These findings from a Nov. 7-10 Gallup poll come at a particularly trying time for President Barack Obama’s signature legislative achievement, the Affordable Care Act. In addition to the malfunctioning federal health insurance exchange website, many Americans have been notified that their current insurance policies will be canceled because they don’t comply with the law’s new standards. Though Obama has offered a temporary reprieve for these policies, it is not clear how this will work, and some individuals may ultimately have to consider policies with higher premiums.

Despite this scrutiny, the share of Americans citing cost as the nation’s top health problem is not inordinately high compared with previous years, though it has increased slightly from the average reading observed throughout Obama’s presidency. Fewer Americans now see access as the foremost health dilemma (16%) than in any year since 2005. This year’s figure represents a 13-point decline from 2007 and 2008, when nearly three in 10 Americans named access as the nation’s main health concern.

Among actual health ailments, obesity ranks first, with 13% naming it. This figure is in line with last year, when an unprecedented 16% saw obesity as the main culprit bedeviling the nation’s health. Simultaneously, cancer, the second-leading cause of death in America, has fallen to fourth place on the list. Two percent mention heart disease, the nation’s leading cause of death.