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Americans want the option of a government-regulated and -subsidized health plan

June 23, 2020

Topics: Quote of the Day

Commonwealth Fund Health Care Poll: COVID-19, May–June 2020

By Sara R. Collins, Munira Z. Gunja, Gabriella N. Aboulafia, Erin Czyzewicz, Christian H. Kline, Robyn Rapoport, and Sarah Glancey
The Commonwealth Fund, June 23, 2020

What do Americans think of providing people who have employer coverage with a new option to buy insurance on their own?

While the Affordable Care Act provides coverage options for people who don’t have, or lose, insurance through an employer-based plan, switching plans after losing a job can mean losing access to preferred physicians and other providers. When health coverage is not connected to a job, coverage and access to care can be more stable over time. And given the impact of rising employer plan premiums on many with low and moderate incomes, the availability of federal subsidies through marketplace plans may make such plans a more affordable option for many.

We asked survey participants whether they think people who get their health insurance through an employer should have the option of getting similar coverage, at similar cost, through government-regulated and -subsidized health plans. Three-quarters of respondents overall said they believed people should have such an option. Democrats, including those leaning Democratic, expressed the strongest support, but about two-thirds of Republicans also held this view.

Question: Millions of Americans get their health insurance through a job. Should people who get health insurance through their employers have the option of getting similar coverage at a similar cost through government-regulated and -subsidized health plans?

Percent of respondents age 18+ who said “yes”

74% – All
81% – Democrat or leaning Democrat
65% – Republican or leaning Republican
80% – Black
77% – Hispanic
71% – White



By Don McCanne, M.D.

Although most of the questions in this latest poll were about job loss and insurance coverage, plus some questions about public policies during the COVID pandemic, the question above stood out since it shows that Americans across the board, including about two-thirds of Republicans, believe that people who get their health insurance through a job should have the option of getting similar coverage at a similar cost through government-regulated and -subsidized health plans.

Recent polls have suggested that there may be some reluctance to support a government-run health plan if it means losing the option to keep an employer-sponsored plan. This poll suggests that there is strong support for being able to move into a government-regulated and -subsidized health plan. So it is not government involvement which people oppose. More likely it is uncertainty about making a change even when the current system has defects such as excessively high deductibles and limiting care to narrow provider networks.

We have yet to see a question such as the following:

Would you prefer a government plan that covered all necessary health care with no deductibles or copayments and allowed free choice of any physician or hospital even though that meant that you could not choose an employer-sponsored plan that required deductibles and copayments and limited you to a list of physicians and hospitals selected by the insurer?

It would be likely that the pollster would have to repeat the question to be sure that the respondent understood the difference. It might be difficult for the respondents to believe that such a government plan could exist, but it would if we enacted a well designed, single payer model of an improved Medicare for All.

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About the Commentator, Don McCanne

Don McCanne is a retired family practitioner who dedicated the 2nd phase of his career to speaking and writing extensively on single payer and related issues. He served as Physicians for a National Health Program president in 2002 and 2003, then as Senior Health Policy Fellow. For two decades, Don wrote "Quote of the Day", a daily health policy update which inspired HJM.

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