What Do Americans Think About Medicare for All? It Depends on What They Hear

January 25, 2019

What do Americans think about Medicare for All or other ways to allow people to have health insurance if coverage does not come through work? This week, the Kaiser Family Foundation released results of a poll about the issue, while a coalition of healthcare industry players released a digital ad arguing against a single-payer option.

What do Americans think about Medicare for All or other ways to allow people to have health insurance if coverage does not come through work?

This week, the Kaiser Family Foundation released results from its monthly tracking poll, which examined opinions about 4 approaches. Answers depended not only on the option at hand, but also on the language that was used to describe the possible coverage.

The poll asked about attitudes after hearing arguments for and against a national plan. With Democrats in control of the House of Representatives, where more members of the liberal wing are forcing possible 2020 presidential candidates to weigh in on such an idea, the healthcare debate that was so prominent in the 2018 elections will only get bigger next year, even though Republicans retain control of the Senate.

Adding to that debate Thursday is a new video ad from a coalition of major industry players arguing against Medicare for All, saying instead that although the healthcare system needs improvement, it would be better to strengthen the current employer-based system and existing public programs.

In the Kaiser poll, 77%, including most Republicans (69%), favor allowing people between the ages of 50 and 64 to buy health insurance through Medicare.

Similar results—75% overall and 64% of Republicans—favor allowing people who aren’t covered by their employer to buy insurance through their state’s Medicaid program.

Similar overall results were seen when respondents were presented with an idea that made a national government plan (like Medicare) open to anyone, but also had the option of retaining current coverage. That appealed to 74% overall, but the number of Republicans in favor dropped to 47%.

When pollsters asked about a Medicare for All proposal in which all Americans would get their insurance through a single government plan with no option to keep a current plan, 56% overall were in favor but only 23% of Republicans.

Kaiser said their poll shows how the public’s attitudes can shift significantly depending on which arguments people hear. Medicare for All starts with a net favorability rating of +14 percentage points (56% who favor it minus 42% who oppose it). This jumps to +45 percentage points when people hear the argument that this type of plan would guarantee health insurance as a right for all Americans.

But views turn negative and net favorability falls to —44 percentage points when people hear the argument that it would lead to delays for some seeking medical tests and treatments.

Healthcare Priorities for Congress

Favorable opinions about Medicare for All do not translate into making it Congress’ number one priority, however.

When asked to choose a top priority, Democrats rank ensuring the Affordable Care Act (ACA)’s protections for people with pre-existing conditions first (31%). Both Medicare for All and lowering prescription drug costs were tied at 20%.

Independents rank preserving the ACA’s pre-existing condition protections as their first priority (24%) and lowering prescription drug costs as second (20%).

Repealing and replacing the ACA ranks as a top priority for Republicans (27%), followed by lowering prescription drug costs (20%).

When Democrats were asked whether their party’s new House majority should focus on improving and protecting the ACA or passing a Medicare for All plan, half (51%) say the ACA and nearly 4 in 10 (38%) choose Medicare for All.

The poll also found that most of the public was unaware that a recent federal court ruling would invalidate the ACA if it is upheld. Only 44% were aware of the ruling, which said that because Congress eliminated the tax penalty for not having health insurance, the entire law cannot stand.

When the ruling is explained, more Americans disapprove (51%) than approve (41%) of the ruling, with a sharp partisan split mirroring the public’s overall views of the law.

Meanwhile, the Partnership for America’s Health Care Future—created by PhRMA, the American Medical Association, America’s Health Insurance Plans, BlueCross Blue Shield Association, and others—released a video that argues against Medicare for All.

“Whether it’s called Medicare for All, single-payer, or a public option, a one-size-fits-all healthcare system will mean all Americans have less choice and control over their doctors, treatments, and coverage. It will also mean trillions in higher taxes for hardworking families, lower quality of care, and longer wait times for patients,” the ad states.

While acknowledging rising costs, the ad, which will run on social media, says that America should focus on refining employer-based coverage and public programs so that they work for everyone.