---
title: "More Americans say government should ensure health care coverage"
description: "As the debate continues over repeal of the Affordable Care Act and what might replace it, a growing share of Americans believe that the federal government has a responsibility to make sure all Americans have health care coverage."
date: "2017-01-13"
authors:
  - name: "Kristen Bialik"
    job_title: "Former Research Assistant"
    link: "https://www.pewresearch.org/staff/kristen-bialik/"
url: "https://www.pewresearch.org/short-reads/2017/01/13/more-americans-say-government-should-ensure-health-care-coverage/"
categories:
  - "Economic Policy"
  - "Federal Government"
  - "Government Spending & the Deficit"
  - "Government Spending & the Deficit"
  - "Health Care"
  - "Political Issues"
  - "Social Security & Medicare"
---

# More Americans say government should ensure health care coverage

As the debate continues over [repeal of the Affordable Care Act](https://www.washingtonpost.com/politics/whitehouse/gop-hesitancy-grows-on-health-law-repeal-without-substitute/2017/01/09/ffc6698e-d6d7-11e6-a0e6-d502d6751bc8_story.html?utm_term=.8880665828a8) and what might replace it, a growing share of Americans believe that the federal government has a responsibility to make sure all Americans have health care coverage, according to a new [Pew Research Center survey](https://www.pewresearch.org/politics/2017/01/10/negative-views-of-trumps-transition-amid-concerns-about-conflicts-tax-returns/).

[![](https://www.pewresearch.org/wp-content/uploads/sites/20/2017/01/FT_17.01.13_healthCoverage_responsibility.png)](https://www.pewresearch.org/short-reads/2017/01/13/more-americans-say-government-should-ensure-health-care-coverage/ft_17-01-13_healthcoverage_responsibility/)

Currently, 60% of Americans say the government should be responsible for ensuring health care coverage for all Americans, compared with 38% who say this should not be the government’s responsibility. The share saying it is the government’s responsibility has increased from 51% last year and now stands at its highest point in nearly a decade.

Just as there are wide differences between Republicans and Democrats about [the 2010 health care law](https://www.pewresearch.org/short-reads/2016/10/27/health-care-law-partisan-divide/), the survey also finds partisan differences in views on whether it’s the government’s responsibility to make sure all Americans have health care coverage. More than eight-in-ten Democrats and Democratic-leaning independents (85%) say the federal government should be responsible for health care coverage, compared with just 32% of Republicans and Republican leaners.

The survey also finds continued differences on this question by race and ethnicity as well as income. A large majority of blacks and Hispanics (85% and 84%, respectively) say the government should be responsible for coverage, while non-Hispanic whites are split on the issue (49% agree, 49% disagree). And while about three-quarters of those with family incomes of less than $30,000 per year (74%) say the government should ensure coverage, only about half (53%) of those with incomes of $75,000 or higher say the same.

[![](https://www.pewresearch.org/wp-content/uploads/sites/20/2017/01/FT_17.01.13_healthCoverage_govtRole.png)](https://www.pewresearch.org/short-reads/2017/01/13/more-americans-say-government-should-ensure-health-care-coverage/ft_17-01-13_healthcoverage_govtrole/)

The belief that the government has a responsibility to ensure health coverage has increased across many groups over the past year, but the rise has been particularly striking among lower- and middle-income Republicans.

Currently, 52% of Republicans with family incomes below $30,000 say the federal government has a responsibility to ensure health coverage for all, up from just 31% last year. There also has been a 20-percentage-point increase among Republicans with incomes of $30,000-$74,999 (34% now, 14% last year). But there has been no significant change among those with incomes of $75,000 or more (18% now, 16% then).

Those who think government should ensure health coverage for all are divided on a follow-up question about whether health insurance should be provided through a mix of private insurance companies and the government (29% of the overall public), or if the government alone should provide insurance (28% of the public).

[![](https://www.pewresearch.org/wp-content/uploads/sites/20/2017/01/FT_17.01.13_healthcare.png)](https://www.pewresearch.org/short-reads/2017/01/13/more-americans-say-government-should-ensure-health-care-coverage/ft_17-01-13_healthcare/)

Overall, 43% of Democrats and Democratic leaners support a so-called single payer approach, but this approach is more popular among liberal Democrats (51%) than among conservative and moderate Democrats (38%).

Most of those on the other side of the issue – people who say the government does *not *have a responsibility to ensure health coverage – say on a subsequent question that the government should continue Medicare and Medicaid (32% of the overall public), while just 5% of the public says the government should have no role in health care.

Among Republicans and Republican leaners, most of whom (67%) say the government does not have a responsibility for ensuring health coverage, there is very little support for the government not being involved in health care at all. Just 10% of Republicans favor no government involvement, while 56% say it should continue Medicare and Medicaid.

While Republicans in Congress have already [taken the first steps](https://www.washingtonpost.com/business/republican-led-senate-to-move-forward-on-obamacare-repeal/2017/01/11/6370597e-d87a-11e6-a0e6-d502d6751bc8_story.html?utm_term=.da0eca2dcf10) toward repealing the ACA, Americans remain largely divided on what Congress should do with the health care law. Overall, in a Pew Research Center survey in December, 39% said it [should be repealed](https://www.pewresearch.org/short-reads/2016/12/08/partisans-on-affordable-care-act-provisions/), while an equal share (39%) said the law should be expanded. Just 15% of Americans said the law should be left as is. Although the public is divided on the future of the law, there is bipartisan [support for a number of ACA provisions](https://www.pewresearch.org/short-reads/2016/12/08/partisans-on-affordable-care-act-provisions/). Regardless of their personal views of the law, a small majority (53%) expects its major provisions [will likely be eliminated](https://www.pewresearch.org/politics/2016/12/08/low-approval-of-trumps-transition-but-outlook-for-his-presidency-improves/).

A [December Kaiser Family Foundation survey](http://kff.org/health-costs/poll-finding/kaiser-health-tracking-poll-health-care-priorities-for-2017/) shows repealing the law is not the public’s top health care priority for President-elect Donald Trump and the next Congress. Lowering the amount individuals pay for health care tops the list, with 67% of Americans saying it should be a top priority for the next administration. This is followed by lowering the cost of prescription drugs (61%) and dealing with the prescription-painkiller addiction epidemic (45%). Only 37% of the public says repealing the law should be the administration’s top priority, though views differ widely by party.

*Note: Survey topline is available [here (PDF)](https://www.pewresearch.org/wp-content/uploads/2017/01/Healthcare_topline_for_release.pdf). Methodology can be found [here.](https://www.pewresearch.org/politics/2017/01/12/the-world-facing-trump-public-sees-isis-cyberattacks-north-korea-as-top-threats/2/#methodology)*

*Related posts:*

[*Public support for ‘single payer’ health coverage grows, driven by Democrats*](https://www.pewresearch.org/short-reads/2017/06/23/public-support-for-single-payer-health-coverage-grows-driven-by-democrats/)

*[Most patients in U.S. have high praise for their health care providers](https://www.pewresearch.org/short-reads/2017/08/02/most-patients-in-u-s-have-high-praise-for-their-health-care-providers/)*