Americans who voted to elect Donald Trump as the 47th president in Tuesday night’s elections expressed concern about several important issues, including the state of democracy, the economy, immigration and foreign policy.

The state of democracy in particular was the most important issue for voters, with 35% saying the same according to ABC News. preliminary exit pollfollowed by 31% who said the economy was the most important issue to them.

Health care, however, did not appear to be a major voting issue for many Americans. Although abortion, for example, was among the top five voting issues, only 14% said it was the most important issue, the exit poll showed.

Experts told ABC News that despite concerns about the repeal of the Affordable Care Act (ACA) and new restrictions on abortion rights, other issues were a priority for Americans.

“Health care issues are always a concern for people, but there were certainly other issues that were more important to people at the time,” Dr. Perry Halkitis, dean of the School of Public Health at the University, told ABC News. Rutgers University in New Jersey. . “It seemed like the economy and migration were the biggest issues, but especially the economy. People expressed very serious concerns about prices, very serious concerns about the affordability of things, very serious concerns about inflation.”

“And those concerns outweighed concerns about access to health care and/or reproductive rights, and many people voted based on their pocketbooks rather than their rights and access to health care,” Halkitis continued.

Affordable Care Act

During his first term, then-President Trump attempted several times to repeal the ACA, but was unsuccessful. he was promising at the end of November 2023 to replace him, saying Republicans “should never stop trying.”

However, throughout 2024, Trump said on several occasions, both in social networks and during the presidential debatethat he wanted to make the ACA “better” rather than replace it.

Ultimately, concerns about health care and potential changes to the ACA didn’t even make the top five voting issues in ABC News exit polls.

Halkitis said he doesn’t think there will be sweeping changes to the ACA during Trump’s second term because it is “embedded in people’s lives.” However, he does have concerns about legislation or policies that could limit the types of services available from health care providers, rather than a complete repeal or dismantling of the ACA.

“An example is that in the state of Texas, about a year ago, the district court decided that he pre-exposure prophylaxiswhich involves taking a pill once a day to prevent HIV, didn’t have to be covered by any particular company’s insurance,” Halkitis said. “I think things like that speak to people’s beliefs, Whether they are right or wrong, (that) can affect the types of health care services that are provided to people, if the president-elect is going to make any changes to the Affordable Care Act.”

Another example is the federal guarantee of contraceptive coverage. Under a provision of the ACA, most private insurance plans must cover the full cost of most contraceptives, such as birth control, without patients paying out-of-pocket costs.

If the incoming Trump administration allows employers and schools to use religious and moral exemptions to prevent contraceptive coverage, such as The White House did it During Trump’s first term, this may lead to out-of-pocket costs that make contraceptives unaffordable for some people, some experts told ABC News.

Those with pre-existing conditions could also be at risk. Under the ACA, insurers cannot charge more or deny coverage to someone or their child because of a pre-existing health condition. However, Vice President-elect JD Vance has suggested placing people with chronic illnesses into separate risk groups, which could increase premiums for those with pre-existing conditions.

“I hope that doesn’t happen because it would actually be disastrous for many millions of Americans,” Halkitis said. “What I think would happen is, if they were to change the pre-existing conditions clause and put people in a different group, it could make it unaffordable for people to have health insurance.”

Dr. Stephen Patrick, professor and chair of the Department of Health Policy and Management at the Rollins School of Public Health at Emory University in Georgia, said he believes voters in future elections will be motivated to go to the polls if they see modifications in the ACA.

For example, Patrick said public opinion is generally favorable to provisions such as parents being able to keep their children on their insurance plans until age 26, as a measure. 2019 KFF Health Tracking Survey Foundwhich may have inspired people to go to the polls in past elections.

“We know that when they start making changes to things like the Affordable Care Act, people care that we start to change things, or change things when they affect their health insurance,” Patrick told ABC News. “If you say to someone, ‘Keep your child on your health insurance until they’re 26,’ people are generally in favor of those types of policies.”

reproductive rights

Some Political strategists believed that the 2022 decision of the United States Supreme Court overturning Roe v. Wade would lead voters who support abortion rights to go to the polls to vote for Kamala Harris. Trump himself took credit for the ruling, boasting that “could have killed Roe v. Wade.”

While supporters of legal abortion were still firmly in favor of Harris, Trump’s focus on states’ rights appeared to resonate with voters who did not view abortion access as incompatible with a Trump presidency.

In Arizona, 23% of those who voted “yes” on the state initiative enshrining abortion rights in the state constitution also voted for Trump. In Nevada, where another abortion rights measure passed, 25% of voters who voted “yes” also voted for Trump, according to the ABC News exit poll.

“I think what we’re seeing (in) the exit polls is that abortion was a very important issue among many, many voters. However, not all of those voters voted for Kamala Harris,” said Dr. Leslie Kantor , professor and chair of the Department of Global Urban Public Health at the Rutgers School of Public Health, told ABC News. “I think there was actually some confusion, which was sown quite deliberately by the Trump-Vance campaign in recent weeks, trying to convince people that, in fact, they are not opposed to abortion, when the record clearly shows yes.”

Kantor said this is evident in statements by Trump and Vance in which they said the president-elect veto a national abortion ban if you came across your desk, or in comments by Trump in which he said he would not use the 150-year-old monument Comstock’s Law prohibit mail delivery of abortifacient drugs.

Kantor noted that even though Trump expressed pride in appointing Supreme Court justices to overturn Roe v. Wade spoke less about abortion rights during the election campaign.

“In 2024, when people are seeing the devastating consequences of the reversal (sic) of Roe v. Wade, he really moved away from that position and was much less clear, and the voters clearly were less clear,” he said. “Because when you see someone who says, ‘I think abortion should be legal in most cases,’ and then votes for someone who clearly doesn’t believe abortion should be legal, you know people are confused.”

Preliminary results from the ABC News exit poll show that abortion was an important voting issue for young women, with about 19% of all women voters saying it was their most important issue, rising to 42%. among women under 30 years of age.

Kantor also noted that she believes young women become scared after reading news about Women pushed to the brink of death. or die after being denied medical care because doctors were hesitant to act due to restrictions imposed by state abortion laws. He added that some abortion providers are also leave states where abortion care is restricted.

“Young women are terrified by what is happening across the country,” Kantor said. “The truth is, it’s not even safe to have a desired pregnancy in this country… So I think young women are facing 30 years, possibly 25 years, of having to manage their sexual and reproductive health with very few providers and very few rights.”

Abortion services can be difficult to access even in states where care is now legal. In Missouri, voters consecrated the right to reproductive freedom in the state constitution, effectively ending the state’s restrictive ban. However, for now, abortion remains unavailable in the state.

“Access to services is incredibly restricted, and at some point having an entitlement doesn’t make sense if you can’t actually get the service,” Kantor said.

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