The Washington PostDemocracy Dies in Darkness

About half of Americans support single-payer health care

Analysis by
Survey analyst
April 12, 2018 at 7:00 a.m. EDT
Protesters rally outside the office of California Assembly Speaker Anthony Rendon in South Gate, Calif., in June as the U.S. Senate prepared to vote on the GOP health-care bill. (Robyn Beck/AFP/Getty Images)

As President Trump’s administration tries to chip away at the Affordable Care Act by giving more authority to states to regulate private insurance, a new poll finds a slight majority of Americans support a move in the opposite direction, with everyone getting health insurance from a national government-run program.

A Washington Post-Kaiser Family Foundation poll finds a 51 percent majority of Americans support a national health plan, also known as a single-payer plan, while 43 percent oppose it.

Nearly three-quarters of Democrats support a single-payer health plan (74 percent), while a slightly larger share of Republicans oppose it (80 percent). Independents break the tie, supporting a government-run health-care plan by 54 percent to 40 percent.

Support is relatively high among rallygoers, defined as those who have attended a rally or a protest within the past two years. A 61 percent majority of this Democratic-leaning group supports a single national health plan. Just under half of non-rallygoers, 49 percent, feel the same way.

Those who attended a protest or rally to express their views on the Affordable Care Act in the past two years favor a national health plan by a more than 4-to-1 margin, 79 percent to 18 percent. This group is also overwhelmingly defensive of the ACA, with 85 percent saying they came out to express support for the law.

Democratic lawmakers have been united in fighting Republican efforts to repeal the ACA but have been more mixed in their support for providing “Medicare for all,” as former presidential candidate Bernie Sanders (I-Vt.) has called for.

While such legislation is a non-starter with Republicans in control of the White House and both chambers of Congress, the poll suggests that Americans are at least open to having a single national plan for health insurance. Other recent polling has also found a slim majority who support a single-payer health plan. The Kaiser Family Foundation in the summer found 53 percent who support such a plan, roughly similar to the year before but more than the share who supported a national health plan in the late 1990s and early 2000s.

As with any policy that has not been intensely debated, it’s possible that attitudes could shift if Democrats were in a position to enact it. A Kaiser Family Foundation poll in the fall gauged whether arguments against a single-payer plan would lead supporters to abandon it. Opposition grew to 61 percent when supporters were told it would “give government too much control over health care.”

The apparently potent messages echo criticisms of the ACA and suggest that Democrats will have to assuage public concerns about costs and government involvement in health care if they are to push for a single-payer policy.

The Post-Kaiser poll was conducted Jan. 24 to Feb. 22, 2018, among a random sample of 1,850 adults with a margin of error of three percentage points.

Scott Clement contributed to this report.