Toxic politics divide Obamacare support, though public backing for law is rising, Health Affairs says

A brutal political atmosphere -- not the popularity of the Affordable Care Act's benefits -- remains the biggest barrier to broad public support for the healthcare law, according to a new study reported in Health Affairs.

While support for the provisions of the ACA is on the rise, along with a willingness to let the law work instead of repealing it, individual opinions are more strongly influenced by party identification and their trust in government, according to authors and professors Lawrence R. Jacobs of the University of Minnesota and Suzanne Mettler of Cornell University.

But not surprisingly, Democrats are becoming more supportive of the ACA over time while Republicans are less so, they said.

As of March 2016, according to the Henry J. Kaiser Family Foundation, 47 percent of Americans held an unfavorable view of the ACA, while 41 percent had a favorable view. This compares to 2014, when 45.6 percent held unfavorable views and 36.2 percent favorable towards the ACA.

[Also: Obamacare premiums rose 8% in last enrollment, far less than predicted]

For the study, the authors surveyed an estimated 1,200 individuals nationwide each year in 2010, 2012, and 2014.

From 2010 to 2014, the share of respondents believing that reform had little or no impact on access to health insurance or medical care diminished by 18 percentage points, the study said. During that time, those considering reform to have some or a great impact increased by 19 percent, the study found.

The study's analysis shows that people credit the ACA's tangible effects with widening access, supplying subsidies, helping seniors with prescription drugs and expanding coverage of young adults. Between 2010 and 2014, in a rise of 13 percent, Americans increasingly credited health reform with delivering tangible benefits to themselves and to their families.

Individuals who identified themselves as strongly affiliated with Democrats had 11 percent greater odds of being more impressed with the ACA's impact than those who identified themselves as weakly affiliated Democrats.

Those Democrats also had 52 percent greater odds of appreciating the ACA than those who leaned Republican.

Independents have grown substantially more inclined toward reform, the study found. Their unfavorable opinion of the ACA declined by 17 percent from 2010 to 2014, while their favorable opinion increased by 13 percent.

This is politically significant given that independents can swing elections, the authors said.

The percentage of respondents who still support repeal of the ACA remains high, but it shrank by 9 percentage points from 2010 to 2014.

Not surprisingly, 68 percent of Americans who supported repeal of the ACA in 2010 were Republicans.

The shift away from repeal occurred after many states expanded eligibility for Medicaid and the state and national health insurance exchanges were established, according to the study. The authors found no conclusive evidence that people's opinions of the ACA were affected by whether or not they lived in states that expanded eligibility for Medicaid.

Political polarization is only heightened during a presidential election season. But the failure of reformers to convince Republican voters into having a favorable assessment of the law has equipped the GOPs to charge that Americans do not want health reform, the authors said.

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The authors do not think the ACA will collapse since the law has created benefits many people have come to rely upon and has created new business models in the insurance and provider industries.

Rolling back the ACA's individual mandate provision would be  impractical in a system that enjoys enormous public support, they said.

For the Republican Party, the ACA has become the symbol of big government and a lack of individual choice. However, unless there is a profound power shift in Washington, the authors said, the most likely scenario is a continuing dueling evaluation of the ACA.

Twitter: @SusanJMorse