Support for a single-payer health care system in the United States has increased modestly over time, according to surveys conducted by the Kaiser Family Foundation. While over half of Americans now favor such a system, Republicans have become less supportive over time. Proposals to expand existing public insurance programs like Medicare and Medicaid are more widely favored across party lines than a single-payer system. However, the level of support depends on how the policy is described and whether it is presented as "replacing" private insurance or not. There is also uncertainty about the potential costs and impacts of a single-payer system.

1. Modest Increase In Support For Single-Payer Health Care Over
Time
NOTE: Question wording has included “Medicare-for-all” since 2017.
SOURCE: KFF Polls. See toplines for full question wording and response options.
Figure 1
Percent who favor or oppose a national health plan in which all Americans would get their insurance from a
single government plan:
40% 39% 46% 50% 57% 55% 59% 56% 57% 56% 56% 51% 53%
53% 55%
49% 43%
38% 43% 38% 42% 37% 39% 38% 42% 45%
0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
1998-2000
(avg of 6
polls)
2002-2004
(avg of 2
polls)
2008-2009
(avg of 7
polls)
Feb 2016 June 2017 Sept 2017 Mar 2018 Jan 2019 Feb 2019 Mar 2019 Apr 2019 Jul 2019 Sept 2019
Favor Oppose

2. Support For Federally-Provided Health Insurance Has Decreased
Among Republicans Over Time
SOURCE: KFF Polls. See toplines for full question wording and response options.
Figure 2
Percent who say they favor the federal government doing more to help provide health insurance for more
Americans:
85%
96%
86%
72%
75%
92%
73%
49%
74%
94%
77%
40%
Total
Democrats
Independents
Republicans
November 2006 September 2008 January 2019

3. Broad Support For Proposals To Expand Public Health Insurance
Programs
SOURCE: KFF Health Tracking Polls. See toplines for full question wording and response options.
Figure 3
Percent who favor or oppose:
53%
69% 74% 75% 77%
45%
28% 24% 18% 18%
0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
Medicare-for-all Public option Optional Medicare-for-all Medicaid buy-in Medicare buy-in for ages
50-64
Favor Oppose

4. A Majority Of Republicans “Strongly Oppose” While A Majority Of
Democrats “Strongly Favor” National Health Plan
SOURCE: KFF Health Tracking Poll (September 3-8, 2019). See topline for full question wording and response options.
Figure 4
21%
26%
26%
8%
31%
51%
27%
11%
12%
11%
14%
10%
33%
10%
31%
69%
Total
Democrats
Independents
Republicans
Strongly favor Somewhat favor Somewhat oppose Strongly oppose
Do you favor or oppose having a national health plan, sometimes called Medicare-for-all, in which all Americans
would get their insurance from a single government plan?

5. 63%
63%
59%
49%
46%
31%
34%
36%
32%
44%
Universal health coverage
Medicare-for-all
National health plan
Single-payer health insurance system
Socialized medicine
Do you have a positive or negative reaction to each of the following terms?
SOURCE: KFF Health Tracking Poll (April 11-16, 2019). See topline for full question wording and response options.
Figure 5
Terminology Affects Public Opinion On A National Health Plan
No opinion
11%
6%
19%
3%
5%
Positive Negative

6. Percent who say they have a positive reaction to each of the following terms:
SOURCE: KFF Health Tracking Poll (April 11-16, 2019). See topline for full question wording and response options.
Figure 6
Language Matters When Describing A National Health Plan
63%
63%
59%
49%
46%
33%
39%
34%
39%
17%
62%
59%
57%
47%
45%
87%
83%
87%
64%
74%
0% 10% 20% 30% 40% 50% 60% 70% 80% 90%
Total Republicans Independents Democrats
Universal health
coverage
Medicare-for-all
National health plan
Single payer health insurance
system
Socialized
medicine

7. 34%
17%
Universal
coverage
Make health care
more affordable/
Costs too high
Favor
56%
DK/Ref.
5%
Oppose
39%
23%
14%
14%
Don’t want
government
involved
Too expensive to
implement
Limits
choice/competition
SOURCE: KFF Health Tracking Poll (March 13-18, 2019). See topline for full question wording and response options.
Figure 7
Reasons For Opinions On National Health Plan Echo Partisan
Messages
Do you favor or oppose
having a national health
plan, sometimes called
Medicare-for-all?
AMONG THE 39% WHO
OPPOSE: What is the main
reason you oppose such a plan?
AMONG THE 56% WHO
FAVOR: What is the main
reason you favor such a plan?
Health care
is a right 7%
NET: 40%

8. NOTE: Among those who favor a national health plan.
SOURCE: KFF Health Tracking Poll (March 13-18, 2019). See topline for full question wording and response options.
Figure 8
Universal Coverage Is Most Important Feature Of A National Health
Plan Among Supporters
How important is it that a national health plan…?
89%
79%
56%
56%
45%
38%
9%
18%
33%
32%
38%
29%
1%
1%
8%
8%
8%
19%
1%
2%
2%
3%
6%
11%
Covers all Americans
Simplifies the health care system
Eliminates monthly premiums
Eliminates out-of-pocket costs like co-pays and
deductibles
Shifts what people pay for health care to taxes
Eliminates private health insurance companies
Very important Somewhat important Not too important Not at all important

9. 26%
19%
12%
18%
69%
75%
85%
77%
Oppose Favor
More Incremental Approach To Universal Coverage: Medicare Buy-
In And Medicaid Buy-In
SOURCE: KFF Health Tracking Poll (January 9-14, 2019). See topline for full question wording and response options.
Figure 9
26%
20%
12%
18%
64%
75%
85%
75%
…allowing people between the
ages of 50 and 64 to buy insurance
through the Medicare program?
… allowing people who don’t get health
insurance at work to buy health insurance
through their state Medicaid program?
Do you favor or
oppose …
Total
Democrats
Independents
Republicans

10. Percent who favor the following proposals:
SOURCE: KFF Health Tracking Polls. See topline for full question wording and response options.
“Optional” Medicare-for-All Slightly More Favorable Across Parties
Than A Government-Administered Public Option
Figure 10
69%
87%
73%
41%
74%
91%
76%
47%
Total
Democrats
Independents
Republicans
A government-administered public option that would compete with private health insurance plans and be available
to all Americans
A national government administered health plan similar to Medicare that would be open to anyone, but would allow
people to keep the coverage they have if they prefer

11. Majorities Think Many Aspects Of Health Care System Would Be
Unchanged Under Medicare-for-all
SOURCE: KFF Health Tracking Poll (May 30-June 4, 2019). See topline for full question wording and response options.
Figure 11
Do you think each of the following would happen under a national health plan, sometimes called Medicare-
for-all?
78%
69%
62%
55%
55%
54%
52%
40%
19%
27%
34%
38%
39%
39%
41%
53%
2%
4%
4%
7%
7%
6%
7%
7%
Taxes for most people would increase
People would continue to pay deductibles and co-pays when…
All U.S. residents would have health insurance coverage
People with insurance through their jobs would be able to keep…
People who buy their own insurance would be able to keep…
Individuals and employers would continue to pay health…
Doctors and hospitals would be paid less
Private health insurance companies would still be the primary…
Yes No Don't know

12. Attitudes Shift After Hearing Messages About How Medicare-for-
all Would Impact Current System
SOURCE: KFF Health Tracking Poll (January 9-14, 2019). See topline for full question wording and response options.
Figure 12
Would you favor or oppose a national Medicare-for-all plan if you heard that it would do each of the following?
27%
30%
58%
60%
60%
70%
71%
67%
37%
37%
32%
26%
Oppose Favor
Guarantee health insurance as a right for all
Americans
Eliminate all health insurance premiums and reduce out-
of-pocket health care costs for most Americans
Eliminate private health insurance
companies
Require most Americans to pay
more in taxes
Threaten the current Medicare
program
Lead to delays in people getting some medical
tests and treatments

13. Uncertainties Persist About National Health Plan Provisions
SOURCE: KFF Health Tracking Poll (January 9-14, 2019). See topline for full question wording and response options.
Figure 13
Percent who think that, if a national Medicare-for-all plan was put into place, they and their family would…
Would Would not
…be able to keep their
current health insurance
…have to pay more in taxes to
cover the cost of health insurance
…be able to access the
health care they need
55%
35%
67%
27%
77%
19%

14. 67%
24%
DK
SOURCE: KFF Health Tracking Poll (January 9-14, 2019). See topline for full question wording and response options.
Most Medicare-for-all Supporters Think They Would Be Able To
Keep Their Health Insurance
Figure 14
41%
51%
DK
55%
35%
DK
Total
Among those who oppose having
a national health insurance plan
or Medicare-for-all
Among those who favor having
a national health insurance plan
or Medicare-for-all
Yes, think they and their family would be able to keep their current health insurance
No, think they and their family would not be able to keep their current health insurance

15. Thinking about the Democratic candidates’ approach to health care. Would you prefer to vote for a candidate
who wants to…?
NOTE: Among Democrats and Democratic-leaning independents.
SOURCE: KFF Health Tracking Poll (September 3-8, 2019). See topline for full question wording and response options.
Figure 15
More Democrats Prefer Candidate Who Would Build On The ACA
Replacing the
ACA with
Medicare-for-all
40%
DK/Ref./Other
5%
Build on the
existing ACA
55%