Majority in U.S. Still Say Gov't Should Ensure Healthcare (2024)

WASHINGTON, D.C. -- A 57% majority of U.S. adults believe that the federal government should ensure all Americans have healthcare coverage. Yet nearly as many, 53%, prefer that the U.S. healthcare system be based on private insurance rather than run by the government. These findings are in line with recent attitudes about the government’s involvement in the healthcare system, which have been relatively steady since 2015.

Majority in U.S. Say Healthcare Is Government Responsibility

In 2000, Gallup began tracking the public’s views of whether it is the federal government’s responsibility to ensure all Americans have healthcare coverage and has found considerable fluctuation. From 2000 through 2008, majorities ranging from 54% to 69% believed the federal government should ensure universal coverage in the U.S.

In 2009, then-President Barack Obama’s administration worked with Congress to pass the Affordable Care Act (ACA), which expanded access to private health insurance via new government mandates and subsidies. The bill was ultimately signed into law in March 2010, and until 2012, the public was divided in their attitudes about the government’s obligation for healthcare coverage in the U.S. From 2012 through 2014, clear majorities said this was not the government’s responsibility.

In 2015, the tide again turned, and a slim majority felt healthcare coverage was a government obligation. Since then, between 51% and 57% of Americans have held this view. The latest findings, from Gallup’s annual Health and Healthcare poll conducted Nov. 9-Dec. 2, 2022, show 57% think the government should be responsible to ensure coverage for all Americans, while 40% say it should not.

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Partisans’ views of the federal government’s responsibility in ensuring healthcare for all Americans diverge sharply, as they have over the past two decades. Currently, 88% of Democrats and 59% of independents but just 28% of Republicans think the government is responsible.

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While an average 79% of Democrats since 2001 have asserted the government’s obligation to ensure healthcare for all in the U.S., an average 71% of Republicans over the same period have said the opposite. A 56% average of independents have said it is a governmental obligation.

Preference for Private Healthcare System Over Government-Run Persists

At the same time that Americans see a government role in ensuring universal U.S. healthcare coverage, they prefer that the nation’s healthcare system be based on private insurance rather than run by the government. Currently, 53% of U.S. adults prefer a private system, while 43% support a government-run system. Since 2010, when the measure was first tracked, the public has consistently favored private insurance, with just one exception: In 2017, U.S. adults were evenly divided in their preferences.

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Partisans’ preferences for the U.S. healthcare system differ sharply, with 72% of Democrats in favor of a government-run system and 83% of Republicans a private system. Independents tilt slightly toward a private (50%) rather than a government-run (46%) system.

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Over the past 13 years, the percentage of Republicans preferring private insurance has not fallen below 79%; it peaked at 91% in 2010, the year the ACA became law. At the same time, between 52% (in 2013) and 77% (in 2021) of Democrats have favored a government-run system.

Majorities of independents backed a private system from 2010 through 2015, but they have been more divided since then, reaching a consensus only once -- in 2021, when 55% favored private insurance.

Bottom Line

Americans continue to hold a nuanced view of the U.S. healthcare system, with a majority saying the government should ensure that all Americans have coverage but preferring that the system be funded privately. Partisans have fundamentally differing views on how healthcare should be delivered in the U.S., with Democrats indicating support for a system where the government not only guarantees coverage but provides healthcare, while Republicans remain wedded to the current system of private coverage and healthcare.

Notably, Democrats are more unified in their belief that government is responsible for ensuring all Americans have healthcare than in wanting a true public health system. Conversely, Republicans are more unified against such medical care than they are against the idea that it is government’s job to make sure no American goes without healthcare.

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