views of the ACA between whites who have graduated from college and those who have not.

Whites without a college degree disapprove of the health care law by a lopsided 66%-27% margin. By contrast, white college graduates are much more divided (51% disapprove, 46% approve), and among white women with college degrees, slightly more approve than disapprove (51% vs. 46%). White college men oppose the ACA, 57%-41%.

Across age groups, whites under 30 are somewhat more supportive of the health care law than older whites. However, even among those 18-29, more disapprove (54%) than approve (43%) of the ACA.

More Strong Disapproval than Strong Approval

As was the case in September, there is substantially more strong opposition than support for the health care law. Overall, 77% of those who disapprove say they feel this way very strongly (41% of public); 64% of approvers hold this view very strongly (26% of the public).

Across most demographic groups, strong opposition to the law is greater than strong support. Moreover, while 79% of Republicans strongly disapprove of the law, a much smaller share of Democrats (53%) strongly approves of it.

Among young people – who split on the law generally (50% approve, 47% disapprove) – about twice as many say they strongly disapprove (32%) as say they disapprove not so strongly (15%); among approvers, roughly equal shares hold this view strongly (27%) as not strongly (23%).

Government’s Responsibility for Providing Health Care Coverage

While more Americans disapprove than approve of the 2010 health care law, opinion is more evenly divided over the broader principle of the government’s responsibility for providing health care coverage. Overall, 47% say it is the federal government’s responsibility to make sure all Americans have coverage, while 50% say this is not the government’s responsibility.

For the most part, demographic differences on this question follow similar patterns as those in views of the 2010 health care law. Yet there are some notable differences. Hispanics are divided over the health care law, but most (61%) say it is the government’s responsibility to make sure all Americans have health coverage.

Nearly half of those with a high school degree or less (49%) say it is the government’s responsibility to make sure all Americans have health care coverage, but just 36% approve of the 2010 health care law. Similarly, a majority of those with family incomes of less than $30,000 (55%) say it’s the government’s responsibility to make sure all Americans have health care coverage, while somewhat fewer (45%) approve of the ACA. There are no differences in views among those with more education and higher family incomes.

Interest in Health Care News

Public interest in news about health care legislation has fluctuated since Barack Obama took office, largely in response to developments surrounding the Affordable Care Act.

In early March 2009, 41% paid very close attention to Obama’s initial proposal for a $630 billion fund to overhaul health care. Interest was sustained throughout the second half of 2009 and into 2010, peaking at 51% around the time of the House passage of the bill.

Interest declined after Obama signed the bill into law, but rebounded in the summer of 2012 when the Supreme Court issued a ruling on the law; in June 2012, 45% tracked news about the Court’s ruling on the health care law very closely.

Recently, interest peaked in mid-November, when 37% said they very closely followed news about the rollout of the health care exchanges. Earlier this month (March 6-9), just 23% were very closely following news about how the health care rollout is going. In the March survey about as many Republicans as Democrats said they were following health care news very closely.