WASHINGTON (AP) — Sylvia Douglas twice voted for President Barack Obama and last year cast a ballot for Democrat Hillary Clinton. But when it comes to "Obamacare," she now sounds like President-elect Donald Trump. This makes her chuckle amid the serious choices she faces every month between groceries, electricity and paying a health insurance bill that has jumped by nearly $400.
"It's a universal thing, nobody likes it," Douglas, a licensed practical nurse in Huntsville, Alabama, said of Obama's signature law. "They need to fix it with whatever works, but not make more of a mess like they have now."
That Americans agree on much of anything is remarkable after a presidential race that ripped open the nation's economic, political and cultural divisions. But on the brink of the Trump presidency, a new poll finds ample accord across those divisions on the need to do something about health care in the United States.
More than 4-in-10 Republicans, Democrats and independents say health care is a top issue facing the country, The Associated Press-NORC Center for Public Affairs Research poll showed. That's more than named any other issue in the survey, conducted Dec. 14-19.
But there seems to be little agreement on what to do about it.
Democrats say they want to fix problems in the current program — among them, rising costs and dwindling competition — but not dismantle it. They warn that the GOP is threatening the coverage gained by 20 million people under the 2010 overhaul.
Republicans want to repeal Obama's signature law but fear the political damage of stranding millions of Americans who secured coverage. Congress' nonpartisan budget analyst lent weight to that concern Tuesday, estimating that a bill passed in 2016 to only repeal — not replace — the law would result in 18 million more uninsured people and a spike in premiums.
Trump says he has a plan, but so far he's given no details. He told The Washington Post last weekend that his approach would provide "insurance for everybody."
Congressional Republicans say the revamp will offer "universal access" to coverage, not quite the same thing
The desire to fix Obamacare stretches across party lines, but some are skeptical it can be done.
"It can't be made to work," said James Gemind, a 55-year-old restaurant worker from Orlando, Florida. "That's why both sides have been unanimous in their agreement that it has to be repealed or replaced. Part of it is funding; it just does not exist to insure everybody."
Health care aside, in the poll there was more modest agreement on other national priorities.
About a third of Republicans and a quarter of Democrats put unemployment among their top issues. About a fifth named the economy in general as a top priority regardless of party, according to the poll. Most Americans said the government should put a substantial amount of effort toward addressing the public's priorities, but few expect much will be accomplished in the next year, the survey said.
Overall, domestic issues including health care, education, the environment and racism were cited by 86 percent of Americans.
But Democrats were more likely to mention the environment, racism and poverty, while Republicans were more likely to cite immigration, terrorism, government spending and taxes.
Immigration was named by 40 percent of GOP respondents, compared to 15 percent of Democrats. Trump during the campaign connected immigration to national security and vowed to build a wall along the southern U.S. border and make Mexico pay for it — an idea Mexican leaders have not accepted. Trump now says Mexico will pay for it "eventually."
In a turn-around from a year ago, most Republicans now say the country is on the right course, while Democrats have become more pessimistic.
But it's health care reform that survives this era of division, in part because it touches on peoples' day-to-day quality of life, and in the most personal ways.
Douglas' husband is disabled and she recently was diagnosed with a condition that required abdominal imaging. Blue Cross Blue Shield of Alabama is now the only provider in her state exchange — a fact she blames for the boost in her monthly premium, from around $600 to nearly $1000. Additionally, she learned, her deductible had zoomed to $4,000. That torpedoed work she'd done to build a future.
"I was going to buy a new home, I was getting my credit straight, but now that is down the drain," Douglas said. "Obamacare helped the less-fortunate, and that's what I liked about it. I had no idea it would tear out the middle class like this."
The AP-NORC poll of 1,017 adults was conducted Dec. 14-19, 2016, using a sample drawn from NORC's probability-based AmeriSpeak panel, which is designed to be representative of the U.S. population. The margin of sampling error for all respondents is plus or minus 3.7 percentage points.
Interviews were conducted online and using landlines and cellphones.
This story has been corrected to delete the incorrect reference to a "monthly" deductible.