Stability and policy threats: US public opinion after a decade of the Affordable Care Act

The Affordable Care Act (ACA) continues to shape US politics at the elite level. We know less about whether this conflict still carries over to the broader public. Moreover, we know little about the degree to which the conflict reaches into its various policies and whether the policy threats to the ACA can affect public opinion. We fielded a large, and demographically diverse survey of US adults using Lucid (N = 6066) from July 8–21, 2020. The survey contained an experiment that introduced the topic to respondents as the 2010 health reform law, the ACA, or Obamacare and at times highlighted the potential undoing of the ACA by the US Supreme Court. Analyses were conducted using Ordinary Least Squares regression. Our findings indicate that perceptions of the ACA differ substantial based on partisanship and racial prejudice. Framing still matters in the minds of Americans and their perception of health reforms in general and its individual components by extending these differences. However, we find only very limited evidence for changes to public attitudes related to the policy threat of the Supreme Court ruling the ACA constitutional in California v. Texas. The ACA remains a political battleground in the minds of Americans. The politics of the ACA continue to be shaped by perceptions of race and partisanship.