As President Donald Trump completes his first year in office, Americans are increasingly concerned about health care, and their faith that government can fix it has fallen.
A new poll by The Associated Press-NORC Center for Public Affairs Research finds that 48 percent named health care as a top problem for the government to focus on in the next year, up 17 points in the last two years.
The poll allows Americans to name up to five priorities and found a wide range of top concerns, including taxes, immigration and the environment. But aside from health care, no single issue was named by more than 31 percent.
And 7 in 10 of those who named health care as a top problem said they had little to no confidence that government can improve matters. The public was less pessimistic in last year's edition of the poll, when just over half said they lacked confidence in the problem-solving ability of lawmakers and government institutions.
"We are way up there on the cost, and as far as giving good health care, we are way down," said Rebekah Bustamante of San Antonio, a retired medical imaging technician. "Now in health care, you're a number."
Bustamante said she voted for Trump, but "he's learning on the job, and he's got a long way to go."
Trump initially promised his own plan that would deliver "insurance for everybody" and "great" health care, "much less expensive and much better." But the White House never released a health care proposal from the president.
GOP legislation to repeal and replace former President Barack Obama's health care law failed in Congress, although the tax bill scraps the Obama requirement that most people get health insurance. Bloodied on both sides, Republicans and Democrats seem to have battled to an uneasy draw on health care.
Meanwhile, conflicting policy signals from Washington, including an abrupt White House decision to cancel insurer subsidies, roiled insurance markets. Premiums on health plans purchased by individuals jumped by double digits. Progress reducing the number of uninsured stalled, and one major survey found an uptick this year.
"There is zero bipartisanship, and it's frustrating," said Eric Staab, a high school teacher from Topeka, Kansas. "It seems like we have thrown everything at this dartboard, and nothing is improving the coverage."
Rumblings of discontent have political repercussions for next year's midterm elections and the presidential contest in 2020, said Robert Blendon, a professor at the Harvard T.H. Chan School of Public Health, who follows opinion trends on health care.
"It's the issue that won't go away," said Blendon. "Given the news cycle, taxes should be first, the economy should be second, and this health care thing should be buried."
Three in 10 Americans listed taxes among their top priorities, about double the percentage who said that last year. About a quarter mentioned immigration, and just under 2 in 10 mentioned environmental issues and education. Meanwhile, concerns about unemployment plunged to 14 percent, about half the mentions as last year.
Health care was by far the top issue mentioned by Democrats and independents. Republicans were about equally likely to mention immigration, health care and taxes.
Democrats were more likely than Republicans to say they have little to no confidence that the government will make progress on health care, 84 percent to 57 percent.
The reason health care doesn't fade away is that costs aren't getting any more manageable, said some people who took part in the AP-NORC survey.
Bustamante said she is planning a trip to Mexico for some dental work, because she can obtain quality service for much less there. "Thank God I live in Texas, where getting to Mexico isn't that far away," she said. "But everybody doesn't have that option."
ShyJuan Clemons of Merrillville, Indiana, said he's currently uninsured because his previous health plan was costing too much money for the benefit he got from it. He faced his insurance plan's annual deductible when he went to the doctor, so he'd wind up paying out-of-pocket for visits, on top of premiums.
"You are not constantly worried about taxes, but you are constantly worried about health care — be it major or minor," said Clemons, a personal care attendant who works with disabled people. "You catch a cold, and you just think about it in passing — 'I hope it doesn't develop into a problem.'"
Clemons, a Democrat, said he's disappointed that Trump and Republicans in Congress seem to be trying to tear down "Obamacare" instead of building on it. "I would like to see them make the thing run smoothly so we can do better, instead of just trying to cripple it," he said.
The lack of confidence in the ability of government to find pragmatic solutions extended to other problems in the AP-NORC poll, including climate change, immigration, and terrorism.
Just 23 percent said that Trump has kept the promises he made while running for president, while 30 percent said he's tried and failed, and 45 percent said he has not kept his promises at all.
Nearly 2 in 3 said they were pessimistic about the state of politics in the U.S. About half were downbeat about the nation's system of government, and 55 percent said America's best days are behind.
The AP-NORC poll surveyed 1,444 adults from Nov. 11-Dec. 4 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.