Physicians Largely Oppose Affordable Care Act Repeal

A new survey shows that a majority of primary care physicians are not in favor of repealing the Affordable Care Act (ACA).

Of the 426 physicians surveyed, only 15% support a full repeal, which is lower than the general public. Approximately 38% of those physicians self-reported voting for President Donald Trump, according to a study published by the New England Journal of Medicine.

"Primary care physicians are on the front lines of health care -- they are physicians that patients know best and turn to first when they are sick,” said study lead author Craig Pollack, MD, MHS. “With primary care physicians often helping patients navigate challenges with their insurance, it is critical to understand their perspectives on the repeal of the act.”

The mail and phone survey was conducted from December 2016 to January 2017, and included responses from internal medicine physicians, pediatricians, geriatricians, and family physicians. Participants were listed in the American Medical Association’s Physician Masterfile.

When asked what they would like to see happen to the ACA, 15% responded that they want it fully repealed, while another survey indicates that 26% of the general public support a full repeal. No self-reported Democrats wanted to see the ACA fully repealed, while 32.4% of Republicans did, according to the survey.

Interestingly, only 37.9% who reported voting for Trump were in favor of a full repeal.

The physicians generally supported mandates that increased the insurance rate, with 95% supporting provisions that prohibit insurance companies from denying coverage, or charging higher rates for patients with pre-existing conditions, according to the study. Approximately 88% support the provision that allows young adults to be covered under their parents’ insurance until age 26.

Nearly all physicians supported providing tax credits to small businesses that supply insurance to employees, and 75% supported subsidies. The researchers also found that 72% were in favor of Medicaid expansion, and 50% supported fines for the uninsured.

"What we heard is that the majority of primary care physicians are open to changes in the law but overwhelmingly opposed full repeal," Dr Pollack said.

Approximately 74% of physicians would like lawmakers to enact changes to the ACA rather than fully repealing it. Those physicians were in favor of creating a public option to compete with private plans, value-based reimbursement, and increasing the use of health savings accounts, according to the study.

Only 29% of respondents supported the increase of high-deductible plans.

These findings may provide additional insight to GOP lawmakers who are currently working to repeal and replace the health law.

"We don't yet know what provisions may be repealed or modified, but we have started to see signs of what could be coming, and what has been absent in the conversation so far is how physicians feel the law has impacted their patients' and the care they are able to deliver," said study co-author David Grande, MD, MPA.