Health Policy$ense

What Physicians Say About Repeal of the Affordable Care Act

Survey says...

As one of his first acts as President, Donald Trump signed an executive order signaling his intent to “seek the prompt repeal” of the Affordable Care Act.  While no one can predict what Congress will do, significant changes to the current system are likely.

What do physicians think should come next? We surveyed 1000 primary care physicians after the election asking them their views on key elements of the Affordable Care Act and their views on repeal of the law – 426 responded to our survey. We report our findings in the New England Journal of Medicine, and summarize them below.

First, very few primary care physicians want the ACA repealed. Just 15% supported repeal – even among physicians voting for Donald Trump – only 38% supported repeal. 

Second, primary care physicians strongly support key elements of the ACA and feel they are important to the health of the nation. Most primary care physicians supported the ACA’s insurance market regulations that prohibit insurance companies from denying coverage or charging higher premiums based on pre-existing conditions, providing subsidies to individuals to make insurance more affordable, and expanding Medicaid. It was only the individual mandate where support slipped to 50%.

With health insurance coverage of more than 20 million people at stake, the views of primary care physicians are important to consider. Primary care physicians are often in the position of helping patients navigate the health care system. Patients are also most likely to turn to their primary care physicians when they are sick or have other health care needs. 

Our study shows that very few primary care physicians support full repeal of the ACA. Most support making some changes – but nonetheless support key elements of the law including regulations on insurance companies, allowing young adults to stay on their parent’s insurance, providing subsidies for individuals to buy insurance, and the expansion of state Medicaid programs to those living in or near poverty.

The study team included Craig Pollack (Johns Hopkins University), Katrina Armstrong (Massachusetts General Hospital), and David Grande (University of Pennsylvania). The study was supported by LDI's Policy Accelerator Program.