On ObamaCare’s sixth anniversary, Americans still don’t view the President’s legacy favorably.

According to a new national and state-based poll by National Public Radio (NPR) and healthcare research organization Robert Wood Johnson Foundation, 65 percent of Americans say the Affordable Care Act has harmed or had no direct impact on people in their state. On a personal level, only 15 percent of individuals say ObamaCare has actually helped them while 25 percent say it hurts them directly. More than half says it has had no impact on them.

The poll asked respondents a number of questions about healthcare in the U.S., including perceptions of healthcare in their states, healthcare costs, healthcare access, emergency room experiences, and the value for their money.

Access to healthcare continues to be a pain-point for one in seven (15 percent) of adults who said they could not get healthcare at least once in the past two years. Being unaffordable was the leading reason (58 percent), followed by not being able to find a doctors who would take their health insurance (35 percent).

Affordability remains a top complaint. More than half (52 percent) of adults say health care costs are a major problem in the state where they live and virtually the same (53 percent) number of Americans say the cost of health care where they lived has increased in the past two years – far outstripping those who believe health care costs have decreased or stayed the same. For a quarter of Americans, the cost of healthcare has been a serious strain on their finances over the past two years.

The survey concluded with a section that addressed the question “What do adults in the U.S. think of national health reform?”:

Americans have mixed feelings on the state- and personal-level effects of the Affordable Care Act. The proportion of U.S. adults who believe the law helped people in the state where they live approximately equals the proportion of people who believe national health reform hurt their fellow state residents. On a personal level, most Americans do not believe the law directly affected them. Among those who do, however, more believe the law directly hurt them than helped them.

So much for President Obama’s legacy health reform. Six years later, the diagnosis is not good.