The data: Sixty-six percent of US adults favor having a national health plan, sometimes called Medicare-for-all, in which all Americans would get their insurance from a single government plan, per a September KFF Health Tracking Poll. That’s up from 53% in October 2020 when KFF last asked the question. Support is highest among Democrats (84%), followed by Independents (72%), and Republicans (34%).

The caveat: US adult’s support for a national healthcare plan shifts depending on the effects. It rises to 76% when consumers are told it would guarantee health insurance as a right for all Americans, but falls to 52% when told it will eliminate private health insurance companies, and to 24% when told it would lead to delays in getting some medical tests and treatments.

Why it matters: Healthcare costs remain the top financial worry for consumers, which likely makes a national health plan appealing. Sixty percent of US voters are worried about healthcare costs, which includes health insurance and out-of-pocket expenses per KFF’s new survey, keeping it as their top economic concern ahead of gas and transportation (59%) and food and grocery (52%) costs.

But the effects on cost and access would depend on how a government-run national health plan is designed, such as how it pays providers and drugmakers or handles increased demand for care. Most US Medicare-for-all proposals would replace private insurance with a single government-run plan. An August Yale School of Public Health study modeled a national public insurance program similar to the proposed Medicare for All Act and estimated it could reduce US health expenditures by $1 trillion, or nearly 20%, through lower prescription drug prices and provider payments, reduced administrative costs, and fewer avoidable ER visits and hospitalizations.

However, a broader 2022 CBO analysis of five government-run single-payer options found that more individuals would be covered by healthcare coverage insurance and out-of-pocket spending would decrease. But increased demand for care would outpace supply, resulting in greater congestion, delays, and missed care.

Implications for pharma and healthcare companies: Broad conditional support for a national health plan is forcing policymakers and the industry to address healthcare costs and coverage, even if there is no clear federal path to a single-payer system. For pharma, broad agreement on the need to lower drug prices is already translating into measures like Medicare drug price negotiation and the Trump administration’s individual pricing deals with drugmakers. High voter concern about healthcare costs and growing support for a national plan could keep that pressure on and lead to further efforts to lower prescription costs.

But favorability for a national health planfalls when consumers hear it could mean worsening their healthcare experience. That gives health systems and insurers a clearer messaging playbook: Show consumers how they’re expanding access to coverage and reducing waits for care.

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