October 3, 2018

Most continue to say ensuring health care coverage is government’s responsibility

Six-in-ten Americans say it is the federal government’s responsibility to make sure all Americans have health care coverage, including 31% who support a “single payer” approach to health insurance, according to a new national survey by Pew Research Center.

Majority continues to say ensuring health care coverage is a government responsibilityThese views are little changed from last year, but the share saying health care coverage is a government responsibility remains significantly higher than it was from 2008 through 2016 (51% said this in 2016, compared with 60% today).

Among those who see a government responsibility to provide health coverage for all, more 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 (31% vs. 25%).

Even among the 37% who say the federal government is not responsible for ensuring Americans have health care coverage, there is little appetite for government withdrawing entirely from involvement in health care. Most within this group (31% of the public overall) say that health care coverage is not the government’s responsibility, but that programs like Medicare and Medicaid should be continued; just 4% of Americans say the government should not be involved in providing health insurance at all.

The issue of the government’s responsibility in ensuring health coverage remains politically divisive. More than eight-in-ten Democrats and Democratic-leaning independents (85%) say this responsibility falls to the federal government, while about two-thirds of Republicans and Republican leaners (68%) say it does not.

Still, a majority of Republicans (55%) say the government “should continue programs like Medicare and Medicaid for seniors and the very poor.” Just 10% of Republicans say the government should not be involved in providing health insurance at all.

About half of Democrats (49%) 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.

Democrats, Republicans disagree over federal government's responsibility to ensure health care coverage for AmericansThe share of Democrats supporting a single national program to provide health insurance is little changed since June of last year, but 6 percentage points higher than in January 2017 and 16 points higher than in 2014.

There remain sizable ideological divides in these views within both partisan coalitions. Among Republicans, just 21% of conservatives say it is the federal government’s responsibility to make sure all Americans have health care coverage. Moderate and liberal Republicans are more divided in their views (46% say it is the federal government’s responsibility, 52% say it is not).

Among Democrats, support for a single national government program is 19 percentage points higher among liberals (59%) than conservatives and moderates (40%). Still, wide majorities in both groups say ensuring all Americans have health care coverage is the government’s responsibility (91% among liberal Democrats, 80% among conservative and moderate Democrats).

Note: See full topline results (PDF) and methodology here. This is an update of a post originally published June 23, 2017. 

Topics: Political Party Affiliation, Federal Government, Health Care, U.S. Political Parties, Political Issue Priorities

  1. Photo of Jocelyn Kiley

    is an associate director of research at Pew Research Center.