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 Just 12 percent say they expect the Affordable Care Act — “Obamacare” to dismissive opponents — to be repealed completely.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are saying there’s a stark choice, but when you ask the voters, they don’t believe that the whole bill will be repealed or implemented as it is today in law.”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: Clerks must issue gay marriage licenses
WASHINGTON (AP) — Linda Massey opposes gay marriage. But she was incensed last summer to see that Kim Davis, a Kentucky county clerk, was refusing to issue marriage licenses to gay couples.

“If the government says you have to give out those marriage licenses, and you get paid to do it, you do it,” says the 64-year-old retiree from Lewiston, Michigan. “That woman,” she said of Davis, “should be out of a job.”

Americans like Massey are at the heart of a shift in public opinion, an Associated Press-GfK poll has found. For the first time, most Americans expect government officials to issue marriage licenses to same-sex couples, even over religious objections.

It’s partly a matter of expecting public servants to do their jobs. But more broadly, the issue touches on a familiar dispute over which constitutional value trumps which: religious freedom, or equality under the law?

The question in recent months has entangled leaders with political sway, among them Pope Francis and the 2016 presidential contenders. But it’s not a new conflict for a nation that has long wrestled with the separation of church and state.

Where Davis’s answer was the First Amendment’s protection of religious freedom — and she served jail time to back it up — a majority of respondents don’t buy that argument when it comes to public officials issuing marriage licenses. That’s a shift since an AP-GfK survey in July, when Americans were about evenly split. Then, 49 percent said officials with religious objections should be exempt from issuing marriage licenses to same-sex couples and 47 percent said they should be required to issue them.

Now, just 41 percent favor an exemption and 56 percent think they should be required to issue the licenses.

That shift was especially stark among Republicans. A majority of them —58 percent — still favor religious exemptions for officials issuing marriage licenses, but that’s down 14 points since 72 percent said so in July.

The timing of the surveys is important, coming during rapid developments in the politics of gay rights and religious freedom.

Public opinion has favored same-sex marriage in recent years and some politicians — President Barack Obama, 2016 presidential contender Hillary Rodham Clinton and some members of Congress among them — have come around to that view. In June, the Supreme Court effectively legalized gay marriage nationwide.

The cultural change has influenced the governing bodies of some of the most conservative religions, including the Catholic Church under Pope Francis and the Mormon Church, which last week called for compromises between protecting religious liberties and prohibiting discrimination. Both institutions are trying to accommodate society’s shifting views while keeping a firm grip internally on their own doctrines against gay marriage and homosexual activity. And both churches steered clear of the appearance of backing Davis. The Vatican said the pope’s brief meeting with her in Washington should not be construed as a sign of support.

Mormon leader Dallin H. Oaks last week told a closed gathering of judges and clergy in Sacramento, California, that when conflicts between religion and law rise and are decided, citizens of a democracy must follow court rulings.

Davis, a Democrat, Apostolic Christian and clerk of Rowan County, Kentucky, became the face of religious Americans who bristle at government requirements that conflict with their beliefs, whether those mandates cover gay marriage, contraception or abortion referrals. On June 27 — the day after the high court ruling — Davis refused to issue same-sex marriage licenses. In September she spent five days in jail for defying a court order to issue the licenses. Affixing her name to the certificate, she wrote in a statement, “would violate my conscience.” After serving her jail sentence, Davis returned to work — but her name no longer appears on marriage licenses for gay couples.

Nick Hawks, a business consultant in Ararat, North Carolina, agrees with Davis.

“We’ve got to decide at some point who’s going to be protected first,” said the father of three boys, 50, who says he’s a Republican-leaning independent. “It doesn’t seem quite fair” to allow a minority such as gay people to “control the policy.”

More generally, the poll offers evidence that Americans remain slightly more likely to say that it’s more important for the government to protect religious liberties than the rights of gays and lesbians when the two come into conflict, 51 percent to 45 percent. But that, too, is a slight shift since July, when 56 percent said it’s more important to protect religious liberties.


The AP-GfK Poll of 1,027 adults was conducted online Oct. 15 to Oct. 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 3.3 percentage points.

Respondents were first selected randomly using telephone or mail survey methods, and later interviewed online. People selected for KnowledgePanel who didn’t otherwise have access to the Internet were provided access at no cost to them.



Poll results:

AP-GfK Poll: Americans still feeling economic gloom

WASHINGTON (AP) — Americans are more likely than they were a year ago to have positive views of the nation’s economy, but they’re still feeling more pessimism than optimism, according to a new Associated Press-GfK poll conducted ahead of CNBC’s GOP primary debate on Wednesday.

The candidates will attempt to impress Republicans in particular, who the poll finds feel much gloomier about the economy than Democrats.

Here are some things to know about opinions on the economy from the latest AP-GfK poll:



A majority of Americans — 54 percent — say the nation’s economy is poor, the new poll shows. Just 45 percent call it good. Still, views of the economy are slightly rosier than they were over the summer, when a July AP-GfK poll found 41 percent of Americans described the economy as good, and more positive than they were a year ago, when just 38 percent said so.

Half of men, but just 4 in 10 women, describe the economy as good.

Americans are even less likely to see the nation heading in a positive direction overall. Just 36 percent think the country is heading in the right direction, while 63 percent think it’s headed in the wrong direction.

More than 8 in 10 Americans in the new poll described the economy as an extremely or very important issue, down slightly since July. Still, the economy rates higher in importance than any other issue in the poll.



The candidates will aim their messages at a Republican Party that has a particularly negative view of the economy.

While 65 percent of Democrats describe the economy as good, just 29 percent of Republicans say the same. Seven in 10 Republicans say the economy is poor, including more than 8 in 10 GOP supporters of the tea party. Eight-five percent of Republicans say the country is heading in the wrong direction.

Independents, too, are unhappy with the economy, with 33 percent seeing it as good and 62 percent poor.



Few Americans — just 17 percent — think the economy has improved over the past month, while 21 percent think it has gotten worse and the bulk — 60 percent — think it’s stayed about the same.

Most Americans don’t expect to see improvement in either the nation’s economy or their own financial situations in the next year, either.

Thirty-one percent say they expect the general economic situation to get better, 32 percent expect it to get worse, and 34 percent expect it to stay about the same. Likewise, 29 percent expect their household financial situation to get better, 25 percent expect it to get worse, and 44 percent expect it to stay the same.

Republicans are more likely than Democrats to say the economy has gotten worse in the last month, 31 percent to 13 percent. Democrats are more likely than Republicans to expect it to get better in the next year, 40 percent to 21 percent.



Whichever GOP candidate emerges victorious in next year’s presidential primaries will need to convince Americans that the party can do a better job than Democrats at handling economic issues.

Americans are slightly more likely to say they trust Democrats than Republicans more on handling the economy, 29 percent to 24 percent, the poll shows.

But neither party’s a clear winner on the issue — 15 percent say they trust both equally and 30 percent say they trust neither party.

Republicans are more likely than Democrats to say they trust neither party, 29 percent to 17 percent. A majority of independents — 55 percent — don’t trust either party.



Americans are slightly more likely to disapprove than approve of President Barack Obama’s handling of the economy, 52 percent to 46 percent, according to the new poll. But that’s an apparent rise in his approval rating on the issue since July, when just 42 percent said they approved.

Americans’ rating of Obama on the economy is nearly identical to how they feel about how he’s handling his job overall, with 46 percent approving and 52 percent disapproving.


The AP-GfK Poll of 1,027 adults was conducted online from Oct. 15 to 19. The sample was 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 3.3 percentage points.

Respondents were selected randomly using telephone or mail survey methods and interviewed online. People selected for KnowledgePanel without Internet access were provided it for free.



Poll results: