ACA Favorability Stays Positive as Trump Nears 100th Day in Office

ACA Favorability Stays Positive as Trump Nears 100th Day in Office
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With an increase of nearly 10 points in public approval polls over the past year, the Affordable Care Act has grown more popular as Donald Trump approaches the 100-day milestone of his presidency.

In the RealClearPolitics polling average of public approval of the health care law, it sits at 6.7 percent favorability, with 49.1 percent approving to 42.4 percent disapproving. By contrast, Trump’s job approval rating is a -9.8 percent in the RCP average.

“There is a natural tendency to [connect] displeasure with your own health care to how the administration is doing,” said the American Enterprise Institute’s James Capretta. 

Republicans campaigned on getting rid of President Obama’s signature legislative achievement, but failed to do so last month when their under-supported alternative, the American Health Care Act, was pulled from the House floor prior to a scheduled vote.

Originally touted by Speaker Paul Ryan as the answer to a “collapsing” system of health care that “will get even worse,” the AHCA has drawn vocal, bipartisan scrutiny since its unveiling in early March. The bill, which was criticized by some lawmakers for being too similar to the ACA and others for its predicted exclusion of millions of Americans, eventually reached public approval ratings below 20 percent, according to a March Quinnipiac poll.

While there has been talk of holding another repeal vote on Friday, the eve of the president’s 100th day in office, nothing has been scheduled.

Some Republicans, such as Rep. Barry Loudermilk, remain optimistic a repeal will eventually happen, citing the GOP’s relative newness to the process of “making the sausage.”

“Is it what everybody wanted? No. I don’t think it’s what anybody fully wanted. But that’s the art of compromise,” the Georgia lawmaker said on Wednesday. “My understanding was when the bill was introduced, it wasn’t the final product. It was the beginning.”

As noted in a November Kaiser Health poll, a mere 8 percent of Americans identified “health care” as the single largest factor in their vote for president. Moreover, less than half of respondents favored weakening or repealing Obamacare, which makes the task of replacing it all the more difficult. 

“Views have been cemented about the AHCA,” said Capretta. The trouble with making any health-care plan popular, he explained, is the fact that patients want low taxes, premiums, and deductibles, but still expect excellent medical services.

“These mixed signals are impossible to meet,” he said, adding that no plan can possibly satisfy all desires.

At this point, Republicans are looking to gain favor from both the center and far-right factions of the party -- particularly the latter, which derailed the first vote to repeal the health-care law.

The moderate Tuesday Group and the conservative House Freedom Caucus have proposed the MacArthur amendment, named after former insurance executive Tom MacArthur, as a possible answer to the GOP’s dilemma. 

The eight-page amendment, the full text of which was released on Tuesday, would permit states to apply for waivers to opt out of certain ACA requirements if they can demonstrate their ability to accomplish one or more of the following:

  • reduce average premiums,
  • increase enrollment in coverage,
  • stabilize the market for health insurance,
  • stabilize premiums for individuals with pre-existing conditions,
  • increase the selection of health plans.

“We’re going to go when we’re ready to go," Ryan said when asked if he felt pressure to vote on a repeal by Trump's 100th day. "This has been a very organic, bottom-up process -- it takes time to do that. We’re working on the path to get it right and not constrain it to some artificial deadline.”



Ford Carson is an editorial intern for RealClearPolitics. He can be reached at

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