Creating a new government-controlled health insurance system, like Medicare at 60, the public option, and Medicare for All, could introduce new costs and consequences for our health care system.

Better access to affordable, high-quality health care coverage doesn’t require starting from scratch. Millions of Americans rely on private plans and public programs for coverage, and improvements to our current system are helping more people gain the coverage they need.

The majority of Americans are satisfied with their current health care coverage and would prefer to build on what’s working rather than start over by creating a new government-controlled health insurance system.

  • The November 2021 edition of Voter Vitals – a nationwide tracking poll conducted by Locust Street Group for the Partnership for America’s Health Care Future – shows that:
    • Voters prefer to build on what’s WORKING by providing subsidies for those in states that did not expand Medicaid to purchase coverage in the existing marketplace (57 percent) over creating a new government-run insurance plan (43 percent). (Voter Vitals, 11/21)
    • 65 percent prefer BUILDING ON our current system rather than creating the public option or opening up Medicare – including a majority of Democratic voters. (Voter Vitals, 11/21)
  • As of October 2021, the favorability rate for the Affordable Care Act (ACA) stands at 58 percent – the highest favorability rate since the ACA became law. (Kaiser Family Foundation, 10/15/21)

Building On Our Current System: Lower Costs

  • About half of Americans who signed up for health care coverage through the Exchange during 2021’s Special Enrollment Period qualified for plans with premiums costing $10/month or less.  (Department of Health and Human Services, 09/15/21)
  • During the 2021 Special Enrollment Period, American families saved an average of $67/month on health care coverage. (Department of Health and Human Services, 09/15/21)
  • Going into 2022’s Special Enrollment Period, larger subsidies are now available to more low-income and middle-income Americans through building on our current system.(Kaiser Family Foundation, 10/28/21)
  • Americans could save $10.6 billion dollars annually through building on our current system. (FTI Consulting, 06/03/21)
  • Building on what’s working through creating permanent subsidies could reduce net premiums by 24 percent.  (FTI Consulting, 06/03/21)
  • With enhancements to our current system, total out-of-pocket spending would decrease for each income group, apart from those in the highest income category. (KNG Health Consulting, 05/17/21)

Building On Our Current System: Expanding Access To Care

  • The public-private cooperation in our current system has helped to keep the uninsured rate stable and provide Americans access to coverage during the COVID-19 pandemic. (Axios, 11/01/21)
  • Millions of Americans rely on our current system for access to care. According to the latest figures from the Kaiser Family Foundation: 158 million Americans receive coverage through their employer, 18.7 million hold non-group coverage, 45.3 million receive coverage through Medicare, 63.2 million receive coverage through Medicaid and CHIP, and 4.4 million receive coverage through the military.(Kaiser Family Foundation, 09/14/21)
  • Over 12.2 million Americans have received new health care coverage through the ACA. (Department of Health and Human Services, 09/15/21)
  • ACA enhancements could reduce the national uninsured rate by 1.5 percentage points. (FTI Consulting, 06/03/21)
  • Permanent ACA subsidies combined with Medicaid expansion could decrease the U.S. uninsured rate by 2.1 percentage points. (FTI Consulting, 06/03/21)


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