Presidential candidates are setting their sights on the ACA. Are voters?

The Affordable Care Act is back in the political spotlight, but few voters have the future of the law at the top of their lists of issues to address, according to a KFF poll published Dec. 1. 

On Nov. 28, former Republican President Donald Trump said he would "REPLACE [Obamacare] with MUCH BETTER HEALTHCARE," on Truth Social, the social media platform under the Trump Media umbrella. 

"Getting much better Healthcare than Obamacare for the American people will be a priority of the Trump Administration," Mr. Trump wrote Nov. 28 on Truth Social. 

Florida Gov. Ron DeSantis, who is polling a distant second to Mr. Trump for the GOP nomination in national polls, said Dec. 3 he would "replace and supercede" the ACA as president.  

2022 was the first election in more than a decade where the ACA was not a central issue.  

Around half of respondents in a KFF poll, conducted Oct. 31 to Nov. 7 and published Dec. 1, said the future of the ACA is "very important" for presidential candidates to talk about. Inflation was the top issue on voters' minds in KFF's survey, with 86% of respondents saying the issue is very important for candidates. Four in 5 said healthcare affordability is important. 

Just 1% of respondents said the ACA is the "most important" issue for candidates to address on the campaign trail. Over 40% rated inflation as the number one issue for candidates to tackle. 

Democrats were more likely to rate the ACA as "very important" than Republicans — 70% of Democrats said the topic was important for presidential candidates to discuss, compared with 32% of Republicans. 

The ACA has had a majority favorable opinion since 2017, according to KFF polling. As of May 2023, 59% of respondents had a favorable opinion of the law, and 40% had an unfavorable opinion. 

Several Republican senators told Politico Nov. 27 they have little interest in repealing the law. A push to repeal the law failed on the Senate floor in 2017. 

"Boy, I haven't thought about that one in a while," Senate Minority Whip John Thune of South Dakota told Politico. 

Senator Thom Tillis, a North Carolina Republican, told Politico the law is "almost technically impossible" to repeal. The number of people who receive insurance through the ACA marketplace has increased, with 14.3 million people enrolled in subsidized plans, up from 8.7 million in 2017. 

"But there is a way to get rid of all the bad and hopefully put some good back in place," Mr. Tillis said. 

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