Poll: By a Wide Margin, Democratic Voters Now Care More About the Affordable Care Act Than Republican Voters Do, And Voters Trust Democrats More Than Republicans to Handle Its Future

The future of the Affordable Care Act, an issue that was once a key health care issue for Republican voters, is now more important to Democratic voters, a new KFF Health Tracking Poll finds. 

About half (49%) of voters say it is a “very important” issue for the candidates to discuss, including more than twice the share of Democratic voters (70%) than Republican voters (32%). 

Fielded prior to former President Donald Trump’s recent social media comments on replacing the 2010 law, the poll also finds that voters give the Democratic Party a 20 percentage-point advantage over the Republican Party on who they trust more to handle the issue (59% versus 39%). The Democratic Party is more trusted on this issue among the vast majority of Democratic voters (94%) and most independent voters (61%), while three in four Republican voters (77%) say they trust the GOP to better handle the future of the ACA.

The findings come from a survey that asked voters about a range of health care and other issues that they want the 2024 presidential candidates to talk about. Inflation (86%) as expected topped the list but notably the affordability of health care (80%) was a close second for the share of voters saying they were “very important” to discuss. 

Large shares of voters also say that the future of Medicare and Medicaid (75%), access to mental health care (70%), immigration (65%), gun violence (65%), and prescription drug costs (64%) are “very important” for the candidates to discuss. 

The poll also examines:

The Medicaid unwinding. Most Medicaid enrollees (58%) have heard little or nothing about ongoing efforts by states to review enrollees’ eligibility that can result in individuals losing their Medicaid coverage. State Medicaid programs began to review enrollees’ eligibility earlier this year after pandemic-era protections expired, leading to millions of adults and children losing their Medicaid coverage. Among the general public, an even larger share (68%) say they have heard little or nothing about the issue. 

Medicare drug-price provisions. About a third (32%) of the public know that the Inflation Reduction Act enacted last year requires the federal government to negotiate prices for some prescription drugs for people with Medicare, up from 25% in July.  About a quarter are aware of two other Medicare drug provisions: capping monthly insulin costs at $35 for people with Medicare (26%) and limiting Medicare enrollees’ annual out-of-pocket drug costs (23%). Even among people at least 65 years old – the age when most people become eligible for Medicare – only a minority are aware of each of the provisions.

Abortion as a voting issue. A quarter (24%) of voters say they would only vote for a candidate who shares their views on abortion, including larger shares of Democratic women (31%) and Democratic men (35%) – both groups where large majorities say abortions should be legal. A quarter (27%) of Republican voters who believe abortion should be illegal in all or most cases also say they would only vote for a candidate who shares their views on abortion. 

Designed and analyzed by public opinion researchers at KFF, the survey was conducted from October 31-November 7, 2023, online and by telephone among a nationally representative sample of 1,401 U.S. adults, including 1,072 registered voters. Interviews were conducted in English and in Spanish. The margin of sampling error is plus or minus 4 percentage points for the full sample and the registered voter sample. For results based on other subgroups, the margin of sampling error may be higher.