Nearly one in four registered voters named support for the Affordable Care Act’s protections for pre-existing conditions as the most important health care issue determining his or her vote for Congress this cycle, according to a new poll released Thursday by the Kaiser Family Foundation.

In general, more than two-thirds of registered voters, 68 percent, said that they would be more likely to support a candidate that wants to maintain protections for pre-existing conditions, while 22 percent said a candidate’s position on the issue didn’t make a difference. A little more than half of Nevada residents surveyed said that someone in their household has a pre-existing condition.

The poll, conducted and paid for by the Kaiser Family Foundation, sampled 599 Nevadans, including 513 registered voters, between Sept. 19 and Oct. 2. The poll has a margin of error of 5 percentage points.

Of all Nevadans polled, 49 percent said that they had a favorable impression of the Affordable Care Act while 39 percent had an unfavorable impression of the federal health-care law. Registered voters generally said that they would be more likely to vote for a candidate that wants to protect the ACA (47 percent) than one that wants to repeal it (34 percent).

Asked what issues would be important in deciding who to vote for in Congress this year, 94 percent of registered voters said the economy and jobs, 89 percent said health care, 83 percent said gun policy, and 83 percent said tax cuts and tax reform. But asked which is the most important issue, 26 percent of those surveyed said health care, compared to 19 percent who said the economy and jobs and another 19 percent who said gun policy.

Among those polled who said health care was an important issue, 28 percent said they were most concerned about health care costs, 14 percent said they were concerned about increasing access to health care and 10 percent said they were concerned about Medicare or other issues related to seniors. Only 7 percent expressed opposition to the Affordable Care Act as their top health-care concern, while 6 percent listed improving and implementing the ACA as a key issue. Three percent listed Medicaid as their top concern.

By and large, registered voters said that candidates’ positions on specific issues were more important to them than the broader political environment, including a candidate’s support for or opposition to President Donald Trump. Fifty-two percent said the candidates’ specific positions were most important while 42 percent said the broader political environment was.

A little over half of registered voters said they would be more likely to support a candidate that wants to increase access to reproductive health services including birth control and abortion, while 25 percent said it didn’t make much of a difference and 18 percent of voters said they would be more likely to support a candidate that wants to decrease access to such services. Registered voters also tended to support increasing regulations on drug prices (39 percent) than oppose (32 percent), though 26 percent of voters said it didn’t make much of a difference.

A plurality of voters said that they would be more likely to favor a candidate that supports passing a national health plan, like Medicare-for-all, (47 percent) than one who opposes such a plan (31 percent).

The poll also found that 45 percent of registered voters in the state are more enthusiastic about this election, while 37 percent have about the same level of enthusiasm as past elections and 17 percent are less enthusiastic. (Ninety-one percent of registered voters surveyed said they were likely to vote, while another 6 percent said they were 50-50, 3 percent said they weren’t sure and 1 percent said they didn’t think they would vote.)