Most primary care doctors want to keep the Affordable Care act, not repeal it, according to a new survey published in the New England Journal of Medicine.

The authors, Dr. Craig Evan Pollack, Dr. Katrina Armstrong, and Dr. David Grande – who noted that there is now “substantial uncertainty about the future of U.S. health policy” – found that even pro-Trump doctors differed from the general presidential supporter regarding killing the law.

"Tens of millions of people could be at risk of losing health insurance if critical elements of the Affordable Care Act are repealed. Given the central role physicians play in the health care system, their views of the legislation are important for informing the public debate," said Grande, an assistant professor of Medicine at the Perelman School of Medicine at the University of Pennsylvania School of Medicine and director of Policy at Penn's Leonard Davis Institute of Health Economics.

Of all specialists, PCPs are on the “front lines” – they are the first to see patients in most cases. “With primary care physicians often helping patients navigate challenges with their insurance, it is critical to understand their perspectives on the repeal of the act,” added Pollack, an associate professor of medicine at the Johns Hopkins University School of Medicine.

He went on to note that the survey showed that "by and large, primary care physicians are open to modifications of the law, but believe several aspects of the ACA, with its focus on increasing insurance coverage, are important to patients' health."

The survey asked doctors what they wanted to see policy makers do with the ACA.

In response, just 15.1 percent of PCPs indicated that they wanted the ACA to be repealed in its entirety.

“Responses varied according to the physicians’ self-reported political party affiliation; no Democrats wanted to see the ACA repealed, whereas 32.4 percent of Republicans did. Among physicians who reported voting for Trump, only 37.9 percent wanted the ACA repealed in its entirety. PCPs were less likely than the general public to want the law repealed. A Kaiser Family Foundation poll conducted after the election that used a question and response options similar to those in our survey showed that 26 percent of the general public wants the law repealed in its entirety.”

Instead, the vast majority (73.8 percent) would like to see the law altered – to increase greater consumer choice, like a public option “similar to Medicare” to compete with private plans; to provide tax breaks for the Medicaid eligible to buy private insurance and to make greater use of health savings accounts.

The authors noted that administration's HHS pick, Rep. Tom Price, has argued that “the law places an undue burden on physicians.”

However, in response to this issue, the PCP survey found “a majority reported that they had seen an increase in the number of Medicaid or newly insured patients, without a decrease in their ability to provide high-quality care.”

The survey took place from December 2016 through January 2017 and a total of 426 physicians responded. Tellingly, a number of parts of the ACA found a lot of support from doctors.

The insurance-market regulations against charging more for or denying insurance for preexisting conditions were supported by 95.1 percent of doctors, who called it “very important” or “somewhat important” for improving Americans' health.

Letting children stay on parents insurance until age 26 garnered support by 87.6 percent; giving tax credits to small businesses was deemed a plus by 90.8 percent; a total of 75.2 percent supported tax subsidies to individuals and 72.9 percent were for expanding Medicaid.

But only 49.5 percent were in favor of a tax penalty for those people who refused to buy coverage.

The doctors in the survey were most against shifting costs to consumers – notably with high-deductible policies. And under 50 percent were in favor of reducing regulations on insurers, such as allowing intra-state selling.

Many others from the health care world have recently echoed the concerns highlighted in this survey. Just this month The American College of Rheumatology sent a letter to House and Senate leaders urging that any replacement to the Affordable Care Act needed to “protect and promote access to adequate and affordable health insurance for all citizens.”

The letter stressed that the ACR “looks forward to working with both Congress and the incoming Administration,” in developing a way to guarantee that there is access to “affordable, high-quality health care, including care for arthritis and other rheumatic diseases."