Health care consistently ranks among voters' top concerns, but only 40% are aware that more than half all health care spending is paid for by the U.S. government. Slightly less (36%) say the statement is false, while 24% say they are not sure.

Knowing the reality of that statement dramatically reshapes how voters view the current system of health care.

Initially, a narrow majority of Republicans (52%) say the U.S. operates under a free market system, and 48% of Democrats agree. Three in 10 Republicans (30%) and nearly 4 in 10 Democrats (37%) say it is more accurate to call the current system government run.

When told that, in fact, more than 60% of all health care spending is paid for by federal, state or local governments, voters change their minds. Given that information, voters say it is more accurate to call the current U.S. health care system government run system by a margin of 48% to 32%. The slimmest majority of Democrats (51%) hold this view, along with a plurality (45%) of Republicans.

Digging a little deeper, voters who prefer policies like President Trump are the only group in our 4-Way Choice category to say we currently operate on a free market system. Just 33% of Traditional GOP voters agree.

Looking Back

The present solid plurality (48%) calling the current system government run is a far cry from the 61% who said the same under Biden in 2024. At that time, just 25% said we had a free market system, down 7 points from today.