- Two-thirds of US adults support Medicare for all, up from 53% in 2020, with backing reaching 84% among Democrats and 72% among independents.
- Support for a single-payer healthcare system falls to 52% when respondents are told it would eliminate private insurance, compared with 37% in 2020.
- Healthcare costs are Americans’ leading economic concern, with 60% worried about affordability as the uninsured population is projected to reach 30 mn.
Nearly two-thirds of American adults support government-funded universal health insurance, according to a new KFF poll, as healthcare affordability and proposals for major reforms gain attention ahead of the November 3 US midterm elections that will determine control of Congress.
The survey found that support for a universal insurance system commonly described as “Medicare for all” has increased from 53% in 2020 to approximately two-thirds of adults.
Political divisions remain substantial. Among Democrats, 84% favor the proposal, compared with 72% of independent voters. Republicans are predominantly opposed, with 66% rejecting the idea.
Public attitudes become more divided when respondents are presented with specific consequences of a single-payer system. Support declines to 52% when participants are told that universal government insurance would eliminate private health plans. Even at that level, approval remains considerably higher than the 37% recorded in the comparable 2020 survey.
Medicare currently provides government-funded health coverage to approximately 70 mn Americans aged 65 and older or living with disabilities.
Lawmakers including Bernie Sanders, the independent US senator from Vermont, have advocated expanding the program to cover the wider population, replacing a system in which health insurance is heavily tied to employment. Single-payer arrangements are used in many developed countries.
KFF also identified bipartisan support for a fundamental redesign of the US healthcare system, reflecting concerns about affordability amid broader economic uncertainty.
Healthcare expenses ranked as the leading economic concern among respondents. Some 60% said they were very or somewhat worried about paying for healthcare, exceeding concerns about gasoline prices at 59% and grocery costs at 52%.
The September survey covered 1,328 US adults, most of whom were registered voters.
Healthcare reform has also become an issue in competitive congressional races. Several progressive candidates in states that could influence the balance of power in Congress have endorsed government-run health insurance.
Abdul El-Sayed, the Democratic Senate candidate in Michigan, has argued that such a system would reduce costs while extending insurance coverage.
KFF reported that voters increasingly want congressional candidates to address access to health insurance ahead of the November 3 elections.
The debate comes as the number of uninsured Americans is expected to increase. Congressional Budget Office estimates indicate that approximately 30 mn people out of a US population of 340 mn will lack health insurance this year, compared with 26.6 mn in 2025.
The projected increase coincides with reductions in federal funding for Affordable Care Act insurance plans and Medicaid, the government healthcare program serving low-income Americans.
Private health insurers, including CVS Health, UnitedHealth and Humana, currently administer employer-sponsored coverage alongside Medicare and Medicaid insurance plans.
A shift toward a single-payer system would therefore affect both private insurance arrangements and publicly funded programs administered by commercial insurers.
The KFF findings indicate that support for Medicare for all depends considerably on how potential costs and benefits are presented.
Kearney said approval declines when respondents are told that a government-run system could result in longer waits for diagnostic tests and treatment, higher taxes or damage to the existing Medicare program, consequences cited by opponents of the proposal.
Support increases when respondents are told that universal coverage would establish health insurance as a right and could eliminate premiums and out-of-pocket cost-sharing.
