ACA Approval Hits 57% Amid Debate Over Pandemic-Era Subsidies

Approval of the Affordable Care Act (ACA) in the U.S. has reached a new high of 57%, driven largely by increased support among political independents as enhanced healthcare subsidies introduced during the pandemic approach expiration on December 31, pending congressional action. This latest approval rating, derived from the West Health–Gallup Health and Healthcare Survey conducted between November 3 and 25, marks a three-point increase from last year and reflects a sustained approval level above 50% since 2017, contrasting with lower support rates in its earlier years. Party affiliation continues to significantly influence ACA approval, with 91% of Democrats, 63% of independents, and only 15% of Republicans approving of the law. While Democratic and Republican viewpoints have remained relatively stable, independents show a notable 10-point increase in approval, underscoring a shift in public perception amid ongoing healthcare policy debates. The survey reveals a nuanced stance among supporters, almost evenly split between those favoring keeping the ACA largely unchanged (45%) and those advocating for significant modifications (49%). Conversely, opposition group preferences are more consolidated: 72% of disapprovers call for repeal and replacement, a record 48-point margin compared to the 24% who prefer revisions rather than full repeal. When breaking down overall public opinion, 26% of Americans approve of the ACA and want it maintained as is, while 28% approve but desire substantial changes. Meanwhile, 9% disapprove but still support major revisions, and 25% oppose the law and favor repealing it. These divisions underscore ongoing partisan differences, with 62% of Republicans supporting repeal, almost half of Democrats favoring retention without change, and independents showing varied preferences. This latest data comes as the federal government recently concluded its longest shutdown, which ended without extending the ACA’s enhanced insurance subsidies. A separate congressional vote on extending these subsidies is anticipated. This political context and evolving public opinion indicate significant implications for healthcare regulatory decisions and insurance market dynamics moving into 2024.