From 2005 to 2007, a slim majority of Americans rated the quality of healthcare in the U.S. as excellent or good. But this percentage increased slightly in 2008 after President Barack Obama was elected, reaching a high of 62% in November 2010 and again in 2012 just after he was elected to his second term. Those higher ratings could reflect optimism about Obama’s promises to reform healthcare and the passage of the Affordable Care Act. However, since November 2013, shortly after the ACA insurance exchanges first opened, no more than 54% of Americans have rated the quality of healthcare in the U.S. as excellent or good.