By Bill Estep | Lexington Herald-Leader

A majority of Kentucky residents surveyed have a favorable opinion of the Affordable Care Act, but residents remain strongly divided over the federal law, according to a new poll.

Forty-four percent of the adults surveyed said they had a favorable view of the law, while 33 percent said they had an unfavorable view, according to the Foundation for a Healthy Kentucky.

The rest of those contacted for the Kentucky Health Issues Poll said they were uncertain about their views.

The 44-to-33 percent split in favorable versus unfavorable was the same result the poll got in 2017, the foundation said.

The popularity of the Affordable Care Act, also known as the ACA or Obamacare, has grown in Kentucky since Congress approved the law.

In 2010, 47 percent of the people contacted for the poll held an unfavorable view of the law, while just 26 percent viewed it favorably.

In 2012, the unfavorable view reached a high mark of 50 percent, but the number of Kentucky residents with a dim view of the law went down significantly in 2016, according to the foundation.

The ACA allows children to stay on their parents’ health insurance until they are 26; requires insurance companies to cover some preventive services at no cost; and bars insurance companies from denying coverage to someone because of a pre-existing health condition.

It initially required adults to buy insurance or pay a penalty, but Congress voted in 2017 to end that rule.

Supporters have credited Obamacare with making health care available to millions more Americans, while opponents have blamed the law for driving up the price of insurance and costs to taxpayers.

In the latest health-issues poll, however, 53 percent of Kentuckians said the law has had no impact on them or their families.

Eighteen percent reported a positive impact and 21 percent reported a negative impact, according to the Foundation for a Healthy Kentucky.

Responses differed by political party.

Thirty-one percent of Democrats said the law had had a positive impact on them and their families, while only 11 percent of Republicans said the same thing.

Thirty-one percent of Republicans said the law had affected them in a negative way, while only 9 percent of Democrats said that, according to the foundation.

The nonpartisan foundation with its mission to address Kentuckians’ unmet health needs sponsored the poll with Interact for Health, a health advocacy nonprofit in the Cincinnati area.

The Institute for Policy Research at the University of Cincinnati conducted the poll through telephone interviews of 1,569 randomly selected Kentucky residents between Aug. 26 and Oct. 21. The margin of error was plus or minus 2.5 percent.

The foundation announced the results last week.

Under the Affordable Care Act, former Kentucky Gov. Steve Beshear, a Democrat, expanded Medicaid in the state to include hundreds of thousands of additional residents, driving down the number of uninsured by one of the largest margins in the nation.

More than 1.3 million Kentuckians were enrolled in Medicaid in September, or about 30 percent of the state’s population.

The program covers disabled people, older Americans, families with dependent children, and able-bodied people with low incomes. Many participants work but don’t get insurance through their employers.

Ben Chandler

“There’s no question that the Medicaid expansion under the ACA in Kentucky made strides toward improving health by increasing the number of people who are covered, and the number of preventive screenings, substance use treatments and other pro-health measures,” Ben Chandler, president and chief executive of the Foundation for a Healthy Kentucky, said in a news release.

The administration of Gov. Matt Bevin, a Republican, has received federal permission for Medicaid changes, including requirements for many beneficiaries to work, go to school or volunteer 80 hours a month, pay small premiums and report monthly on their work status.

The changes are projected to reduce the number of Medicaid participants.

Bevin has argued that the changes will benefit able-bodied Medicaid beneficiaries by getting them engaged in their communities and contributing toward the cost of their insurance.

“This idea that we are somehow punishing people — that somehow this will be a detriment to people — I think is a huge, huge misunderstanding of what people need, the dignity and the respect that comes from giving people an opportunity,” Bevin said.

There is likely to be another lawsuit to block the changes.

The Foundation for a Healthy Kentucky said in a news release that it has set up a partnership with the state to help Medicaid participants understand and comply with the changes, and plans to help people pay Medicaid premiums if they are at risk of losing coverage.

“Our singular goal is to ensure health care coverage for as many Kentuckians as possible because it improves access to preventive health care and reduces the likelihood and severity of chronic illness,” Chandler said.