Now that open enrollment is closed and the first year of the coverage under the Affordable Care Act is underway, six in ten Americans say they have felt no direct impact of the law.
However, according to a new Kaiser Health Tracking survey, Americans still view the ACA unfavorably by a margin of 45% to 38%.
Among those reporting an impact, 24% of respondents say they have been directly hurt than the 14% who have been directly helped by the law.
However, personal impact numbers also seem to fall along party lines, just as the overall opinion of the law. Democrats are more likely to say the law has helped them (26%) as Republicans are more likely to say they have been hurt (37%). Party identification is the most significant predictor of whether a person reports being helped or hurt by the ACA.
Of those saying they have been hurt by the law, 14% say it is from increased their health care costs, 3% say it is more difficult to access care, 2% say it is because someone in their family lost insurance.
Among those helped by the law, 5% say it has allowed someone in their immediate family to get or keep coverage, 4% say it was easier to get needed care, and 3% say it lowered health care costs.
As of May 2014, Americans have an unfavorable opinion of the health care law than favorable, a margin of 45-38% — a seven-point gap that has been steady since March, but smaller than the 14- to 16-point unfavorable numbers measured in Kaiser tracking polls from November 2013 through January 2014, just after the botched rollout of the healthcare.gov exchanges.
Again, strong political polarization continues; 64% of Democrats see the ACA favorably, while 75% of Republicans have an unfavorable opinion. The intensity gap also continues, with 61% of Republicans stating a “very” unfavorable opinion; 36% of Democrats have a “very” favorable opinion.
Nearly one-third of Americans (31%) say they personally know someone able to get health insurance because of the ACA; only 23% report knowing someone who lost health insurance; 19% report either losing a job or had hours cut due to the law.
There is a partisan gap here as well: 46% of Democrats and 19% of Republicans say they know someone who gained coverage; 34% of Republicans and 10% of Democrats believe they know someone who lost coverage or had a job-related impact (34 % versus 10%).
Despite the negative overall opinion of the law, respondents would rather Congress make improvements to the ACA than ditch the program.
Nearly six in ten (59%) say they would prefer their Congressional representative work to improve the law, and a third (34%) want their representative to repeal and replace the law.
When asked how Congress can improve the law, 20% of respondents say to make insurance more affordable, and 11% say increasing help for seniors, the poor or other specific groups. Eleven percent want to expand access and availability. About one quarter of respondents who want Congress to work on improvements to the law were uncertain or did not specify a way to improve the ACA.
With the 2014 midterms nearly six months away, the ACA is has become a major topic of political conversation and takes up a large chunk of campaign advertising. Even so, a little more than half of registered voters (51%) are tired of hearing Congressional candidates talk about the health care law, and they would rather have them focus on issues like jobs; 43% say they want more debate on the law.
Seven in ten Democrats voters want their candidates to discuss other issues; six in ten Republican voters say to keep up the discussion. Independents are somewhat split evenly with half saying they want to stop hearing abbot it and 44% wanting the debate to continue.
Health care has become one of the most politicized issues of the 2014 election season; however, for most voters the top issue is economy and jobs (34%); health care is second (25%), followed by education (8%), energy and environmental issues (8%), the federal budget deficit (8%), and immigration (7 %).
Economy/jobs and health care as the two top issues are consistent across the board — Democrats, Republicans and independents.
More than half of registered voters (52%) will consider a candidate’s position on the health care law as important factors in their decision; 31% would only vote for a candidate with views on the law that are similar to theirs. Only 11% say the issue of the ACA is not a major factor in their vote.
The final caveat to examining the role of the ACA in the midterms at this point is that most voters say they have not yet paid much attention to the campaign. Just 17% of registered voters say are paying “a lot” of attention to the campaign this early, while approximately half (51%) say they are paying “not much” or “no attention” to the race so far.
The Kaiser Health Tracking Poll was conducted May 13-19, 2014, using a nationally representative random telephone sample of 1,505 adults ages 18 and older residing in the continental United States, Alaska and Hawaii. The margin of error is +/- 3 points.