New Pew data: 66% of U.S. adults say the federal government should ensure health coverage, while 33% disagree. Partisan gaps persist — 90% of Democrats versus 41% of Republicans — but GOP support for a federal guarantee has risen 10 points in five years. A 35% plurality favors a government-run single-payer system, compared with 31% who prefer a mixed public-private model. Rising premiums and limited GOP action raise the prospect of voter backlash.
Majority Of Americans Say Federal Government Should Guarantee Health Coverage, Pew Finds
Sixteen years after the Affordable Care Act reshaped the U.S. health system, public expectations about the federal role in health coverage appear to be shifting. New Pew Research Center data show a clear majority now believes the federal government has a responsibility to make sure all Americans have health care coverage — and opinion is moving in ways that could reshape political debates.
Key Findings From The Pew Survey
Most Americans (66%) say the federal government has a responsibility to make sure all Americans have health care coverage. Far fewer (33%) say it does not, according to a Pew Research Center survey conducted Nov. 17-30, 2025, among 10,357 U.S. adults.
Those who believe the federal government should guarantee coverage are divided on how to do it. A 35% plurality of adults favor a single national, government-run health insurance system, while 31% prefer a mixed model that combines private insurers with government programs.
Partisan divides remain wide but have narrowed in some respects. About 90% of Democratic voters say the federal government should ensure coverage, compared with 41% of Republican voters. Notably, GOP support for a federal guarantee has risen about 10 percentage points over the past five years, indicating movement on the political right.
Culver City, CA - September 23: Leilani Chan gets a COVID-19 vaccination by Pfizer by Tamina Nassiri, a licensed practical nurse at Kaiser Permanente Venice Medical Office Building in Culver City Tuesday, Sept. 23, 2025. (Allen J. Schaben / Los Angeles Times via Getty Images)(Allen J. Schaben / Los Angeles Times via Getty Images)
Political And Practical Implications
Short-term pressures could sharpen these attitudes: tens of millions of Americans face premium increases next week — a development the survey notes alongside limited legislative action from Republican leaders to address those hikes. Pew’s findings suggest rising public expectations for federal action may produce political consequences if cost spikes persist and policymakers do not respond.
Methodology: The figures cited come from a Pew Research Center survey conducted Nov. 17-30, 2025, among 10,357 U.S. adults.
This article summarizes the Pew findings and their possible implications for the near-term political landscape.
