Voters Prefer Clinton’s Public Option Over Left, Right Choices

Hillary Clinton appears to have positioned herself as the winning candidate on health care issues in both the primary and general election after she announced support of a “public option,” according to a new Morning Consult poll.

Clinton recently updated her campaign’s health proposals, saying she wants to create the state equivalent of a public option for health insurers. She said she would work with interested governors to create a “public option” in their state, essentially a state-run health insurance program. The state health programs would presumably coexist with the private insurance market.

The public likes that idea. Almost half of registered voters (44 percent) said they would prefer a health care system in which Americans can choose to get health coverage through a private plan or one offered by the government.

Only 21 percent of voters said they prefer a system of mostly private-sector health coverage, which is essentially what we have now.  

When it comes to Bernie Sanders’ dream of single-payer coverage, only 25 percent of voters said they prefer a system where all Americans get their health coverage through the federal government.

The idea that Clinton is touting — basically a hybrid of public and private health insurance systems — polls best among almost all demographic and voter groups. It is the system most widely supported by Democrats (44 percent), independents (47 percent) and, interestingly enough, Republicans (41 percent).

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Clinton added a public option to her health platform earlier this month. Until then, it seemed that Democrats’ choices were limited to Clinton, a candidate who supported the existing system of private insurance, and Sanders, who supports the single-payer Medicare-for-all system. That set Clinton up to be the loser on health care in a primary election. A single-payer system is favored by a large portion of the party’s liberal base, even with the passage of Obamacare.

From a pure policy perspective, it hardly matters. A public option is a political nonstarter in Congress. It almost sunk the Affordable Care Act. The idea drove Republicans away from the negotiating table in 2009, and it almost lost key Democratic support until it was stripped from the ACA. It was replaced with nonprofit co-op insurers designed to help control prices on insurance exchanges. But more than half of the co-ops have failed, raising questions of their effectiveness and sustainability.

Republicans argue that a public option would undercut private insurers and eventually lead to a single-payer system. Supporters of the policy say that it would provide a form of accountability to private insurers by providing competition based on fair pricing.

It’s worth noting that Sanders’ proposed Medicare-for-all system isn’t politically viable either. While a public option could be folded into the existing health care system structure under Obamacare, a single-payer system would completely upend the healthcare industry and cause major disruption. Even Democrats in Congress are wary of approaching the idea.

Other Morning Consult polling finds that when asked to choose between either a private insurance system or a system where most Americans got coverage through the federal government, 45 percent of voters choose the private system and 37 percent choose the public system. This data comes from Morning Consult’s Policy Index, an ongoing poll of voters’ opinions about economic, technology, health, and environmental issues.

Democrats generally are more amenable to government-run health care. More than half of them (54 percent) favor a government-run or single-payer system, while 29 percent favor private insurance. This suggests that Sanders is more closely identified with the views of the party’s base.

Democrats’ disenchantment with private insurance is explained by another question from Morning Consult’s Policy Index. When asked who or what is most responsible for the considerable rise in health care costs over the past decade, the most selected choice among Democrats (34 percent) is insurance companies. (Respondents are offered a variety of choices, including the federal government, sick people and uninsured people.) Another 19 percent of Democrats lay the blame for high health care costs at the feet of pharmaceutical companies.

Morning Consult’s poll about a possible public option was conducted Feb. 26 and Feb. 27 among 2,002 registered voters. The margin of error was plus or minus 2 percent.

The Morning Consult Policy Index data, which does not specifically ask about a public option, was conducted from Oct. 22 to Feb. 16, and includes 13,838 registered voters.