A narrow majority of Americans believes that the federal government is obligated to guarantee that all of its citizens have access to health care.

A Gallup poll finds that 52 percent believe the U.S. government is responsible for ensuring universal coverage, compared to 45 percent who disagree.

Polls by Gallup in past years have shown large swings in how people respond to the question. In 2006, 69 percent said that the government should ensure health care coverage, but support for that position plummeted to 42 percent in 2013.

Attitudes on the role of government in health care have likely been strongly shaped in recent years by attitudes towards the Affordable Care Act. Support for the law has fluctuated, hitting a low point during the flawed rollout of Healthcare.gov at the end of 2013.

That support for universal coverage has risen again highlights the challenge that Republicans will face in fulfilling their promise to repeal the ACA.

Since the principal Republican and conservative opponents of the ACA have framed the health law as a “government takeover,” many interpreted polls that showed dissatisfaction with the law as evidence that Americans are opposed to an increased government role in health care.

However, a certain percentage of those who don’t like the ACA are drawn to the rhetoric of Bernie Sanders and others on the left, who generally view Obamacare as enshrining a predatory private insurance industry that drives up the costs of health care.

The Gallup poll indicates why Obamacare — which aimed to ensure universal coverage without scrapping the private health care industry — was the path taken by President Obama. Fifty-three percent of the poll respondents say they would prefer a private health care system, while only 43 percent favor a publicly-run system.

Supporters of a single-payer system have argued that Americans have simply not been exposed enough to the arguments in favor of a fundamental shift, and that they have been scared away from embracing that change by threats that they will lose the employer-provided coverage they currently enjoy.

Others, such as Speaker Paul Ryan, firmly believe the opposite. Not only do they believe that Americans would be better off under a private system, but they argue that Americans would embrace privatization of systems that are currently publicly-run, such as Medicare, if only they were given the opportunity.

Instant Insights /

Americans divided on role of government in health care

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