Approval of the 2010 Affordable Care Act (ACA) climbed to 47% in July, according to Gallup’s most recent poll on the subject. The new mark is the best that the ACA—commonly referred to as “Obamacare”—has reached since 2012, when Gallup began using the current version of this poll. The ACA’s surge comes following the Supreme Court’s recent decision to uphold the law for the second time. The ACA did register a 48% disapproval rating, but with a margin or error of plus or minus 3% the newest poll suggests that Americans are essentially split evenly on it now.
Background
The new Gallup poll shows a remarkable shift in public opinion regarding the ACA, which has been fairly unpopular since President Barack Obama signed it into law. Its popularity took a significant hit in late 2013 and early 2014, when insurance companies started dropping plans that did not meet the ACA’s minimum standards, forcing people who had those plans to find new ones. In late 2014, the ACA’s popularity hit a new low, at 37% approval, when Republicans had a strong showing in the midterm elections. Since then, the ACA’s reputation has gradually recovered as more people signed up for coverage through federal and state-run exchanges and congressional campaigns ended. In April, the ACA’s approval climbed to 44%.
The ACA’s most recent bump in popularity probably has something to do with the Supreme Court’s recent decision in King v. Burwell, which it handed down on June 25th. For the second time, the Supreme Court confirmed the legality of the law, lending it further legitimacy and stabilizing its place in America’s health care system.
King v. Burwell centered on the question of whether health care plans sold through the federal exchange website legally qualified for subsidies. The challenge to the ACA focused on one sentence, which seemed to suggest that only plans sold through state-run exchanges would qualify for the subsidies. The law’s challengers contended that subsidies for plans purchased through the federal exchange were illegal, so a court ruling in their favor could have resulted in the end of subsidies for anyone purchasing plans through the federal exchange. Only 16 states currently operate their own exchanges—either for political reasons or because it’s simply easier to let the federal government handle it—which made King v. Burwell a significant threat to the law’s survival.
However, the Supreme Court ultimately found that while the sentence in question did suggest that only purchases made through state-run exchanges would qualify for tax credits, it was out of step with the fuller context of the law, which clearly intended to allow subsidies for those who purchased their plans on the federal exchange.
Implications
With the ACA legitimized by two Supreme Court rulings (from a conservative court, no less), the law is now on solid footing legally. The ruling may have also eased anxiety about the security of the ACA’s subsides (as well as the law itself), which could be contributing to its increased popularity. If the ACA’s popularity continues its upward trend, it should remain stable even against shifting political forces going forward.
Of course, the ACA would be difficult to repeal at this point, even without its increased popularity, because it would mean stripping health insurance from millions of Americans who were unable to afford coverage prior to the ACA. Republicans also have an uphill battle to muster the political strength needed to make a serious effort at repealing the law. In addition to retaking the White House, Republicans would also have to gain a filibuster-proof majority in the Senate, and maintain their majority in the House of Representatives, just to pose a viable threat. But the law’s increasing popularity presents another major problem for Republicans who would like to repeal it, which may keep them from making a serious effort to do so even if they score the necessary electoral victories.
The biggest problem for the repeal effort is that the ACA has not only gained in popularity among Americans in general, it has made remarkably steady gains across all of the major demographics. In fact, it made some of its strongest gains among groups that are going to become more and more influential in future elections, including in 2016. Most notably, the ACA’s approval rose by 12 points among nonwhites, from 56 to 68%, and 12 points among 18-to-29-year-olds from 42 to 54%. It also made strong gains among Independents, rising eight points from 33 to 41%. Even among Republicans, who have strongly opposed the ACA from its very beginning, the law gained six points, moving from eight to 14% approval. Overall, support for the ACA is highest among nonwhites, young adults, and college graduates.
As more and more Americans start to reap the benefits of the ACA, it will only become more entrenched within the United States’ health care system. It survived a bumpy rollout period, including the two Supreme Court cases, and now that it is firmly in place it looks unlikely that it will be going anywhere any time soon.
