There was a sudden surge in support for Obamacare earlier this year according to polling by Gallup. The law had long been underwater, with more people disapproving of it than approving but in April of this year that flipped as support for the law reached 55%, an all-time high. Since then approval for Obamacare has slipped to 50 percent. Gallup reported Monday:

In April, after House Republicans’ first attempt to repeal the law stalled before it could come up for a vote, Americans’ opinions shifted to viewing the law positively for the first time. The House succeeded in passing repeal legislation in May, but separate efforts in the Senate failed during the summer months. The issue has come up again as the Senate has included a repeal of the individual mandate provision in the ACA as part of its tax reform bill.

The good news, for supporters of the law, is that disapproval remains unchanged at 44 percent. That’s up just 4% since April of this year but far below the high of 56% disapproval in November 2014. This graph, created by Gallup, shows the change of fortune of the law just as Republicans set about trying to repeal it:

As for what is driving all of this, that’s no mystery. The results of the poll are extremely partisan with Democrats expressing strong support (85%) and Republicans expressing almost no support (11%). But Americans still aren’t satisfied with the law. More than 40% would like to see significant changes:

Last November and again this year, Gallup asked Americans who approve of the ACA if they would like to leave the law in place as it is or keep it but make significant changes to it. Americans who disapprove of the ACA were asked if they want to keep the law but with significant changes or to repeal and replace it.

When the responses to the two questions are combined, an overall total of 42% of U.S. adults — a group that includes some who initially approve of it (28%) and some who disapprove (14%) — want to change the ACA significantly. That is a larger percentage than the 29% who disapprove and want the law repealed and replaced or the 21% who approve and want the law kept as is.

Of course, there can also be disagreement about what type of significant changes should be made. Republicans are preparing to vote on a tax bill that would include a provision repealing the individual mandate. That could significantly reduce the number of people who sign up and also drive premiums much higher. On the other hand, some progressives want to expand the law, restore cost-sharing payments and add a “public option” to compete with private insurers. There are also a significant number of Democrats, led by socialist Bernie Sanders, who want Obamacare replaced with some form of single payer.

Early enrollment for next year has been up, though that may be the result of people signing up early because the enrollment period is half as long this year. Despite the early surge, it’s still likely overall enrollment will be down again next year. Charles Gaba at ACA signups (a big supporter of the law) is keeping careful track of developments and has a helpful graph at the bottom of this post showing where we were last week compared to the previous two years.