Public Opinion on Single-Payer, National Health Plans, and Expanding Access to Medicare Coverage

Kaiser Family Foundation

For many years, Kaiser Family Foundation has been tracking public opinion on the idea of national health plan. Since the 2016 presidential primary and Bernie Sanders’ rallying cry for “Medicare-for-all,” our polls have shown a modest increase in support for the idea of a national health plan (Figure 1), and broad support for proposals that expand Medicare (Figure 2). Overall, about six in ten adults favor a national health plan or Medicare-for-all plan (Figure 3). There is robust support among Democrats, and even somewhat among Republicans, for expansions of the Medicare program through a Medicare buy-in (Figure 6) or an “optional” Medicare-for-all proposal (Figure 7). Yet, it is unclear how much staying power this support has once people become aware of the details of any plan. Public support quickly erodes when people hear further explanation about potential tax increases or increased government control (Figure 8) and recent polling also shows many people falsely assume they would be able to keep their current health insurance under a single-payer plan (Figure 10), suggesting another potential area for decreased support.

While health care appears to be playing a role in the 2018 midterm campaigns (Figure 11) and single-payer has been a hot-button issue in some Democratic primaries, it is unclear that it will play a major role in the general election, with few voters saying a candidate’s position on a national health plan is an important factor in their vote (Figure 12). So while the general idea of a national health plan (whether accomplished through an expansion of Medicare or some other way) may enjoy fairly broad support in the abstract and it can be used as a rallying cry to motivate the liberal base of the Democratic party, it is unlikely to be a determining issue for most 2018 midterm voters.

12 Power Point slides which can be downloaded:…

Kaiser Family Foundation has summarized in twelve Power Point slides the public opinion on single payer, national health plans, and expanding access to Medicare coverage. Over the last two decades support for “a national health plan in which all Americans would get their insurance from a single government plan” has gradually grown from 40 percent to 53 percent.

Support increases when those initially opposed are told that such a plan would “reduce health insurance administrative costs,” “ensure that all Americans have health insurance as a basic right,” or “reduce the role of all private health insurance companies in health care.”

Support diminishes when those initially in support are told that such a plan would “give the government too much control over health care,” “require many Americans to pay more in taxes,” or “eliminate or replace the Affordable Care Act.”

However the polling suggests that there is considerable support for more incremental approaches. When asked, “Do you favor or oppose letting some people under the age of 65 buy insurance through the Medicare program?”, 63 percent are in favor and 33 percent are opposed. When asked if they would favor “A national Medicare-for-all plan open to anyone who wants it but people whom currently have other coverage could keep what they have,” support is 75 percent as opposed to 59 percent who favor “A national health plan, or Medicare-for-all, in which all Americans would get their insurance from a single government plan.”

Thus it seems that support for a multi-payer system that expands the role of Medicare is greater than support for a single payer version of Medicare for all. This, of course, plays into the hands of those who support expanding the use of private Medicare Advantage plans – a concept that currently is being sold under the false label of “Medicare for All.”

A Medicare Advantage option for all has almost nothing in common with a bona fide single payer improved Medicare for all. The former perpetuates all of the injustices, waste, and excess costs of our current fragmented, dysfunctional method of financing health care, whereas the latter finally brings to us an efficient, effective, equitable method of removing financial barriers to care for absolutely everyone with a system that each of us could afford.

It is going to be very difficult to get this crucial message across when “let those who want to buy into Medicare do it” becomes the reflex response. The polling suggests that it may already be a meme.

Stay informed! Visit to sign up for daily email updates.