A new poll about “Medicare for All” should make you think twice before trusting polls on Medicare for All. Yes, that sounds a little weird. But it’s the biggest takeaway from the new survey, one designed specifically to measure the public’s understanding of how Medicare for All would actually work. It turns out that a lot of people don’t really get it. That lack of awareness could have big implications for the debate over Medicare for All, an idea that has already figured prominently in the Democratic 2020 presidential primaries and is sure to get attention at next week’s candidate debates in Miami. Of course, figuring out exactly what those implications are isn’t easy. It’s possible that, as people learn more about Medicare for All, some supporters will get skittish. Or that some skeptics will get more enthusiastic. Or both. A lot depends on how the debate unfolds and, ultimately, whether proponents or opponents are more successful at getting their messages across to the public. But this much is clear: Opinion about Medicare for All isn’t at all fixed. The Public Misconceptions Cut Both Ways Medicare for All is the catchphrase for a policy proposal that would enroll all Americans into a new, government-run health insurance program. Ever since Bernie Sanders, the independent Vermont senator, made Medicare for All a cornerstone of his 2016 presidential campaign agenda, support for the idea has become something of a litmus test for progressives. He’s running on Medicare for All again this year, and this time he has a lot more company, with nearly a dozen other Democratic presidential candidates claiming that they support the idea too. It’s safe to assume these Democratic candidates wouldn’t be so openly enthusiastic about Medicare for All if surveys hadn’t shown the concept to be so popular with voters in general and with Democratic voters in particular. But, according to a new telephone poll that the Henry J. Kaiser Family Foundation published Tuesday morning, many of those voters seem to think that Medicare for All would do things it wouldn’t ― or, more precisely, that it wouldn’t do things it would.

Sarah Silbiger via Getty Images Sen. Bernie Sanders is Medicare for All's best known proponent, and he has been upfront about what it would mean for private insurance.

That’s especially true when it comes to the future role of private insurance. Two-thirds of Democratic voters think that people with employer coverage could hold on to their policies under Medicare for All, according to the Kaiser study, which used a nationally representative sample of more than 1,200 adults. In reality, both the Sanders proposal and its House counterpart, from Rep. Pramila Jayapal (D-Wash.), would prohibit the sale of private insurance that is “duplicative” of what the new government plan would offer. That would effectively wipe out existing employer policies. Private insurers could still offer supplemental plans, but only to pay for extras, like cosmetic surgery and premium hospital rooms, that the government plan didn’t cover. Veterans of past health care policy fights, including many sympathetic to Medicare for All in principle, have warned about this kind of disruption and its potential to alienate voters ― especially with Republicans and with advocacy groups that represent the health care industry already making a big issue out of it. Awareness of those dangers undoubtedly helps explain why some Democratic candidates, including Sens. Kamala Harris of California and Elizabeth Warren of Massachusetts, have made it clear they would support incremental steps toward Medicare for All ― while others, including former Congressman Beto O’Rourke of Texas and Mayor Pete Buttigieg of South Bend, Indiana, have said they prefer starting with an alternative to Medicare for All that would preserve a role for employer coverage. Other Democrats have declined to endorse Medicare for All, even in principle. That group includes Joe Biden, the former vice president. He has said he supports the creation of a government-run insurance program open to all, but he would stop short of getting rid of existing arrangements. But the voters’ lack of awareness about Medicare for All extends to some of its benefits.

Henry J. Kaiser Family Foundation