Since Democrats launched their Affordable Care Act initiative 16 years ago, there’s been a spirited political debate, not just about how officials can extend coverage, but also about whether officials should even try.
Throughout this public discussion, a great many Republican officials have argued that there is no such thing as a “right” to health care coverage and that decisions about insurance and affordability are better left to the free market.
The latest Pew Research Center survey suggests the right has lost that argument. From its summary:
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.
Yet those who say the federal government has this responsibility are split over how it should ensure coverage.
The percentage of Americans who share this view has steadily increased in recent years, reaching a new high in the latest Pew poll.
Not surprisingly, there’s an enormous gap among partisans — 90% of Democratic voters believe the federal government has a responsibility to make sure all Americans have health care coverage, while 41% of Republican voters agree — though it’s worth emphasizing that there’s been a significant shift on the right: The percentage of GOP voters who expect the federal government to guarantee coverage has increased 10 points in five years.
But just as notable were the answers to the next question in Pew’s survey: A 35% plurality of American adults endorsed a single national health insurance system run by the government, while 31% said the insurance system should continue to include a combination of private companies and government programs. In other words, a single-payer system enjoys more political support than is generally recognized. As for the short-term political implications, tens of millions of Americans are poised to see their premiums soar next week — a problem that Donald Trump and GOP lawmakers have made no real effort to address. If Republicans are hoping to avoid a public backlash, the Pew Research Center’s data suggests the party might want to adjust its expectations.
Steve Benen is a producer for "The Rachel Maddow Show," the editor of MaddowBlog and an MS NOW political contributor. He's also the bestselling author of "Ministry of Truth: Democracy, Reality, and the Republicans' War on the Recent Past."
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