(CNN) -- President Barack Obama's re-election neutralized efforts by Republicans to overturn the Affordable Care Act and marks the continued implementation of the law, but a majority of Americans now say it's not the federal government's role to provide healthcare insurance coverage.
The Gallup poll indicates 54% of Americans believe guaranteed healthcare coverage is not the government's responsibility while 44% believe it is -- the first time since 2000 the Gallup poll trend has shown a majority of Americans feel the government should not be responsible for providing healthcare insurance coverage for all Americans.
Before 2009, a plurality of Americans believed the government should make sure all Americans have healthcare coverage but since then Americans have wavered in their support of the idea of government-guaranteed healthcare.
While the Affordable Care Act passed in March 2010, Obama's November 6 re-election victory paved the way to implementation of the remaining portions of the law. Prior to Obama re-election and following a Supreme Court June ruling upholding most of the president's initiative, the law allowed for patients with pre-existing conditions access to insurance and young adults to stay on their parents' insurance plans.
Now, in the next phase of its implementation, states are tasked with setting up affordable insurance exchanges, subsidizing coverage lower-income consumers. States can choose to set up their own exchanges or allow the federal government to manage their state's exchange.
Republicans see the law as a key part of on-going negotiations on how to tame the nation's debt. Republican and Democratic leaders are pressed to reach common ground before the end of the year deadline to avoid a series of automatic tax hikes and federal spending cuts that could knock the U.S. economy back into a recession.
The top Republican locked in the negotiations with congressional leaders and the president is House Speaker John Boehner. Boehner said portions of Obama's healthcare law, namely the part requiring states to subsidize insurance for lower-income earners, should be on the table as an option to balance the nation's budget.