Public support for ‘single payer’ health coverage grows, driven by Democrats
A majority of Americans say it is the federal government’s responsibility to make sure all Americans have health care coverage. And a growing share now supports a “single payer” approach to health insurance, according to a new national survey by Pew Research Center.
Currently, 60% say the federal government is responsible for ensuring health care coverage for all Americans, while 39% say this is not the government’s responsibility. These views are unchanged from January, but the share saying health coverage is a government responsibility remains at its highest level in nearly a decade.
Among those who see a government responsibility to provide health coverage for all, more now say it should be provided through a single health insurance system run by the government, rather than through a mix of private companies and government programs. Overall, 33% of the public now favors such a “single payer” approach to health insurance, up 5 percentage points since January and 12 points since 2014. Democrats – especially liberal Democrats – are much more supportive of this approach than they were even at the start of this year.
Even among those who say the federal government is not responsible for ensuring Americans have health care coverage, there is little public appetite for government withdrawing entirely from involvement in health care coverage. Among the public, 33% say that health care coverage is not the government’s responsibility, but that programs like Medicare and Medicaid should be continued; just 5% of Americans say the government should not be involved at all in providing health insurance.
The issue of the government’s responsibility in ensuring health coverage remains deeply divisive politically, according to the new survey, conducted June 8-18 among 2,504 adults. More than eight-in-ten Democrats and Democratic-leaning independents (85%) say that this responsibility falls to the federal government, while about two-thirds of Republicans and Republican leaners (68%) say it does not.
Still, most Republicans (57%) say the government “should continue programs like Medicare and Medicaid for seniors and the very poor.” Just 9% of Republicans say the government should not be involved in providing health insurance at all.
Among Democrats, 52% now say health insurance should be provided through a single national insurance system run by the government, while fewer (31%) say it should be provided through a mix of private companies and government programs. The share of Democrats supporting a single national program to provide health insurance has increased 9 percentage points since January and 19 points since 2014.
Nearly two-thirds of liberal Democrats (64%) now support a single-payer health insurance system, up 13 percentage points since January. Conservative and moderate Democrats remain about evenly divided: 38% prefer that health insurance continue to be provided by a mix of private insurance companies and government programs, while 42% favor a single-payer approach.
Overall, support for a single-payer health insurance system is much greater among younger adults than older people. Two-thirds of adults younger than 30 (67%) say the government has a responsibility to provide health coverage for all, with 45% saying coverage should be provided through a single national program.
Among those 65 and older, 54% say the government has a responsibility to provide coverage for all, with 30% favoring a single payer approach.
Both parties are divided by age in views of the government’s role in health care. Fully 66% of Democrats and Democratic leaners ages 18 to 29 say government health coverage should be provided through a single national system, compared with 48% of Democrats and Democratic leaners ages 30 and older.
Among Republicans, a greater share of those younger than 30 (39%) than those 30 and older (28%) say the government is responsible for providing health coverage for all; more young Republicans than older Republicans favor single payer (22% vs. 10%).
While the new survey finds no change since January in opinions about the government’s responsibility to provide health care coverage, the share viewing this as a government responsibility has increased 9 percentage points since 2016, from 51% to 60%.
As recently as 2013, during the flawed rollout of health insurance exchanges under the Affordable Care Act, just 42% said the government was responsible for providing health coverage, while a majority (56%) said it did not have this responsibility.
Jocelyn Kiley is an associate director of research at Pew Research Center.