Republicans Once Wanted Government out of Health Care. Trump Voters See It Differently.

Yahoo

04-03-2025

Jason Rouse of Alpena, Michigan, Sarah Bognaski of Clayton, New York, and Charles Milliken of New Martinsville, West Virginia, all voted for President Donald Trump in November. They'd like to see the new administration put limits on what health care providers can charge patients. (Jason Rouse; Sarah Bognaski; Charles Milliken)
Like many Americans who voted for Donald Trump, Jason Rouse hopes the president's return will mean lower prices for gas, groceries, and other essentials.
But Rouse is looking to the federal government for relief from one particular pain point: high health care costs. 'The prices are just ridiculous,' said Rouse, 53, a retired Michigan firefighter and paramedic who has voted for Trump three times. 'I'd like to see a lower cap on what I have to pay out-of-pocket.'
Government regulation of health care prices used to be heresy for most Republicans. GOP leaders fiercely opposed the 2010 Affordable Care Act, which included government limits on patients' costs. More recently, the party fought legislation signed by former President Joe Biden to cap prescription drug prices.
But as Trump begins his second term, many of the voters who sent him back to the White House welcome more robust government action to rein in a health care system many Americans perceive as out of control, polls show.
'That idea that government should just keep its hands off, even when things are tough for people, has kind of lost its sheen,' said Andrew Seligsohn, president of Public Agenda, a nonprofit that has studied public attitudes about government and health care.
'We're wandering around the country with a set of old, outdated frameworks about what ordinary Democrats and ordinary Republicans like,' he said.
Republican voters strongly back federal limits on the prices charged by drug companies and hospitals, caps on patients' medical bills, and restrictions on how health care providers can pursue people over medical debt.
Even Medicaid, the state-federal insurance program that Republican congressional leaders are eyeing to dramatically cut, is viewed favorably by many GOP voters, like Ashley Williamson.
Williamson, 37, a mother of five in eastern Tennessee who voted for Trump, said Medicaid provided critical assistance when her mother-in-law needed nursing home care. 'We could not take care of her,' Williamson said. 'It stepped in. It made sure she was taken care of.'
Williamson, whose own family gets coverage through her husband's employer, said she would be very concerned by large cuts in Medicaid funding that could jeopardize coverage for needy Americans.
For years, Republican ideas about health care reflected a broad skepticism about government and fears that government would threaten patients' access to physicians or lifesaving medicines.
'The discussions 10 to 15 years ago were all around choice,' said Christine Matthews, a Republican pollster who has worked for numerous GOP politicians, including former Maryland governor Larry Hogan. 'Free market, not having the government limit or take over your health care.'
Matthews and fellow pollster Mike Perry recently convened and paid for several focus groups with Trump voters, including Rouse and Williamson, which KFF Health News observed.
Skepticism about government lingers among rank-and-file Republicans. And ideas such as shifting all Americans into a single government health plan, akin to 'Medicare for All,' are still nonstarters for many GOP voters.
But as tens of millions of Americans are driven into debt by medical bills they don't understand or can't afford, many are reassessing their inclination to look to free markets rather than the government, said Bob Ward, whose firm, Fabrizio Ward, polled for Trump's 2024 campaign.
'I think most people look at this and say the market is broken, and that's why they're willing for someone, anyone, to step in,' he said. 'The deck is stacked against folks.'
In a recent national survey, Fabrizio Ward and Hart Research, which for decades has polled for Democratic candidates, found that Trump voters were more likely to blame health insurers, drug companies, and hospital systems than the government for high health care costs.
Sarah Bognaski, 31, an administrative assistant in upstate New York, is among the many Trump voters who say they resent profiteering by the health care industry. 'I don't think there is any reason a lot of the costs should be as high as they are,' Bognaski said. 'I think it's just out of pure greed.'
High health care costs have had a direct impact on Bognaski, who was diagnosed four years ago with Type 1 diabetes, a condition that makes her dependent on insulin. She said she's ready to have the government step in and cap what patients pay for pharmaceuticals. 'I'd like to see more regulation,' she said.
Charles Milliken, a retired auto mechanic in West Virginia, who said he backed Trump because the country 'needs a businessman, not a politician,' expects the new president to go even further.
'I think he's going to put a cap on what insurance companies can charge, what doctors can charge, what hospitals can charge,' said Milliken, 51, who recently had a heart attack that left him with more than $6,000 in medical debt.
Three-quarters of Trump voters back government limits on what hospitals can charge, Ward's polling found.
And about half of Trump voters in a recent KFF poll said the new administration should prioritize expanding the number of drugs whose price is set through negotiation between the federal Medicare program and drug companies, a program started under the Biden administration.
Perry, who's convened dozens of focus groups with voters about health care in recent years, said the support for government price caps is all the more remarkable since regulating medical prices isn't at the top of most politicians' agenda. 'It seems to be like a groundswell,' he said. 'They've come to this decision on their own, rather than any policymakers leading them there, that something needs to be done.'
Other forms of government regulation, such as limits on medical debt collections, are even more popular.
About 8 in 10 Republicans backed a $2,300 cap on how much patients could be required to pay annually for medical debt, according to a 2023 survey by Perry's polling firm, PerryUndem. And 9 in 10 favored a cap on interest rates charged on medical debt.
'These are what I would consider no-brainers, from a political perspective,' Ward said.
But GOP political leaders in Washington have historically shown little interest in government limits on what patients pay for medical care. And as Trump and his allies in Congress begin shaping their health care agenda, many Republican leaders have expressed more interest in cutting government than in expanding its protections.
'There is oftentimes a massive disconnect,' Ward said, 'between what happens in the caucuses on Capitol Hill and what's happening at family tables across America.'
We'd like to speak with current and former personnel from the Department of Health and Human Services or its component agencies who believe the public should understand the impact of what's happening within the federal health bureaucracy. Please message KFF Health News on Signal at [phone] or .
KFF Health News is a national newsroom that produces in-depth journalism about health issues and is one of the core operating programs at KFF—an independent source of health policy research, polling, and journalism. Learn more about KFF.
Subscribe to KFF Health News' free Morning Briefing.
This article first appeared on KFF Health News and is republished here under a Creative Commons license.