Primary care physicians favor ACA over repeal

In a survey conducted between January and March 2015, only 15 percent of primary care physicians supported a complete repeal of the Patient Protection and Affordable Care Act (ACA) (P.L. 111-148). With the Republican party intent on changing the healthcare landscape dramatically over the next year, researchers from Johns Hopkins University School of Medicine, the University of Pennsylvania Perelman School of Medicine, and Massachusetts General Hospital found that primary care physicians were split on their views towards the ACA, with approximately 48 percent favorable and 52 percent unfavorable. The survey, published in the New England Journal of Medicine, also found that a majority of the physicians reported that they had seen an increase in the number of Medicaid or newly insured patients, without a decrease in their ability to provide high-quality care.

About 95 percent of all respondents said they did not believe insurers should be allowed to deny coverage to those with pre-existing conditions or charge these patients more; 88 percent favored children kept on parents’ plans until age 26; 91 percent supported tax credits for small businesses that offered employees health insurance; 75 percent supported tax subsidies for individuals to buy insurance; 72 percent supported the Medicaid expansion; and 50 percent supported tax penalties for people who did not buy insurance.

These numbers are substantially less than the 26 percent of the general public who say they want Obamacare gone, as reported by the Kaiser Family Foundation. In the NEJM published survey, no physicians who self-identified Democrats reported being in favor of ACA repeal. But the survey also demonstrated a dissonance between physicians beliefs about patients’ healthcare entitlements and what a healthcare system can cover. For instance, as noted, 95 percent of physicians believed the prohibition on denying coverage for those with pre-existing conditions should continue, but only 50 percent supported the individual mandate despite the difficulties of covering as many individuals as possible without the penalty in place.

Overall, 426 physicians responded to the survey and the response rate was 45.1 percent. The researches noted that nonresponses limited their ability to generalize findings and that primary care physicians could have different views from other physicians.