The number of US physicians who support the Affordable Care Act (ACA) has increased over its 5-year implementation period, according to a study published in Health Affairs.

Researchers mailed a 9-page survey to a randomly selected sample of US physicians from the American Medical Association (AMA) Physician Masterfile (n=1200) in summer 2017 and compared responses with those from the same survey conducted on a different— though compositionally similar— group in 2012. The 2017 survey contained exactly the same questions as the 2012 survey, with the addition of some new items. The survey asked for the respondents’ impressions of the ACA’s overall impact on US health care, access to insurance and healthcare, fairness of physician payment, and impressions regarding specific provisions.

Of the 1200 physicians who received surveys in 2017, 445 returned complete responses. More than half (53%) of the 2017 respondents agreed with the statement that “the ACA, if fully implemented, would turn United States health care in the right direction,” which was an increase from the 42% who reported agreement with the same statement in 2012. A majority of physicians (60%) supported the statement that the ACA has had a positive impact on access to healthcare and insurance. There was a decrease in percentage of physicians who believed that ACA implementation would make physician reimbursement less fair from 44% in 2012 to 34% in 2017 (P <.0001). Responses from physicians in surgical specialties demonstrated greater overall support for the ACA, increasing from 30% in 2012 to 47% in 2017. Likewise, physicians in procedural specialties also reported increased overall support for the ACA, increasing from 36% approval in 2012 to 53% in 2017.

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Limitations of this study include: possible shifts in the characteristics of practicing physicians over the study period; the fact that the 2012 sample may have been less susceptible to response bias given the higher response rate to the survey; changes in the definition of “if fully implemented” from 2012 to 2017.

Physicians’ opinions were split or neutral on the overall impact of the ACA on their own practices. However, the percent of physicians agreeing with the overall direction of the ACA increased from 2012 to 2017 across all specialties. Physicians reported favorable impressions regarding improved access to insurance and coverage for preexisting conditions, while reporting unfavorable impressions about the ACA’s impact on the affordability of insurance, patient demand, and the role of employers. Overall, the percentage of US physicians who believe that the ACA is a net positive for health care has increased since its implementation period.


Riordan L, Warsame R, Jenkins S, et al. US physicians’ reactions to ACA implementation, 2012–17. Health Aff (Millwood). 2019;38(9):1530-1536.