A clear majority of Americans say the federal government should make sure everyone has health insurance coverage, according to a new Pew Research Center survey.
About 66% of U.S. adults say ensuring health care coverage for all is the government’s responsibility. Just 33% say it is not, based on a survey conducted Nov. 17–30 among more than 10,000 adults.
No consensus on how to do it
While most Americans agree the government has a role, they split on how that role should look.
Thirty-five percent of all adults favor a single national health insurance system run by the government. Another 31% say coverage should continue through a mix of private insurance and government programs.
Among those who say the federal government should not be responsible for universal coverage, most still support a limited role. About 26% say the government should continue covering seniors and very low-income Americans through Medicare and Medicaid. Only 7% say the federal government should not be involved in health insurance at all.
Views steady, but higher than in 2021
Pew researchers say these opinions have stayed mostly stable over the past year. Still, support for a government responsibility remains modestly higher than it was a few years ago, when 62% held that view in 2021.
That increase largely reflects changes among Republicans.
Partisan divide remains wide
The survey shows a sharp split along party lines.
Most Republicans and Republican-leaning independents, 59%, say the federal government is not responsible for making sure all Americans have health coverage. Still, 41% now say it is, up nine points since 2021.
Democrats and Democratic leaners overwhelmingly take the opposite view. About 90% say the government has a responsibility to ensure coverage. That includes 52% who favor a single national insurance program and 37% who prefer the current mix of private and public coverage.
Income shapes Republican views
Income plays a major role among Republicans.
Six-in-ten lower-income Republicans say ensuring health coverage for all is the government’s responsibility. Far fewer middle-income Republicans, 36%, and upper-income Republicans, 28%, agree.
Among Democrats, large majorities across all income levels say the government is responsible. Differences emerge mainly over how coverage should be provided, with middle- and upper-income Democrats more likely than lower-income Democrats to support a single national program.
Differences across age and race
Support for a government role also varies by race, age, and education, though majorities across most groups say the federal government has a responsibility to ensure health coverage.
Pew notes that the findings update similar research first published in 2020 and reflect a public that remains divided on solutions, even as agreement grows on the basic responsibility.
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