Donald Trump couldn’t repeal Obamacare in 2017, largely because it had become too popular. It’s even more popular now.
Roughly three-in-five Americans like the 2010 health care law, even more than when Trump and Republicans in Congress came to the brink of wiping it out. And some of the Affordable Care Act’s better-known provisions — like protections for preexisting health conditions — engender even greater support.
When Trump said last week he’d try again to repeal the law if he wins next year’s presidential election, he did more than pick at an electoral scab that party strategists hoped had healed by now. He threatened to bring back to life a potent electoral issue that contributed significantly to the GOP’s wipeout in the 2018 midterms and on which public opinion has only moved away from Republicans since.
Republican voters are far less interested than Democrats in hearing the candidates talk about the health care law, according to new polling data released Friday by KFF, formerly known as the Kaiser Family Foundation. Only 32 percent of self-identified Republican voters think it’s very important for candidates to talk about the future of the Affordable Care Act, the poll shows, compared to 70 percent of Democrats.
So not only is Trump crosswise with the overall electorate over his renewed repeal push — he’s also injected an issue into the campaign for which there’s no groundswell of support among Republicans.
The former president has succeeded over the course of his political career by tapping into sentiments of Republicans that other candidates have ignored or missed, but that does not appear to be the case here.
“Republican voters weren’t itching for him to come out and make a statement on the ACA,” said Ashley Kirzinger, the director of survey methodology at KFF, which maintains the most comprehensive trendlines in polling on health care policy.
Those trendlines suggest relitigating Obamacare would be a minefield for Republicans.
Obamacare has continued to get more popular since 2017.
The story of the Affordable Care Act’s once-unlikely survival is well known: Unpopular for much of Barack Obama’s presidency, the law gained public support as Republicans who controlled Congress moved closer to repealing it. By the time of then-Sen. John McCain’s famous “thumbs-down” vote against repeal in July 2017, KFF’s tracking poll showed Obamacare had just reached majority support for the first time.
By November 2018, when Democrats successfully leveraged the health care issue to win the House majority and narrow Republicans’ advantage in the Senate, 53 percent of Americans viewed the law favorably.
And the spike in Obamacare’s popularity hasn’t receded since those midterms, which eliminated any real legislative threat to the law. It’s steadily increased.
The latest KFF tracking poll, conducted in May, found 59 percent of Americans had a favorable opinion of the Affordable Care Act, while 40 percent viewed it unfavorably. The 19-point net favorability advantage is the second-largest KFF has ever recorded — bested only by another poll earlier this year.
This doesn’t mean the Affordable Care Act is popular with Republicans. In the poll this May, only about a quarter of self-identified Republicans, 26 percent, had a favorable opinion of Obamacare. Still, that’s greater than the 16 percent of Republicans who viewed it favorably during the peak of the 2017 repeal fight
But opposition to Obamacare is a loser with independents: 62 percent viewed the law favorably.
While it’s not always easy to untangle the electoral impact of one issue from another, exit polls and other voter surveys provide clues. In 2018, the network exit poll, conducted by Edison Research, found that 41 percent of voters nationally said health care was their most important issue, and they voted for the Democratic congressional candidate in their districts by a three-to-one margin, 75 percent to 23 percent.
By the time of the 2020 election, when repeal was in the distant political past, only 11 percent of voters said health care was most important to their vote for president, according to the exit poll. (Those voters backed Joe Biden over Trump by 25 points.) And AP VoteCast, another voter survey, found that only 24 percent of 2020 voters wanted to repeal all of Obamacare, though another 25 percent said they would favor repealing parts of it.
Republicans aren’t motivated by Obamacare anymore.
Repealing Obamacare was the hallmark of Trump’s first months in office, but now it’s barely on Republicans’ minds.
The 32 percent of Republican voters who say it’s “very important” for the 2024 candidates to discuss the future of the law is significantly fewer than the 49 percent of registered voters overall who agree.
By a 20-point margin, 59 percent to 39 percent, all voters say they trust the Democratic Party to do a better job handling the Affordable Care Act than the GOP.
The latest KFF poll was conducted Oct. 31-Nov. 7 — prior to Trump’s musings about repealing Obamacare. Kirzinger, the KFF pollster, said it’s possible Trump can bring Republicans along on another repeal push, though there was little appetite for it in the survey.
More voters say it’s “very important” for the candidates to talk about inflation, though “the affordability of health care” — an issue that combines inflation and health care, to some degree — was second.
That, Kirzinger said, could present an opportunity for Republican candidates to tailor their health care messaging.
“If there is a framing of the ACA that is around health care costs, that could be a really popular talking point,” she said.
But for now, Obamacare remains more popular than the 2017 repeal fight. And given Democrats’ advantage on health care — both historic and present-day, according to the polling — any foray into the issue from Trump would be venturing into hostile territory.
