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The GOP base will punish Republicans in upcoming elections if they fail to deliver on their promise to repeal the Affordable Care Act, or at least make an all -out effort to do so. That's the conventional wisdom, right? It was the political motivation behind Republican efforts to pass a widely unpopular repeal-and-replace plan, and then to consider a risky repeal-and-delay plan in the Senate.

Except for one problem: When you look at the polling, the idea that the base will rise up and punish Republicans if they don't repeal the ACA appears to be exaggerated, and possibly even a political fiction.

Expand chart
Data: Kaiser Family Foundation Health Tracking Poll (Nov. 15-21, 2016); Chart: Andrew Witherspoon / Axios

Consider:

  • As the chart shows, health care was not the top concern for Trump voters and Republican voters in the 2016 presidential election. It ranked far behind their general concerns about the direction the country is headed in, jobs and the economy, and their feelings about Hillary Clinton. Just 7% of Trump voters and a paltry 5% of Republican voters picked health care as the biggest factor in their vote.
  • Focus groups with Trump voters reinforce this picture; they are focused much more on making ends meet and, when health comes up, getting help with paying their premiums and deductibles. They hoped candidate Trump would find a way to help them pay their health care bills. Just like Democratic voters, and all voters, they care more about their health care costs than the partisan Washington debate about the ACA.
  • Republicans also don't show high levels of intensity on the issue. For example, in July, just 25% of Republicans said they had a "very favorable" view of the Republican ACA replacement plans, while 52% of Democrats said that about the ACA.
  • About half (52%) of Republicans have supported the idea of repealing the ACA now and replacing it later, but that is hardly an overwhelming mandate. (Just 26% of the public overall supported the idea.) Still, most Republicans do want to keep trying. In July, 80% said they don't want to give up on efforts to repeal and replace the ACA.
  • The most conservative Republicans who advocate repeal come from safe districts. They have little to worry about, whether the ACA is repealed or not.

Republicans don't like the ACA, and there is no doubt voting for repeal would be a real plus with the Republican base as well as with big campaign contributors. But the assumption that Republicans will be punished if they fail to repeal the law is a different thing altogether; it has become unexamined conventional wisdom. Republican voters have other things on their minds that matter to them more than health care.

The next election is not until 2018, and the agenda could switch to taxes or a foreign conflict or the Trump administration's continuing problems. In fact, the one thing most likely to keep the ACA on the agenda now would be an effort by the administration to undermine it, and it's far from clear who benefits and loses politically from that.

Go deeper

Trump threatens to veto Defense spending bill over social media shield

Photo: Erin Schaff - Pool/Getty Images

President Trump tweeted Tuesday a threat to veto a must-pass end-of-year $740 billion bill defense-spending authorization bill unless Congress repeals a federal law that protects social media sites from legal liability.

Why it matters: Trump's attempt to get Congress to end the tech industry protections under Section 230 of the Communications Decency Act is the latest escalation in his war on tech giants over what he and some other Republicans perceive as bias against conservatives.

The walls close in on Trump

Photo: Tasos Katopodis/Getty Images

With Bill Barr's "Et tu, Brute!" interview with AP, President Trump is watching the walls close in on his claims of fraud, hoaxes and conspiracies.

Why it matters: Trump and his legal team continue to claim election fraud. But the Republican governors of Arizona and Georgia have certified their elections, a loyalist like Barr has weighed in, and lower-ranking officials have taken potshots.

Congress plots COVID pandemic-era office upgrades

oving crates outside Rep. Elise Stefanik's old office Tuesday. Photo: Bill Clark/CQ-Roll Call, Inc via Getty Images

The House plans to renovate members' suites even though staff are worried about an influx of contractors and D.C. is tightening restrictions on large gatherings, some staffers told Axios.

Why it matters: The Capitol has been closed to public tours since March. Work over the holiday season comes as U.S. coronavirus cases spike, Americans beg for more pandemic assistance and food lines grow.

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