Amid ongoing political gridlock over the future structure and funding of American healthcare, a new survey from the Pew Research Center reveals that most Americans (66%) say the federal government has a responsibility to make sure all citizens have health coverage. Only 33% of U.S. adults surveyed say the government does not have this responsibility.
The overall view that the government must ensure coverage remains relatively stable since last year but is modestly higher than the 62% reported in 2021, a trend primarily reflecting a shift in Republican perspectives. The analysis surveyed 10,357 U.S. adults between November 17-30 of this year.
While a majority supports government responsibility, Americans are split over the preferred method for delivering coverage.
Among all adults:
35% favor a single national health insurance system run entirely by the government.
31% prefer that insurance continue to be provided through a mix of private companies and government programs.
For the one-third of Americans who believe the federal government is not responsible for universal coverage, most still support existing government intervention. Specifically, 26% of all adults say the government should continue to cover seniors and the very poor through Medicare and Medicaid. Just 7% of adults say the federal government should have no involvement in providing health insurance at all.
The mandate for universal coverage remains highly polarized along party lines. A decisive 90% of Democrats and Democratic leaners say the government has a responsibility to ensure coverage. Among Democrats, 52% favor a single national insurance program, and 37% prefer a mix of government and private programs.
Conversely, 59% of Republicans and Republican-leaning independents say the federal government is not responsible for ensuring health coverage for all, although 41% of Republicans do say it is responsible. Notably, the share of Republicans who believe the government has this duty is 9 percentage points higher than in 2021.
The survey highlighted significant variation across demographic groups, particularly related to income within the Republican base.
60% of Republicans in lower-income households say ensuring health coverage is the federal government’s responsibility. This is a sharp contrast to middle-income Republicans (36%) and upper-income Republicans (28%) who hold this view.
Overwhelming majorities of Democrats across all income levels (ranging from 89% to 92%) believe the federal government is responsible.
Views also varied significantly by race and ethnicity, with non-White groups showing stronger support for government responsibility: 85% of Black adults, 78% of Asian adults, and 75% of Hispanic adults agree the government is responsible, compared to 59% of White adults. Younger Americans (ages 18-29) are most likely to say the government has this responsibility (74%).