Voters reject repealing the Affordable Care Act but are wary of Medicare for All: poll

New polling suggests voters would rather work to improve the current U.S. healthcare system and keep the Affordable Care Act in place, rather than drastically overhaul the system in favor of a national public option or Medicare for All.

Three-quarters of survey respondents said they prefer fixing the current health insurance system versus starting fresh with a Medicare for All system, while 64% said Medicare should begin at the age of 60 instead of 65 and 58% believe people should be allowed to purchase health insurance beginning at the age of 50.

Repealing the ACA struck a chord with respondents as just 32% of voters and only 44% of GOP voters said they support repealing the ACA. When asked if ACA subsidies should be extended, 60% said they should while only 41% of Republicans agreed.

Notably, the survey was conducted on behalf of the Partnership for America’s Health Care Future, an industry group created in 2018 comprised of America’s Health Insurance Plan, the American Hospital Association, BlueCross BlueShield Association, the Federation of American Hospitals, PhRMA and other major hospital systems, payers and healthcare advocacy groups that seek to quell support and prevent passage of Medicare for All. In 2021, the group spent $80,000 lobbying members of Congress on the issue.

The American Medical Association left the coalition in 2019 but does not support a national public option.

Still, 44% of swing voters polled support Medicare for All and 47% support a public option, while 47% of respondents believe a new Medicaid Coverage Gap Plan should be created in states that chose to not expand Medicaid.

Support for these proposals shrunk when directly polled one-on-one against building upon the current healthcare system. Just 29% prefer a public option to strengthening the current system, and 39% believe lowering the Medicare eligibility age to 60 is the correct decision as opposed to improving the status quo.

Voters said they are concerned about the government’s ability to manage access to care, as well as the cost and long-term fiscal impacts of any public option proposal.

“A growing majority of likely voters would be unwilling to pay more for healthcare or in taxes to fund the creation of a public option,” the report’s key findings said. “A majority would be less likely to vote for a lawmaker who supports creating a new government-run health insurance system funding by higher taxes or cuts to doctors and hospitals.”

Bringing down healthcare costs is a point of bipartisan agreement, according to the poll. Nearly three-quarters of Democrats and Republicans said that is their top priority in improving the healthcare system. And while respondents were split on their satisfaction with the health insurance system overall, 70% said they were satisfied with their current plan.

Healthcare policy did not cut the top three issues voters care about in the poll, instead ranking fourth ahead of crime and public safety, gun policy, national security and the environment. Respondents said they are most concerned with inflation, the economy and immigration. That could spell bad news for Democrats, many of whom believe President Joe Biden’s best chances of winning reelection is by hitting President Donald Trump on healthcare, namely through pro-choice policies and the ACA.

A recent KFF poll showed that 59% trust Democrats more to manage the ACA's future, while GOP voters are more likely to trust Republicans. But interest in the ACA could be waning, as just 1% listed the ACA as the "most important" issue for 2024 and 49% listed the issue as "very important" below inflation, healthcare affordability, the future of Medicare and Medicaid, access to mental health care, immigration, gun violence, prescription drug costs, gun violence, the opioid crisis and abortion.

Former President Donald Trump recently dug up old Republican rhetoric, saying he would push to repeal Obamacare despite its recent high approval and popularity, but both polls were conducted before President Trump raised the issue again last week. It remains to be seen if GOP voters will reverse course and support a repeal, or if his comments will prompt Democratic voters to rally behind keeping the program.

While campaigning in support of the ACA could be a winning issue for Democrats in elections around the country, the report suggests abortion may not be as high of a priority for voters. Just 14% of respondents and 9% of swing voters polled said abortion was one of the most important issues.

Of the 2,000 respondents polled, 61% said they trust the free market more than the federal government to manage healthcare, a 7% increase since May 2023. However, 61% of respondents to the poll who identify as Democrats said they trust the federal government more than the market, though a plurality of Democrats polled distrust lawmakers’ ability to design and manage an effective health insurance plan, especially when contemplating the ever-looming threat of a federally induced government shutdown.

A clear majority, 80%, of respondents said the need for mental health care will increase over the next decade, and 26% said the federal government’s response to dealing with mental health issues so far has been inadequate.

The online poll was conducted by strategic advisory firm Locust Street Group (LSG).