Most Want to Improve, Not Repeal, the Affordable Care Act
Californians Support ACA, Lack Consensus on Single-payer System
SAN FRANCISCO, September 27, 2017—As congressional Republicans discuss repealing and replacing the Affordable Care Act (ACA), most Californians say they should instead work with Democrats to improve the law. This is among the key findings of a statewide survey released today by the Public Policy Institute of California (PPIC).
Majorities of Californians (58% adults, 58% likely voters) say Republicans in Congress should work with Democrats to make the 2010 health care law better. Far fewer say Republicans should continue working on their own plan (18% adults, 20% likely voters) or move on from health care to other priorities (22% adults, 21% likely voters). Across parties, solid majorities of Democrats (69%) and independents (60%) say Republicans should work to improve the ACA. Republicans are divided (45% continue working to repeal and replace the law, 41% work with Democrats to improve it).
Solid majorities of state residents (67% adults, 62% likely voters) also say it is the federal government’s responsibility to make sure that all Americans have health care coverage. Majorities across all regions and demographic groups express this view, but there is a stark split across parties: 83 percent of Democrats and 67 percent of independents agree, while 70 percent of Republicans say ensuring health care coverage is not the responsibility of the federal government. However, support for the idea of a single, government-run, national health insurance system falls short—just 35 percent of adults say there should be a single-payer system run by the government and 29 percent favor a mix of private insurance companies and government programs. Likely voters’ views are similar.
The congressional debate on health care is taking place as support for the ACA has reached its highest point since PPIC began asking a similar question in December 2013. Today, 58 percent of adults and likely voters alike hold a generally favorable opinion of the law. Majorities of Democrats (79%) and independents (62%) have a favorable opinion, while most Republicans (75%) view it unfavorably. In a September Kaiser Family Foundation survey, fewer adults nationwide (46%) view the law favorably.
Mark Baldassare, PPIC president and CEO, summed up the findings: “While Republicans in Congress debate proposals to repeal and replace Obamacare, the majority of Californians have a favorable view of the current health care law and want Republicans and Democrats to work together to make improvements. Most believe it is government’s role to provide health care coverage for all, but there is no consensus about switching to a single-payer system.”
Large Majorities Favor DACA Protections
Following President Trump’s announcement ending the Deferred Action for Childhood Arrivals (DACA) program, three-quarters of California adults (78%) and likely voters (77%) favor the protections given by DACA, which shields some undocumented immigrants brought to the United States as children from deportation and allows them to get a work permit if they pass a background check. Solid majorities across parties (90% Democrats, 77% independents, 61% Republicans) favor the protections given by DACA, as do strong majorities across age, education, income, racial/ethnic, and regional groups.
As the president continues to focus on immigration, 76 percent of California adults say immigrants are a benefit to the state because of their hard work and job skills—a high mark in PPIC surveys. Just 20 percent say immigrants are a burden to the state because they use public services. Democrats (86%) and independents (75%) are far more likely than Republicans (43%) to see immigrants as a benefit. Large majorities of Californians (73% adults, 68% likely voters) oppose building a wall along the entire border with Mexico, as the president has proposed.
“Californians are rallying around immigrant issues in response to recent federal immigration policy changes,” Baldassare said. “Record-high numbers of residents view immigrants as a benefit to the state, and they express bipartisan support for DACA protections and strong opposition to building a wall along the Mexico border.”
Uneasiness about Trump’s Approach to North Korea
Amid a war of words between President Trump and North Korea’s leader, Kim Jong-un, half of California adults (49%) say they are very concerned about the possibility of North Korea having a nuclear missile that could reach California. Another 28 percent are somewhat concerned. Notably, views across parties are similar: 50 percent of Democrats, 48 percent of independents, and 46 percent of Republicans are very concerned. When Californians are asked whether they have confidence in Trump’s ability to handle the situation with North Korea’s nuclear program, 67 percent of adults and 65 percent of likely voters say they are uneasy about his approach. Just 29 percent of adults and 32 percent of likely voters say they have confidence in the president’s approach.
Most Say Russians Tried to Meddle in Election, See It as Serious Issue
Asked to describe their views on possible interference in the 2016 election, two-thirds of California adults say it is a serious issue. This includes 37 percent who say it is a critical issue of national security that needs top priority and 28 percent who say it is serious but not as serious as other issues. About a third (31%) say it is a political distraction that should be put aside. Responses are similar among likely voters. Most adults (60%) say the Russian government tried to influence the outcome of the election, including 47 percent who say the Trump campaign intentionally helped Russian efforts and 10 percent who say the Trump campaign did not intentionally help. Responses are similar among likely voters.
Low Ratings for Trump, Less than Half Say Feinstein Should Run Again
Trump’s job approval rating (27% adults, 31% likely voters) is similar to what it has been since he took office. Today, 70 percent of Republicans approve of the way he is doing his job, while an overwhelming majority of Democrats (91%) disapprove. Independents are far more likely to disapprove (69%) than approve (27%). Approval ratings for Congress are also low (24% adults, 18% likely voters). However, in contrast to Trump, Congress gets a poor rating across parties: only 18 percent of Democrats, 22 percent of independents, and 24 percent of Republicans approve.
California’s two senators fare much better. Eight months after beginning her first term, Senator Kamala Harris has a job approval rating of 42 percent among adults and 47 percent among likely voters. Roughly a quarter (27% adults, 23% likely voters) remain unsure about how to rate her. Half of adults (48%) and a slight majority of likely voters (54%) approve of Senator Dianne Feinstein’s job performance. As Feinstein considers whether or not to run for a sixth term, 41 percent of adults say she should and 46 percent say she should not. Among likely voters, 43 percent say she should seek another term and half (50%) say she should not. Most Democrats (57%) say she should run again, while most independents (55%) and Republicans (69%) say she should not.
Californians Approve of Brown But Signal They Want Change
Most Californians (55% adults, 55% likely voters) approve of the way Governor Jerry Brown is handling his job. His approval rating is 72 percent among Democrats, 49 percent among independents, and 21 percent among Republicans. With Brown’s approval ratings high and his term nearing an end, are Californians looking for continuity or change in their next governor? Nearly half (47% adults, 49% likely voters) would rather see the next governor mostly change Brown’s policies, while fewer (39% adults, 43% likely voters) want his policies to generally continue. Most Democrats (58%) favor continuity, while a majority of independents (55%) and an overwhelming majority of Republicans (81%) favor change.
“Californians give positive ratings to the state of the state and their state’s elected leaders today, yet the early signals point to ‘change’ as a major theme in 2018,” Baldassare said. “Many likely voters say they are looking for a different type of leadership in next year’s gubernatorial and US senate election.”
At the end of the 2017–18 legislative session, half of adults (49%) and 44 percent of likely voters approve of the way the state legislature is handling its job. Across parties, 61 percent of Democrats, 44 percent of independents, and 18 percent of Republicans approve.
Dim View of Race Relations
Amid an intensifying national debate, the PPIC survey asks about race relations in the United States. Half of adults (49%) say things are worse compared to a year ago, 35 percent say things are about the same, and 14 percent say things are better. Among racial/ethnic groups, Latinos (58%) are the most likely to say things are worse. Californians are less pessimistic when it comes to race relations in the state (31% worse, 50% the same, 18% better).
Asked the most important issue facing people in the state, Californians name jobs and the economy (20% adults, 18% likely voters), immigration (13% adults, 16% likely voters), and housing and homelessness (12% adults, 14% likely voters). Fewer than one in ten name any other single issue.
Support for Proposed Real Estate Fee Falls Short of Majority
When residents are asked whether the cost of their housing is making them seriously consider moving away from the part of California where they live, 44 percent of adults and 41 percent of likely voters say that it is. Residents are divided about SB 2, a bill that would raise transaction fees to pay for affordable housing projects in California. When read a brief description of the bill—which the legislature passed and is on the governor’s desk—less than half of adults (46%) and likely voters (44%) favor it. A more popular idea to address concerns about cost and supply is building more housing. Most (64% adults, 59% likely voters) favor more housing in their cities or communities. Solid majorities in the Central Valley (72%), the San Francisco Bay Area (70%), Los Angeles (63%), and Orange/San Diego (60%), and about half in the Inland Empire (48%) favor more local housing.
More Key Findings
- Californians hopeful about bridging the political divide —page 17
Most (56%) are optimistic that Americans with different views can work out their differences.
- Residents concerned about the elections system in California—page 18
Less than half (40%) have a great deal or a lot of confidence in the way votes are cast and counted.
- Political engagement a dividend of Trump election—page 19
Half of state residents (51%) are paying more attention to politics since Trump’s election (30% paying the same amount of attention as before, 17% paying less attention).
About the Survey
This PPIC Statewide Survey was conducted with funding from the James Irvine Foundation, the California Endowment, and the PPIC Donor Circle. Findings are based on a telephone survey of 1,734 California adult residents, including 1,095 interviewed on cell phones telephones and 639 interviewed on landline telephones. Interviews took place from September 10–19, 2017. Interviews were conducted in English or Spanish, according to respondents’ preferences.
The sampling error, taking design effects from weighting into consideration, is ±3.1 percent for all adults, ±3.3 percent for the 1,350 registered voters, and ±3.8 percent for the 1,103 likely voters. For more information on methodology, see page 21.
Mark Baldassare is president and CEO of PPIC, where he holds the Arjay and Frances Fearing Miller Chair in Public Policy. He is founder of the PPIC Statewide Survey, which he has directed since 1998.
The Public Policy Institute of California is dedicated to informing and improving public policy in California through independent, objective, nonpartisan research. We are a public charity. We do not take or support positions on any ballot measure or on any local, state, or federal legislation, nor do we endorse, support, or oppose any political parties or candidates for public office. Research publications reflect the views of the authors and do not necessarily reflect the views of our funders or of the staff, officers, advisory councils, or board of directors of the Public Policy Institute of California.