Gallup Poll: Americans Still Split on Government’s Health Care Role

Slightly more than half say health care coverage is Washington’s responsibility

Slightly more Americans agree (52%) than disagree (45%) that the federal government is responsible for making sure that all Americans have health care coverage, according to a new Gallup survey. This balance of views is similar to last year but represents a shift from 2012 to 2014, when majorities said ensuring health care coverage for all was not the government’s job.

Compared with today, Americans were more widely inclined to say that ensuring health care coverage is a federal responsibility between 2000 and 2008, with majorities of 54% to 69% saying this. But as the Patient Protection and Affordable Care Act (PPACA) was debated and implemented, the issue became politicized, leading to a nearly even division on the question from 2009 to 2011, according to Gallup.

By 2012, sentiment against health care being a government responsibility rose to 54%, and it remained the majority view through 2014. But last year’s poll found Americans shifting more toward the view that the government should ensure that all have health care, and this holds today.

When asked whether they would prefer a government-run health care system or a system based on private insurance, majorities of Americans have consistently said they prefer a private system. However, this year's 10-percentage-point gap in favor of a private system (53%) compared with a government system (43%) is the narrowest in Gallup’s trend.

When Americans’ views on both questions were assessed, they largely fell into two similarly sized camps. One group, capturing 39% of the public, consisted of those who said that ensuring health care for all is not the government’s responsibility and preferred a system based on private insurance. The other group (35%) consisted of Americans who said it is the government’s responsibility to provide health care and preferred a government-run health care system. A much smaller 14% believed that it is the government’s responsibility to make sure that everyone has health care, but wanted the system to be based on private insurance.

Nearly three-quarters of Republicans (72%) fell into the “free enterprise” group, saying that it is not the government’s responsibility and preferring a system based on private insurance. Meanwhile, a majority of Democrats (56%) fell into the “pro-government” group, contending that it is the government’s responsibility to provide health care and preferring a government-run system. Roughly equal percentages of Democrats believed it is the government’s responsibility to ensure insurance coverage but preferred a private system (16%) or take the “free enterprise” view (14%).

Independents were evenly split between the two major groups, with 36% falling into each.

President-elect Donald Trump has promised to repeal and replace the PPACA, but has said he would like to keep certain elements of the current system, such as requiring insurers to cover adults with pre-existing conditions and allowing parents’ insurance to cover their children until they are 26 years of age.

While the details of what could replace the PPACA are still unknown, slight majorities of Americans favor government ensuring health care coverage and, separately, a system based on private insurance—both of which are major elements of the act as it currently stands. This could complicate the president-elect’s efforts to undo the PPACA while appealing to the interests of the Americans who recently elected him, Gallup noted.

Results for the poll were based on telephone interviews conducted on November 9–13, 2016, with a random sample of 1,019 adults (18 years of age and older) in all 50 states and the District of Columbia.

Source: Gallup; December 8, 2016.