With Donald Trump and Paul Ryan threatening to repeal and replace, just how popular is Obamacare?

From Donald Trump to Paul Ryan to Ron Johnson, "repeal and replace" has been the mantra of national Republicans almost since Obamacare became law in 2010.

With Barack Obama or Hillary Clinton in the White House, of course, the Affordable Care Act wasn’t going anywhere.

But now, with the GOP not only in control of Congress but having won the presidency, Obamacare is in jeopardy -- even if repeal isn’t necessarily easy and the replacement not entirely clear. 

During the campaign, Trump pledged to ask Congress to repeal the law the first day he takes office in January 2017. But in recent days, he has indicated a willingness to perhaps amend the law, rather than repeal and replace it.

So, where does the rest of the country stand on Obamacare?

On Nov. 9, 2016, the day after Trump defeated Clinton and Ryan and Johnson were re-elected, Ryan held a news conference in his hometown of Janesville, Wis. Asked about repealing and replacing, the House speaker reaffirmed that that is his aim, and he made this declaration:

"This health care law is not a popular law."

Is he right?

For the most part, yes. When Americans are asked about the Affordable Care Act, more generally disapprove than approve of it. That’s true in the latest polling and in surveys done throughout 2016.

But there is more to consider in the numbers.

Overall popularity

To back Ryan’s claim, his office cited a Politico/Harvard poll of likely voters from late-September 2016. We found two more-recent polls, takne in late-October 2016 of registered voters, that found similar results.

Politico/Harvard poll

How well is the Affordable Care Act working?

Very poorly/Somewhat poorly: 54%

Very well/Somewhat well: 43%

New York Times/CBS News poll

Approve/disapprove of the 2010 health care law?

Disapprove: 54%

Approve: 39%

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Pew Research Center poll:

Approve/disapprove of the 2010 health care law?

Disapprove: 53%

Approve: 45%

Averaging the 16 national polls taken throughout 2016 that have asked about Obamacare produces similar results, according to Charles Franklin, director of the Marquette University Law School poll: 47 percent said they have an unfavorable opinion or disapprove of it, while 41 percent said favorable or approve.

So, it’s fair to say that if the question is about Obamacare overall, more Americans have a negative view than a positive one.

At the same time, it’s not clear that Americans want repeal. When Pew asked what Congress should do with the law, 51 percent said expand (40 percent) the law or leave it as is (11 percent), while 45 percent said repeal it.

And the picture changes a bit if you go deeper, particularly with polls done by the Kaiser Family Foundation, a research center widely seen as a source of objective data that has surveyed on Obamacare since 2010.

Other views

In Kaiser’s mid-October 2016 poll, 45 percent of adults said they had a favorable opinion and 45 percent said unfavorable.

That tie reflects the partisan divide in the country.

"Everything that you hear from the public about the ACA is seen through a partisan lens," said Mollyann Brodie, Kaiser’s head public opinion and survey research, referring to Kaiser’s seven years worth of polling on the law.

Indeed, the poll found that 76 percent of Democrats had a favorable opinion of the law and 83 percent of Republicans had an unfavorable view.

It’s worth noting, though, that like the Pew poll, there was some sign of popularity when respondents were asked by Kaiser what the next president and Congress should do with the law: 49 percent said expand it or implement it as is, compared to 41 percent who said repeal it or scale it back.

(That’s not a new sentiment. In April 2014, PolitiFact National gave a Mostly True to this claim: "One thing that is much more unpopular than the Affordable Care Act is repealing the Affordable Care Act.")

Two more Kaiser questions were not clear one way or the other, in terms of the law’s popularity:

• Are you and your family better off as a result of the law? The most popular answer -- 50 percent -- was that the law has not made much of a difference to them.

• Is the country as a whole better off? This was a tie -- 39 percent said better off, 39 percent said worse off.

A final point before we close: Some parts of the law get high ratings, although the data isn’t as recent on this.

Kaiser’s December 2014 poll asked about five features of the law and three were rated as very or somewhat favorable by 75 percent or more of the respondents: The exchanges, where people who don’t get employer-provided coverage can shop for insurance; financial aid to help lower-income people not covered by employers to buy insurance; the option for states to expand Medicaid to cover more people. (Sixty-four percent had a very or somewhat unfavorable view of the requirement to have insurance or pay a fine.)

Our rating

Ryan said: Obamacare "is not a popular law."

A majority in two national polls done in late-October 2016 say they have an unfavorable opinion of the Affordable Care Act. Those findings track polls taken throughout 2016 -- unfavorable or disapprove leads favorable or approve. Similarly, the majority in a September 2016 poll say the law is working somewhat or very poorly.

But it’s worth noting that in one October 2016 poll, favorable and unfavorable tied. And in two polls, expanding or keeping the law as-is was favored by more people than repealing it or scaling it back.

Overall, Ryan’s statement is accurate, but needs more information – our definition of Mostly True.

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