With the Affordable Care Act hitting its five year birthday and the second open enrollment period nearly finished, Americans are turning their attention and wishes for Congress and the Obama administration to a focus on prescription drugs.

A non-partisan Kaiser Family Foundation poll released Tuesday found that when asked about many different aspects of health care delivery and the health care system, the issue that comes out on top for Democrats, Republicans and independents is making sure high-cost drugs for chronic conditions – such as HIV, hepatitis, mental illness and cancer – are affordable to those who need them, with three-quarters of the public (76%) saying this is a top priority.

Six-in-ten (60%) say government action to lower prescription drug prices should be a top priority and 56% say “protecting people from being charged high prices when they visit hospitals covered by their health plan but are seen by a doctor not covered by their plan,” should also be a priority.

After prescription drugs, the public’s top priorities varied based on political party. For Democrats, the issues that rank second and third focused on expanding the ACA: Requiring states to expand Medicaid (74%) and increasing subsides offered under the law (72%). For Republicans, the focus was on repealing the law (60%) and repealing the individual mandate (52%.)

Also see: Employers to Congress: Five years in, the ACA is a burden

"Concern about health care costs has always been a strong bipartisan issue, and this poll once again reflects the fact that pocketbook trumps politics when people think about their most important health care concerns,” says Katherine Hempstead ,a director at the non-partisan Robert Wood Johnson Foundation in Washington. “Republicans and Democrats, who agree about little in terms of health policy issues, will often find common ground when identifying major cost drivers, as seen in the response about specialty drug prices. And they are spot-on, as drug prices are the major source of the recent increase in health care spending."

ACA favorability

The poll also found Americans’ views on the ACA are nearly even. The April poll of more than 1,500 Americans found 43% view the law favorably and 42% unfavorably.

Also see: Why do more re-enroll with federal than state HIX?

This is the first time since November 2012 that the number of those who expressed a favorable view exceeds those with an unfavorable view, Kaiser notes. The non-profit notes the difference of one percentage point is within the survey's margin of sampling error and is not statistically significant.

Those numbers have held pretty steady over the last few monthly Kaiser polls. Bianca DiJulio, an associate director, public opinion and survey research program at Kaiser in Menlo Park, Calif., says that likely has something to do with the ACA moving along with fewer incidents involving it. With second open enrollment nearly finished and no election cycle, the ACA is moving forward as is, she says.

Hempstead explains these numbers have been creeping toward each other since January, “and the day has finally arrived when lines have crossed ever so slightly.”

“The absence of disasters during the second open enrollment period is surely a factor, as well as the fading of concerns about cancelled plans and receding fears of widespread labor market impacts,” she adds. “At the same time, the changes in the insurance markets and other major reforms are probably starting to seem more normal and are more widely accepted. The partisan nature of the divide is likely to remain."

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