Health care costs have become one of the most urgent crises in American life. Premiums keep climbing faster than inflation. Families across the country report rationing medications or simply not seeking treatment just to make ends meet.
The political story we tell ourselves is that this is an intractable partisan standoff – that Republicans and Democrats are simply too far apart on what role the government should play in health care to ever agree.
But what if that story is wrong?
My colleagues and I at the University of Maryland's Program for Public Consultation (PPC) surveyed Americans nationally and in 11 states and 28 House districts with competitive races in November's midterm elections. What we found should force a rethinking of Washington's
conventional wisdom.
Numerous proposals have been put forward in Congress to address the problem of health care costs. On proposal after proposal – related to drug pricing, health insurance and substance abuse treatment – clear majorities of Republicans and Democrats actually agree on solutions.
The conventional political narrative suggests Republicans are generally wary of expanding the federal government’s role in health care. But our findings complicate that picture. On a wide range of proposals to bring down health care costs and expand access to treatment, majorities of Republicans support federal action.
There is one clear throughline: Americans think the federal government should do more to help Americans afford health care.
Americans support Affordable Care Act subsidies
The debate over expanding government health insurance is often framed as a litmus test of ideology. Our findings suggest Americans are less interested in the ideological debate than in the practical question of how more people can get covered.
Premiums for Affordable Care Act policies spiked this year after Congress let the enhanced subsidies put in place during the COVID-19 era expire, leading to major increases for millions of Americans. Large majorities of both parties want those subsidies restored.
Support for reinstating enhanced ACA subsidies:
- Nationally – 90% of Democrats; 73% of Republicans.
- Competitive states and districts – 83-94% of Democrats; 65-85% of Republicans.
More than half of Republicans support increased Medicaid spending
On Medicaid – which covers very low-income individuals and families, children, pregnant women, elderly adults and people with disabilities – Congress has recently moved to cut funding for the program starting next year. But when Americans are given the options to increase or decrease spending (and cover more or fewer people) or keep it the same, a majority of Republicans joined an overwhelming majority of Democrats in choosing to increase it.
Support for increasing Medicaid spending to cover more people:
- Nationally – 83% of Democrats; 59% of Republicans.
- Competitive states and districts, 74-91% of Democrats; 51-83% of Republicans.
The idea of allowing more Americans to buy into government-run health insurance (creating competition with private insurance) is another idea that has been around for decades but has never gained enough support in Congress to pass.
When Americans are asked about allowing 55- to 64-year-olds to buy into Medicare, it draws broad support across party lines.
Support for Medicare buy-in for people ages 55-64:
- Nationally, 84% of Democrats; 75% of Republicans.
- Competitive states and districts – 74-92% of Democrats; 66-87% of Republicans.
There is bipartisan support for government-run health insurance
Even the bolder idea of the government offering a “public option” so that all Americans could buy into government-run insurance gets support from three-quarters of both Democrats and Republicans.
Support for a government-run insurance plan that anyone can buy into:
- Nationally – 79% of Democrats; 76% of Republicans.
- Competitive states and districts – 77-93% of Democrats; 66-84% of Republicans.
Perhaps nothing draws more bipartisan fury than the cost of prescription drugs. And on this issue, Americans are not divided – they are aligned, and they want the government to take action.
Drug companies have been selling drugs in other developed countries at prices substantially lower (at least half) than the prices here at home. Overwhelming majorities of Republicans and Democrats say the government should step in to set maximum prices for drugs sold here, based on what those same drugs sell for in other developed countries.
Support for drug price caps set at the (lower) prices charged in other developed countries:
- Nationally – 86% of Democrats; 90% of Republicans.
- Competitive states and districts – 80-96% of Democrats; 81-95% of Republicans.
Most Americans want public money to help with substance abuse treatment
The devastating effects of substance abuse, especially the opioid epidemic, impact everyone regardless of party. It is no surprise then that increasing access to treatment has widespread support across party lines. When presented with a multibillion dollar federal investment to expand access to treatment for substance use disorder, majorities of Republicans and Democrats alike were on board.
Support for $13 billion in federal funding for substance use treatment to ensure that nearly everyone who wants and needs it can get it:
- Nationally – 83% of Democrats; 69% of Republicans.
- Competitive states and districts – 68-91% of Democrats; 57-91% of Republicans.
The truth is that only our elected leaders are divided on health care
Too often, our politics assumes that difficult policy questions inevitably divide the public into opposing partisan camps. Health care has become perhaps the defining example of that assumption.
Our research tells a different story. Drug pricing. Medicaid. Medicare. The ACA. Substance use treatment. On every one of these fronts, bipartisan majorities want the government to do more.
The challenge before Congress is not figuring out what Americans want on health care. The public has spoken – not in whispers, but in overwhelming numbers that cut across party lines.
The real question is whether our political institutions are capable of hearing them.
Steven Kull is director of the University of Maryland's Program for Public Consultation (PPC), a nonpartisan research center affiliated with the School of Public Policy.
This article originally appeared on USA TODAY: Americans aren't divided on health care. Washington is. | Opinion
