A funny thing happened on the Republican road to repealing the Affordable Care Act.
It appears the general public became more fond of the healthcare program and it may now be tougher than ever to replace.
In a Kaiser Health tracking poll released earlier this month, 54 percent of respondents said they had a favorable view of the Affordable Care Act (ACA).
That’s the highest favorability level for the program known as Obamacare in more than 80 tracking polls taken since 2010.
That higher level of support may have been indicated in preliminary estimates released last month that showed 11.8 million people enrolled in 2018 ACA marketplace plans.
That was down only slightly from the 12.2 million people who signed up in 2017. It came despite what critics said were Republican attempts to “sabotage” Obamacare.
The enrollment and the latest poll have not gone unnoticed by Republican politicians.
Experts interviewed by Healthline say the healthcare law’s rising popularity is causing some elected officials to tone down their anti-ACA rhetoric. That includes a Republican governor who has been one of the ACA’s most vocal critics.
All in all, they say Obamacare may remain in place for a while now.
“I don’t think it’s going anywhere any time soon,” Kurt Mosley, vice president of strategic alliances at Merritt Hawkins health consultants, told Healthline.
Reasons for increased support
Despite an uptick in support, Obamacare remains a divisive issue.
In the Kaiser poll, 83 percent of Democrats said they had a favorable opinion of the law, while 78 percent of Republicans said they viewed it unfavorably.
The difference was with independents. About 55 percent of those folks said they support the ACA, compared to 48 percent in January.
All three experts interviewed by Healthline said they felt the poll was accurate.
They noted several reasons for the increase in support for Obamacare.
First, the program has been operating for four years now and it has helped millions of people obtain health insurance.
In addition, the ACA allows states to expand the number of people eligible for the federal Medicaid health program for lower-income households. So far, 32 states and the District of Columbia have taken advantage of this provision.
Federal officials estimate that 68 million Americans are now enrolled in Medicaid. That’s nearly a 30 percent increase from 2013.
“The support has always been there from the people who need it. I think the general public is now catching up,” Dr. Krishnan Narasimhan, a family medicine specialist in the Washington, D.C. area and a board member of Doctors for America, told Healthline. “Healthcare is an absolute need for people. It’s a kitchen table issue.”
There’s also an old adage in politics that once you give something to the public, it’s difficult to take it away.
Last year, the Republican leadership in Congress tried and failed several times to repeal Obamacare.
Experts say the thought of this marketplace for health insurance disappearing may have sobered up a segment of the public.
In fact, in a survey by The Commonwealth Fund, 36 percent of respondents who have health plans through ACA marketplaces said they are pessimistic about keeping their coverage.
“The prospect of losing this, I suspect, may be a reason Obamacare is more popular,” said Mosley.
In December, the Republicans chipped away at the law by approving a tax cut bill that included a repeal of the ACA’s individual mandate that required everyone to have health insurance.
Dan Mendelson, the president of Avalere Health consultants, said this action may have actually boosted support for the ACA.
His theory is that if people aren’t mandated to sign up for health insurance, they don’t mind having a program around to help others.
“With the repeal of the mandate, I think people don’t feel threatened,” Mendelson told Healthline.
There’s also the overall sense that people are used to having the ACA around and have settled in with that idea.
“I think support rises as people get more comfortable,” said Narasimhan.
Politicians paying attention
Over the past few years, Wisconsin Gov. Scott Walker has been one of the most adamant opponents of Obamacare.
However, this year the Republican incumbent is facing reelection and seems to have at least softened his tone.
Walker is now supporting a plan to provide $200 million to insurance companies in Wisconsin to help compensate them for their expensive high-risk customers.
“[Obamacare] supports a lot of people,” said Mosley. “It’s a smart move on his part.”
“[Walker] is paying attention to his constituents,” added Narasimhan.
The Wisconsin governor isn’t alone.
Other Republican candidates are adopting the view that they repealed the individual mandate and now they need to make the healthcare system that’s left work.
“They’re walking a tight rope,” said Narasimhan, “and I think they’ll be going onto the other side.”
Republicans are still vocal about their dislike for the ACA.
Last week, Sen. Orrin Hatch (R-Utah) called Obamacare supporters the “stupidest, dumbass people” he’s ever known. However, he quickly apologized for those remarks.
Officials in the Trump administration have also wondered aloud if the federal Health and Human Services (HHS) Department can reject any attempts by states to expand their Medicaid programs.
There’s also the prospect that fewer people will sign up for ACA programs in 2019 due to the repeal of the mandate and other issues.
A recent poll indicated almost 20 percent of Californians with health plans in that state’s market will not sign up again next year because they no longer face a tax penalty.
A decrease in enrollees, especially younger, healthier ones, could propel insurance companies to drop out of the ACA markets, sending the healthcare program into a tailspin.
However, the experts who talked to Healthline said unless Congress offers an alternative to the ACA, they suspect people will continue to sign up, and support will continue to increase.
“I think the higher acceptability rate is an indication people see this as a need,” said Mendelson.