WASHINGTON (AP) — They may not like it, but they don’t see it going away. About 7 in 10 Americans think President Barack Obama’s health care law will go fully into effect with some changes, ranging from minor to major alterations, an Associated Press-GfK poll finds.

 Just 12 percent say they expect the Affordable Care Act — “Obamacare” to dismissive opponents — to be repealed completely.

 The law — covering 30 million uninsured, requiring virtually every legal U.S. resident to carry health insurance and forbidding insurers from turning away the sick — remains as divisive as the day it passed more than two years ago. After surviving a Supreme Court challenge in June, its fate will probably be settled by the November election, with Republican Mitt Romney vowing to begin repealing it on Day One and Obama pledging to diligently carry it out.

 That’s what the candidates say. But the poll found Americans are converging on the idea that the overhaul will be part of their lives in some form, although probably not down to its last clause and comma.

 Forty-one percent said they expect it to be fully implemented with minor changes, while 31 percent said they expect to see it take effect with major changes. Only 11 percent said they think it will be implemented as passed.

 Americans also prefer that states have a strong say in carrying out the overhaul. The poll found that 63 percent want states to run new health insurance markets called “exchanges.” They would open for business in 2014, signing up individuals and small businesses for taxpayer-subsidized private coverage. With many GOP governors still on the sidelines, the federal government may wind up operating the exchanges in half or more of the states, an outcome only 32 percent of Americans want to see, according to the poll, which was developed with researchers from Stanford University and the University of Michigan.

 Finally, the poll found an enduring generation gap, with people 65 and older most likely to oppose the bill and those younger than 45 less likely to be against it.

 ”People are sort of averaging out the candidates’ positions,” said Harvard School of Public Health professor Robert Blendon, who tracks polling on health care issues. “The presidential candidates are saying there’s a stark choice, but when you ask the voters, they don’t believe that the whole bill will be repealed or implemented as it is today in law.”

 Republicans remain overwhelmingly opposed to the overhaul and in favor of repeal. But only 21 percent said they think that will actually come about.

 Romney supporter Toni Gardner, 69, a retired school system nurse from Louisville, Ky., said that until a few weeks ago she was sure her candidate fully supported repeal, as she does.

But then Romney said in an interview there are a number of things he likes in the law that he would put into practice, including making sure that people with pre-existing medical problems can get coverage. The Romney campaign quickly qualified that, but the candidate’s statement still resonates.

 ”If Romney gets in, he’ll go with parts of it,” Gardner said, “and there are parts of that he won’t go with.”

 Gardner thinks expanding coverage will cost too much and may make it harder to get an appointment with a doctor. Besides, she doesn’t believe the government can handle the job. She’s covered by Medicare — a government-run health system — but says “that wasn’t a choice that I had.”

 At 26, Santa Monica, Calif., web developer Vyki Englert has only bare-bones health insurance coverage. Her parents, a preschool teacher and a self-employed photographer, are uninsured. Englert says she thinks the law will largely go into effect as passed. (Among 18- to 29-year-olds, 60 percent think it will be implemented with only minor changes or none at all.)

 Englert says that she supports guaranteeing coverage to people with health problems and that provisions such as broader coverage for birth control will help younger women such as her.

 ”I kind of see a day-to-day way where this law could benefit me,” she said. Englert says the health care law dovetails with a trend toward consumerism in her generation. Older Americans “don’t have the context of the young people,” she added. “They are looking more at the theoretical impact on the budget and the country.”

 Overall, the poll found Americans divided on the question of repeal, with neither side able to claim a majority. Forty-nine percent said the health care law should be repealed completely, while 44 percent said it should be implemented as written.

 The notion that the law will be implemented with changes, captured in the poll, mirrors a discussion going on behind the scenes in Washington, particularly among some Republicans.

 ”Whoever wins the election, the (health care law) is going to be modified,” Mark McClellan, who ran Medicare under former President George W. Bush, said in a recent interview.

Congressional Republicans say if tax increases are on the table in a budget negotiation with a re-elected Obama next year, changes to the health care law — including possible delays in implementation — also must be considered. For now, White House officials refuse to be drawn in on that question.

 Some parts of the law already are in effect; its big coverage expansion for the uninsured doesn’t come until 2014.

 Public opinion about the law itself has barely budged since the summer of 2010, soon after it passed. At the time, 30 percent supported the law. It’s now 32 percent. And 40 percent opposed the overhaul. That’s now 36 percent.

 And misconceptions about the law that reigned two years ago continue to live on, including former Alaska Gov. Sarah Palin’s widely debunked charge that it would create “death panels” to decide on care for the elderly and disabled. In 2010, 39 percent believed the law would set up committees to review individual medical records and decide who gets care paid for by the government. Forty-one percent currently hold that view, according to the poll.

 The poll asked people to say whether 18 different items were in the law or not and to rate how certain they were about their answers. Just 14 percent were right most of the time and sure of it.

Still, knowledge about what the law actually does is growing. More people are aware of provisions that allow adult children to stay on their parents’ coverage until age 26, impose insurance mandates on individuals and businesses, and protect those with pre-existing medical conditions.

 The poll was conducted Aug. 3-13 and involved interviews with 1,334 randomly chosen adults nationwide. It has a margin of sampling error of plus or minus 3.4 percentage points.

The survey was conducted online by GfK using its KnowledgePanel sample, which first chose people for the study using randomly generated telephone numbers and home addresses. Once people were selected to participate, they were interviewed online. Participants without Internet access were provided it for free.



AP News Survey Specialist Dennis Junius contributed to this report.




Topline results are available at and


AP-GfK poll: Voters more confident in Trump’s health
WASHINGTON (AP) — The “stamina,” the “look”: A new poll suggests voters are buying in to Donald Trump’s insinuations about Hillary Clinton’s health. They’re ignoring the medical reports.

Voters — especially men — have more confidence that Trump is healthy enough for the presidency than Clinton, according to the Associated Press-GfK poll.

It’s a disconnect considering Clinton has released more medical information than Trump, and that outside doctors who’ve looked at the available data say both candidates seem fine. But it shows the political points Trump scored after the Democratic nominee’s much-publicized mild case of pneumonia.

 Another gender divide: Nearly half of women but just 4 in 10 men think Clinton’s health is getting too much attention, found the poll, which was taken before the presidential candidates’ debate on Monday.

“Everybody gets sick,” said Sherri Smart, 56, of New York. She said she hasn’t decided who to vote for but wishes the candidates would discuss issues instead of sniping about who’s most vigorous.

“What’s important is, what are you going to do for me?” Smart said.

The AP-GfK poll found 51 percent of voters are very or extremely confident that Trump is healthy enough to be president. In contrast, just over a third of voters — 36 percent — had the same confidence in Clinton’s health.

Men are more likely to question Clinton’s physical fitness for the job, with 45 percent saying they’re only slightly or not at all confident compared to 34 percent of women. Men and women are about equally likely to express confidence in Trump’s health. More Democrats are confident of Trump’s health than Republicans are of Clinton’s.

Health is a legitimate issue as the nation is poised to elect one of its oldest presidents. Trump, 70, for months held off disclosing much about his own fitness while stoking questions about a woman in the White House with his assertion, repeated on national TV Monday, that Clinton lacks the look and stamina for the job. (As for his apparent sniffles during Monday’s debate, he blamed a bad microphone.)

“Stamina is a code word for maybe not physically up to the job,” said New York University bioethicist Arthur Caplan, who has called for an independent panel to certify the health of presidential candidates. “There’s something of a bias about men versus women that subtly Trump has played to, that men are more fit, tough enough to do the job.”

Clinton, 68, last year released more detail about her own health history only to buy trouble earlier this month by refusing to take a sick day until a public stumble forced her to reveal the pneumonia diagnosis. But Monday she rebutted Trump’s talk of stamina by wondering if he could match her grueling schedule as a secretary of state — traveling to 112 countries, negotiating peace deals, spending 11 hours testifying before a congressional committee.

What exactly do we know about their health? Neither has released their actual medical records, just a summary from their personal physicians with no way to know if anything important was left out.

Yet another disconnect: The AP-GfK poll found nearly 4 in 10 voters don’t consider such a release important, and another 2 in 10 say it’s only moderately important.

Trump’s gastroenterologist in December released a four-paragraph letter saying the GOP nominee would be “the healthiest individual ever elected.” Earlier this month, Trump took to “The Dr. Oz Show” to say he felt great, while releasing a bit more detail, such as his cholesterol levels and cancer screenings.

Bottom line: Trump takes a cholesterol-lowering statin medication and a baby aspirin, has some mild plaque in his arteries and is overweight — but was declared generally in good health.

Last summer, Clinton’s internist released a two-page letter detailing her family history, prior exams including lab test results, and some prior ailments that have healed — including a 2012 concussion and blood clot Clinton suffered after becoming dehydrated from a stomach virus and fainting. This month, a second letter outlined the mild pneumonia and revealed some updated check-up results.

Bottom line: Clinton takes a blood thinner as a precaution given a history of blood clots, as well as a thyroid medication and allergy relievers — but also was declared generally in good health.

Some doctors say just watching how the candidates handle a physically demanding campaign trail and the cognitive finesse needed to debate can give voters a good idea of health.

But while the public may not pay attention to cholesterol tests and EKGs, it was hard to miss that image of Clinton stumbling.

“The public is feeding off the impressions they’ve received, but that’s not borne out by the letters of health,” said Dr. Howard Selinger, chair of family medicine at Quinnipiac University.


The AP-GfK Poll of 1,694 adults, including 1,476 registered voters, was conducted online Sept. 15-19, using a sample drawn from GfK’s probability-based KnowledgePanel, which is designed to be representative of the U.S. population. The margin of sampling error for all respondents is plus or minus 2.5 percentage points, and for registered voters is plus or minus 2.7 percentage points.

Respondents were first selected randomly using telephone or mail survey methods and later interviewed online. People selected for KnowledgePanel who didn’t have access to the internet were provided access for free.



Poll results:

AP-GfK poll shows voter distaste for Putin-style leadership
WASHINGTON (AP) — Donald Trump has called Russian President Vladimir Putin “a leader — unlike what we have in this country.”

But most Americans don’t agree with Trump’s assessment of Putin’s leadership skills, a new Associated Press-GfK poll shows.

Only 24 percent of registered voters say Putin has leadership qualities that would be good for an American president to share, while 71 percent say he does not. In fact, a majority, 56 percent, said they have an unfavorable view of Putin, while only 10 percent said they view the Russian leader favorably.

 Voters were split on whether Trump would be too close to Putin, with 42 percent saying they think Trump would be too close, and 41 percent saying his approach would be about right. Fourteen percent think he would not be close enough.
By comparison, most voters (53 percent) think Democrat Hillary Clinton’s relationship with Putin would be about right, while 11 percent think she would be too close and 32 percent think she would not be close enough.

The relationship between the Republican nominee and the Russian strongman began taking on new life when Putin praised Trump last December as “bright and talented” and “the absolute leader of the presidential race.”

The billionaire businessman hailed Putin’s regard for him as a “great honor,” brushing off widespread allegations that the Russian president has ordered the killing of political dissidents and journalists.

“Our country does plenty of killing also,” Trump told MSNBC’s “Morning Joe” in December.

Four in 10 Trump supporters and only 1 in 10 Hillary Clinton supporters say Putin has leadership qualities that would be good for an American president to have. Still, even among Trump’s supporters, just 16 percent have a favorable opinion of Putin. Only 5 percent of Clinton’s supporters do.

Marissa Garth, a 28-year-old stay-at-home mom from Smithfield, Utah, said she plans to vote for Trump this November because he exhibits the qualities of a strong leader — not to be compared with Putin.

“I think (Putin) is a strong leader for his country,” she said. “But at the same time I don’t think he necessarily has the qualities that I would want as a president.”

In fact, the poll finds that men are more likely than women to say that Putin has leadership qualities that would be good in an American president, 28 percent to 19 percent.

Among Clinton’s supporters, 69 percent say Trump would be too close to Putin. Forty-nine percent of those supporting another candidate share that view, but only 8 percent of Trump supporters say their candidate would be too close to Putin. Eighty percent of Trump supporters say his approach would be about right. Among conservatives, 20 percent say Trump would be too close to Putin.

There is nothing 54-year old Gary Sellers, of Homewood, Illinois, likes about Putin — or Trump. He called Putin a “dictator,” adding, “there are no qualities of his that I wish that an American president would have.”

A lukewarm Clinton supporter, he’s concerned that Trump shares Putin’s extreme views of governing. “I feel he has a dictatorial approach toward being president of the United States,” Sellers said of Trump.

Forty-seven percent of voters say they approve and 52 percent disapprove of President Barack Obama’s handling of the U.S. relationship with Russia.

Voters are divided over whether the next president should take a tougher approach to Putin (42 percent) or whether the current approach is about right (39 percent). Just 16 percent think the next president should take a friendlier approach.

Just under half of voters (48 percent) say the U.S. relationship with Russia is a very or extremely important issue, ranking it low on Americans’ list of priorities, far below issues like the economy (92 percent), the threat posed by the Islamic State group (70 percent), the U.S. role in world affairs more generally (68 percent) and immigration (60 percent).

There’s a generational divide over Russia. Two-thirds of voters age 65 and over and more than half of those between 50 and 64 call the U.S. relationship with Russia very or extremely important, while only 4 in 10 30-49 year olds and only a third of those under 30 say the same.

Generally speaking, voters are more likely to say they trust Clinton than Trump on negotiating with Russia, 40 percent to 33 percent. Nineteen percent say they trust neither and 7 percent trust both equally.

John Eppenger, 68, a retiree in Fairfield, Ala., said that when it comes to dealing with Russia, Clinton would “do a much better job than Trump. She’s not perfect, she’s not ideal, but she’s better.”


The AP-GfK Poll of 1,694 adults, including 1,476 registered voters, was conducted online Sept. 15-19, using a sample drawn from GfK’s probability-based KnowledgePanel, which is designed to be representative of the U.S. population. The margin of sampling error for all respondents is plus or minus 2.5 percentage points, and for registered voters is plus or minus 2.5 percentage points.

Respondents were first selected randomly using telephone or mail survey methods and later interviewed online. People selected for KnowledgePanel who didn’t have access to the internet were provided access for free.



Poll results: