Despite ACA, abortion concerns, health care was not a voting issue, experts say

Americans who voted to elite Donald Trump nan 47th president successful Tuesday night's election expressed concerns astir respective awesome issues, including nan authorities of democracy, nan economy, migration and overseas policy.

The authorities of populist successful peculiar was nan astir important rumor to voters, pinch 35% saying arsenic overmuch according to an ABC News preliminary exit poll, followed by 31% who said nan system was nan astir important rumor to them.

Health care, however, did not look to beryllium a awesome voting rumor for galore Americans. Though abortion, for example, was among nan apical 5 voting issues, only 14% said it was their astir important issue, nan exit canvass showed.

Experts told ABC News that contempt concerns astir nan repeal of nan Affordable Care Act (ACA) and further restrictions connected abortion rights, different issues were apical of mind for Americans.

"Health attraction issues are ever a interest to people, but surely location were different issues that were much important to group astatine this time," Dr. Perry Halkitis, dean of nan School of Public Health astatine Rutgers University successful New Jersey, told ABC News. "It seemed for illustration nan system and migration were nan biggest issues, but particularly nan economy. People expressed very superior concerns astir prices, very superior concerns astir nan affordability of things, very superior concerns astir inflation."

"And those surpassed concerns astir wellness attraction entree and aliases reproductive rights, and galore group voted based connected their pocketbooks alternatively of their wellness attraction authorities and access," Halkitis continued.

Republican statesmanlike nominee erstwhile President Donald Trump and erstwhile first woman Melania Trump depart nan shape astatine an predetermination nighttime watch party, Nov. 6, 2024, successful West Palm Beach, Fla.

Evan Vucci/AP

Affordable Care Act

During his first term, then-President Trump tried respective times to repeal nan ACA but was unsuccessful. He was promising arsenic precocious November 2023 to switch it, saying Republicans "should ne'er springiness up" trying.

However, passim 2024, Trump said connected respective occasions, some connected social media and during nan presidential debate, that he wanted to make nan ACA "better" alternatively than switch it.

Ultimately, worries astir heath attraction and imaginable changes to nan ACA didn't moreover ace nan apical 5 voting issues successful ABC News exit polls.

Halkitis said he doesn't deliberation location will beryllium extremist changes to nan ACA during Trump's 2nd word because it's "baked into people's lives." However, he does interest astir authorities aliases policies that could limit nan types of services that are disposable from wellness attraction providers, arsenic opposed to a complete repeal aliases dismantling of nan ACA.

"One illustration is that successful nan authorities of Texas, astir a twelvemonth ago, nan district tribunal decided that nan pre-exposure prophylaxis, which is nan usage of 1 pill erstwhile a time to forestall HIV, did not person to beryllium covered by security of a peculiar company," Halkitis said. "I deliberation things for illustration that that speak to people's beliefs, whether correct aliases incorrect, [that] whitethorn impact nan kinds of wellness attraction services that are provided to people, if nan president-elect is to make immoderate changes to nan Affordable Care Act."

Another illustration is nan federal contraceptive sum guarantee. Under a proviso of nan ACA, astir backstage security plans must screen nan afloat costs of astir contraceptives, specified arsenic commencement control, without making patients salary out-of-pocket costs.

If nan incoming Trump management allows employers and schools to usage belief and civilized exemptions to forestall sum of contraceptives, arsenic nan White House did during Trump's first term, this whitethorn lead to out-of-pocket costs that make contraceptives unaffordable to some, immoderate experts told ABC News.

Also astatine consequence could beryllium those pinch preexisting conditions. Under nan ACA, insurers cannot complaint much aliases contradict sum to personification aliases their kid because of a preexisting wellness condition. However, Vice President-elect JD Vance has suggested placing group pinch chronic conditions into abstracted consequence pools, which could raise premiums for those pinch preexisting conditions.

"I dream that doesn't hap because that would really beryllium disastrous for truthful galore millions of Americans," Halkitis said. "What I deliberation would hap is that, if they were to modify nan preexisting conditions clause, and put nan group successful a different bracket, is that it whitethorn go unaffordable for group to person wellness insurance."

Dr. Stephen Patrick, professor and chair of nan Department of Health Policy and Management astatine nan Rollins School of Public Health astatine Emory University successful Georgia, said he thinks voters successful early elections will beryllium motivated to spell to nan polls if they spot modifications to nan ACA.

For example, Patrick said nationalist sentiment is mostly favorable for provisions specified arsenic parents being capable to support their children connected their security plans until property 26, arsenic a 2019 KFF Health Tracking Poll found, which whitethorn person inspired group to spell to nan polls successful past elections.

"We cognize that arsenic you commencement to make modifications to things for illustration nan Affordable Care Act, group do attraction arsenic we commencement to modify things, aliases alteration things erstwhile it affects their wellness insurance," Patrick told ABC News. "If you opportunity to someone, 'keeping your kid connected your wellness security until they're 26,' group mostly are successful favour of those types of policies."

Reproductive rights

Some political strategists believed that nan U.S. Supreme Court's 2022 determination overruling Roe v. Wade would thrust voters who support abortion authorities to nan polls to ballot for Kamala Harris. Trump himself took in installments for nan ruling, boasting that he "was capable to termination Roe v. Wade."

Sign successful favour of proposition 139, nan correct to abortion initiative, are displayed astatine nan entranceway room of nan Tucson HQ of Arizona List, an relation made to empower and elite progressive pro-choice Democratic women leaders, successful Tucson, Ariz., Oct. 16, 2024.

Olivier Touron/AFP via Getty Images, FILE

While supporters of ineligible abortion still collapsed powerfully for Harris, Trump's attack focusing connected states' authorities appeared to resonate pinch voters who didn't position abortion entree arsenic incompatible pinch a Trump presidency.

In Arizona, 23% who voted "yes" connected nan state's inaugural enshrining abortion authorities successful nan authorities constitution besides voted for Trump. In Nevada, wherever different abortion-rights measurement was approved, 25% of "yes" voters likewise went for Trump, according to nan ABC News exit poll.

"I deliberation what we're seeing [in] nan exit polls is that abortion was a very important rumor among many, galore voters. However, those voters did not each ballot for Kamala Harris," Dr. Leslie Kantor, professor and chair of nan Department of Urban Global Public Health astatine nan Rutgers School of Public Health, told ABC News. "I deliberation that location was really a definite magnitude of confusion, which was sown beautiful deliberately by nan Trump-Vance run successful nan last weeks, trying to person group that, successful fact, they don't reason abortion, erstwhile nan way grounds intelligibly shows that they do."

Kantor said this is evident successful statements by Trump and Vance successful which they said nan president-elect would veto a nationalist abortion ban if it came crossed his desk, aliases successful comments by Trump successful which he said he would not usage nan 150-year-old Comstock Act to prohibition message transportation of abortion medication.

Kantor noted that, contempt Trump expressing pridefulness for appointing justices to nan Supreme Court to overrule Roe v. Wade, he was little vocal astir abortion authorities connected nan run trail.

"In 2024, erstwhile group are seeing nan devastating consequences of nan overturn [sic] of Roe v. Wade, he really backed distant from that position and was overmuch little clear, and voters were intelligibly little clear," she said. "Because erstwhile you spot personification who says, 'I deliberation abortion should beryllium ineligible successful astir cases,' and past voting for personification who intelligibly does not judge abortion should beryllium legal, you cognize that group person been confused."

Preliminary exit canvass results from ABC News show that abortion was an important voting rumor for young women, pinch astir 19% of each women voters saying it was their astir important issue, rising to 42% among women younger than 30.

Kantor further noted that she thinks young women are frightened aft reference news reports astir women pushed to nan brink of death aliases dying aft aesculapian attraction was denied because physicians were hesitant to enactment owed to restrictions to authorities abortion laws. She added that immoderate abortion attraction providers are besides leaving states wherever abortion attraction is restricted.

"Young women are terrified astir what's happening each astir nan country," Kantor said. "The truth is it isn't moreover safe to person a wanted gestation successful this country. …So, I deliberation young women are staring astatine 30 years, perchance 25 years, of having to negociate their intersexual and reproductive wellness pinch very fewer providers and very fewer rights."

It whitethorn beryllium difficult to entree abortion services moreover successful states wherever attraction is now legal. In Missouri, voters enshrined nan right to reproductive state successful nan state's constitution, efficaciously ending nan state's restrictive ban. However, abortion for now remains unavailable successful nan state.

"Access to services is incredibly restricted and, astatine immoderate point, having a correct is meaningless if you can't really get nan service," Kantor said.

ABC News' Gary Langer and Gibran Okar contributed to this report.