Majority in US still says government should ensure healthcare

story highlights

  • 57% say the government should ensure health coverage for everyone in the US
  • 53% in favor of a health system based on private insurance; 43% run by a government
  • 72% of Democrats, 13% of Republicans support a government-run system

WASHINGTON, DC – 57% of US adults believe the federal government should ensure that all Americans have healthcare coverage. Yet around 53%, prefer the US healthcare system to be based on private insurance rather than run by the government. These findings are in line with recent attitudes about government involvement in the healthcare system, which has been relatively stable since 2015.

Majority in US says healthcare is the responsibility of the government

In 2000, Gallup began tracking public views on whether it is the responsibility of the federal government to ensure that all Americans have healthcare coverage and found considerable volatility. From 2000 to 2008, a majority ranging from 54% to 69% believed that the federal government should ensure universal coverage in the US.

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 through new government mandates and subsidies. The bill was eventually signed into law in March 2010 and, as of 2012, the public was divided in their view of the government’s obligation for healthcare coverage in the U.S. From 2012 to 2014, a clear majority said it was the government’s responsibility. There was no responsibility.

In 2015, the tide turned again, and a slim majority felt that health care was a government obligation. Since then, 51% to 57% of Americans hold this view. The latest findings from Gallup’s annual Health and Fitness Survey, conducted Nov. 9-Dec. 2, 2022, show that 57% think the government should be responsible for ensuring coverage for all Americans, while 40% say it should not.


The parties’ views of the federal government’s responsibility to ensure healthcare for all Americans differ sharply, as have over the past two decades. Currently, 88% of Democrats and 59% of independents but only 28% of Republicans think the government is responsible.


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

Preference persists for government-run private healthcare system

At the same time that Americans see a government role in ensuring universal US healthcare coverage, they prefer that the country’s healthcare system be based on private insurance rather than run by the government. Currently, 53% of American 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, American adults were evenly split in their preferences.


The parties’ preferences for the US healthcare system differ sharply, with 72% of Democrats favoring a government-run system and 83% of Republicans favoring a private system. Independents lean slightly towards a private (50%) rather than government-run (46%) system.


Over the past 13 years, the percentage of Republicans who prefer private insurance has not dropped below 79%; This peaked at 91% in 2010, the year the ACA became law. Whereas, between 52% (in 2013) and 77% (in 2021) of Democrats support a government-run system.

A majority of independents supported a private system from 2010 to 2015, but they have become more divided since then, reaching consensus only once – in 2021, when 55% supported private insurance.

ground level

Americans continue to hold a nuanced view of the US healthcare system, with a majority saying that the government should ensure that all Americans have coverage, but preferring that the system be privately funded. Let’s do. The partisans have radically different views on how healthcare should be provided in the US, with Democrats indicating support for a system where the government not only guarantees coverage but provides healthcare, while Republicans stick 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 access to healthcare than in wanting a true public health system. In contrast, Republicans are more united against this kind of medical care than they are against the idea that it is the government’s job to make sure no American goes without healthcare.

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