Majority of Americans believe Trump is sabotaging ACA, Kaiser poll shows

According to the results of the July Kaiser Family Foundation's Health Tracking Poll, a majority of Americans believe the Trump administration is sabotaging the Affordable Care Act to the country's detriment and said they will hold the Administration responsible for what happens as a result of those changes.

Almost six in ten Americans, or 56 percent, said they think President Trump and his administration are trying to make the ACA fail, while 32 percent said they believe the Trump Administration is trying to make the law work. 

The majority of those who said they think Trump is trying to sabotage the law said that is a bad thing, and additionally, 58 percent said President Trump and Republicans in Congress are responsible for the changes they make and for any problems with it moving forward. However, 27 percent of respondents said since President Obama and the Democrats created the legislation, they are responsible for the law's issues. Only 7 percent of the public said that making the law fail is a good thing, results showed.

The survey was conducted July 17-22, among a nationally representative random digit dial telephone sample of 1,200 adults ages 18 and older, living in the United States, including Alaska and Hawaii, carried out in English and in Spanish.

One of the ACA's signature provisions, and one of the most supported, was its protection of patients with pre-existing conditions. KFF's poll found that this facet of the law is a major focus for Americans. Results showed a candidate's position on continuing protections for people with pre-existing health conditions ranked at the top of healthcare campaign issues for voters, with 74 percent of Democratic voters, 64 percent of independent voters, 61 percent of battleground area voters and almost half of Republican voters calling a candidate's position on this issue either the single most important factor or a very important factor in their 2018 vote. An overall repeal of the ACA and the potential reversal of the Roe v. Wade decision were other high-ranking priorities after protections for those with pre-existing conditions.

The issue even permeates Americans' views on the future of the Supreme Court. Protections for people with pre-existing conditions, with 64 percent of respondents saying they don't want to see the Supreme Court overturn these protections. A little more than half, 52 percent, don't want to see the Supreme Court overturn the ACA more generally, the results said.

According to KFF, currently 14 states have not expanded their Medicaid programs and three are considering it. For those living in non-expansion states, 51 percent support expanding their state's Medicaid program, and among those who don't initially support expansion, 68 percent said they would be "more likely" to support it if a work requirement was included for nonelderly adults who the state deems able to work. Only 10 percent said including a work requirement would make them "less likely" to support expanding Medicaid.

Overall, 67 percent support work requirements for adults without disabilities in order to get health insurance through Medicaid while 28 percent opposed it. However, those attitudes seemed somewhat flexible depending on context.

When those who initially supported work requirements were informed such provisions could result in many low-income people in their state losing health insurance coverage, a third changed their mind, bringing the total opposition to about half (49 percent). Conversely, when those who initially opposed work requirements were told that work requirements might help beneficiaries "become more self-sufficient," one-fifth (six percent of the public overall) supported Medicaid work requirements, pushing total support to 72 percent, the poll results said. 

The poll results could potentially have implications for the 2018 midterm elections, and could potentially inform the strategies of politicians in how to approach hot-button healthcare issues, especially the ACA and its more popular provisions. 

Twitter: @BethJSanborn
Email the writer: beth.sanborn@himssmedia.com