Medical Students’ Views and Knowledge of the Affordable Care Act: A Survey of Eight U.S. Medical Schools

Tyler N A Winkelman, Lisa Soleymani Lehmann, Navjyot K. Vidwan, Meredith Niess, Cynthia S. Davey, Derek Donovan, Joseph Cofrancesco, Mia Mallory, Sandi Moutsios, Ryan M. Antiel, John Y. Song

Research output: Contribution to journalArticlepeer-review

6 Scopus citations


BACKGROUND: It is not known whether medical students support the Affordable Care Act (ACA) or possess the knowledge or will to engage in its implementation as part of their professional obligations. OBJECTIVE: To characterize medical students’ views and knowledge of the ACA and to assess correlates of these views. DESIGN: Cross-sectional email survey. PARTICIPANTS: All 5,340 medical students enrolled at eight geographically diverse U.S. medical schools (overall response rate 52 % [2,761/5,340]). MAIN MEASURES: Level of agreement with four questions regarding views of the ACA and responses to nine knowledge-based questions. KEY RESULTS: The majority of respondents indicated an understanding of (75.3 %) and support for (62.8 %) the ACA and a professional obligation to assist with its implementation (56.1 %). The mean knowledge score from nine knowledge-based questions was 6.9 ± 1.3. Students anticipating a surgical specialty or procedural specialty compared to those anticipating a medical specialty were less likely to support the legislation (OR = 0.6 [0.4–0.7], OR = 0.4 [0.3–0.6], respectively), less likely to indicate a professional obligation to implement the ACA (OR = 0.7 [0.6–0.9], OR = 0.7 [0.5–0.96], respectively), and more likely to have negative expectations (OR = 1.9 [1.5–2.6], OR = 2.3 [1.6–3.5], respectively). Moderates, liberals, and those with an above-average knowledge score were more likely to indicate support for the ACA (OR = 5.7 [4.1–7.9], OR = 35.1 [25.4–48.5], OR = 1.7 [1.4–2.1], respectively) and a professional obligation toward its implementation (OR = 1.9 [1.4–2.5], OR = 4.7 [3.6–6.0], OR = 1.2 [1.02–1.5], respectively). CONCLUSIONS: The majority of students in our sample support the ACA. Support was highest among students who anticipate a medical specialty, self-identify as political moderates or liberals, and have an above-average knowledge score. Support of the ACA by future physicians suggests that they are willing to engage with health care reform measures that increase access to care.

Original languageEnglish (US)
Pages (from-to)1018-1024
Number of pages7
JournalJournal of general internal medicine
Issue number7
StatePublished - Jul 19 2015

Bibliographical note

Funding Information:
We thank Mark Winkelman (Winkelman Consulting) for his contribution to survey development, for which he received no financial compensation. Research reported in this publication was supported by the National Center for Advancing Translational Sciences of the National Institutes of Health, award number UL1TR000114. The content of this article is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.

Publisher Copyright:
© 2015, Society of General Internal Medicine.


  • Affordable Care Act
  • Health care reform
  • Medical students
  • Survey


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