Minnesotans are evenly divided over Republican steps in Washington to replace the Affordable Care Act, although a larger number say it has done more good than harm, according to a new Star Tribune Minnesota Poll.

Those findings come as a debate over federal health insurance policies continues to grip Congress and preoccupy the Trump White House. The poll showed that 44 percent of Minnesota voters support Republican efforts to undo the federal law, while another 44 percent oppose it. The rest said they are undecided. Meanwhile, 49 percent of Minnesota voters polled think the Affordable Care Act has been mostly a good thing, while 44 percent think it has been mostly bad.

Some Minnesotans polled said they were torn: While they said insurance has become costlier, they like particular provisions of the current law, including protections for people with preexisting conditions, and the option for young adults to remain on their parents' insurance plan.

Tom Barenbaum, a 37-year-old banking company employee from Eagan who participated in the poll, said he wonders why members of Congress want to start from scratch and not opt for a more "efficient and affordable" solution to the country's health care woes.

"I don't quite understand why they don't just fix the Affordable Care Act," Barenbaum said. "They already have a law in place."

The poll of 800 registered voters was conducted between April 24 and 26 and has a margin of sampling error of plus or minus 3.5 percentage points. It revealed that Minnesotans living in and around the Twin Cities overwhelmingly support the ACA and oppose efforts to repeal and replace the law, but those living in other parts of the state have the opposite view.

(See the poll results here.)

While 74 percent of voters surveyed in Hennepin and Ramsey counties say the legislation has been mostly a good thing, just 36 percent of people in southern Minnesota and 25 percent in northern Minnesota are similarly supportive. Greater Minnesota residents polled were also far more likely to back Republican efforts to repeal the law and start over, including 57 percent in southern Minnesota and 64 percent of people in the northern part of the state.

Cost is an issue

That includes Dan Andrus, a 33-year-old electrician from Pine River, who said he knows plenty of people who struggled to sign up for — and afford — insurance through the state's individual marketplace. In many cases, he said, costs are so high that workers have to put in "16-hour days to just pay for your health insurance and everything else." For some, he said, it makes sense to just work less to be able to qualify for state-subsidized health care.

"You pretty much are better off not working at all and getting everything through the state," Andrus said.

Minnesota lawmakers voted earlier this year to spend $868 million to prop up the state's individual insurance market, which has seen insurance companies leave and premiums skyrocket in recent years. State officials say fewer than 5 percent of Minnesotans buy their insurance on that market, rather than getting it from their employer or a public program.

Of those polled, 53 percent said they got their insurance through their employer, 27 percent through the government and 13 percent purchased plans on the individual market. Three percent reported being uninsured, while 4 percent weren't sure about their plans. The number of people who reported being on the individual market was split pretty evenly across the state.

Along with the geographic divide, voters' support for the Affordable Care Act — or for its repeal — were split along party lines. Republicans and Trump voters overwhelmingly want to see the legislation dismantled, while Democrats and Hillary Clinton voters favored keeping the law on the books.

Partisan divide

The poll showed a similar partisan division on whether Republicans were attempting to make too many, not enough, or the right amount of changes to the health care law. Statewide, 34 percent of Minnesotans thought Republicans were trying to make too many changes, 25 percent thought there were not enough changes, and 25 percent thought GOP lawmakers had proposed the right amount of changes.

Julie Schreifels, a 58-year-old retired teacher from Welch, said she doesn't want to see Republicans chip away at provisions that have made a difference, including in her own family.

"I have three sons who would not have health insurance if it wasn't for [the ACA]," she said. "Though it has its issues, I think it's a good program and it's got a lot more people who now have health insurance."

Minnesotans 65 and older had the broadest support for the Affordable Care Act, and showed the most widespread opposition toward the efforts to repeal it. Fifty-four percent of people in that age group said the law was mostly a good thing, while just 35 percent were supportive of the repeal efforts. By contrast, 49 percent of people ages 35 to 49 percent said they wanted to see the ACA repealed.

Regardless of age or the type of insurance they carry, Minnesotans like Dollie Acton, a 79-year-old retired nurse from Preston, are concerned about the rising costs of being insured. Acton said she knows of many people who have seen their premiums double, and she thinks the ACA's requirement that everyone have coverage is unfair to those who can't afford it.

"I don't think it should be a thing that dictates that people really have to do it," she said. "It's up to them, but I think it should be more affordable than it is."

Erin Golden • 612-673-4790