Bold opening: Most Americans are satisfied with their health insurance overall, but the stubborn reality is that a sizable minority still faces denials or delays. And this tension is exactly what makes the issue so hard to ignore. But here’s where it gets controversial: the numbers reveal both broad approval and meaningful friction, depending on who you are and what coverage you rely on.
A new NBC News Decision Desk Poll, conducted with SurveyMonkey, finds that a large majority of U.S. adults are satisfied with their health insurance coverage overall. This includes many older adults and people on Medicare and Medicaid. Yet nearly one in four respondents say they have faced a denial or a delay from their insurer in the past two years, highlighting ongoing challenges in access to care.
Overall, about 82% of Americans say they’re satisfied with their health care coverage, and roughly one in three describe themselves as very satisfied. Satisfaction is highest among older adults: nine in ten people over 65 say they’re satisfied, and 42% of that group report being very satisfied.
Among those with public coverage through Medicare or Medicaid, about 9 in 10 report satisfaction, compared with 77% of people with private coverage.
These findings align with other surveys and underscore a broader national debate about health care and affordability in Washington and across the country. They also set the stage for a year expected to bring Medicaid changes and rising costs for many Americans, alongside anticipated premium increases for Obamacare plans unless Congress extends subsidies.
Younger Americans appear less content with their coverage. Just under a quarter of people under 45 say they’re dissatisfied, a share similar to the proportion of college graduates and self-identified independents who report discontent.
When it comes to access to care, delays and denials add another layer to the discussion. NBC News has extensively covered the issue of insurance denials and delays, which sits at the center of a high-profile New York case involving a health insurance company CEO.
In the poll, 24% of Americans report that their health insurance has delayed or denied a health service, treatment, or medication in the past two years. Women report higher rates of denial or delay than men (27% vs. 21%). Those with private coverage are slightly more likely (26%) than those with public coverage (23%) to have experienced delays or denials.
Public opinion on the ACA is nuanced. When asked about keeping or repealing Obamacare, 46% favor keeping it, 24% favor repeal, and 31% are unsure. Importantly, people with private coverage are almost as likely as those with public coverage to want to keep the ACA (47% vs. 46%).
Support for keeping the ACA is strong among many groups: majorities of Democrats (79%), Black Americans (61%), women under 30 (59%), and all adults under 30 (52%). In contrast, a majority of Republicans (56%) and a sizable share of supporters of the MAGA movement (69%) want to repeal the ACA. Among men aged 65 and older, four in ten favor repeal.
Looking ahead to the 2026 midterms, opinions on health care costs divide along party lines, with 57% trusting the Democratic Party to handle the issue compared with 43% who trust the Republican Party. Trust levels also differ by gender: women favor the Democrats on health care costs (64% to 36%), while men are evenly split (50% to 50%).
The NBC News Decision Desk Poll surveyed 20,252 adults online from November 20 to December 8, with a margin of error of ±1.9 percentage points. Percentages may not sum exactly to 100 due to rounding.
If you’re following the health-insurance conversation, the takeaway is clear: broad satisfaction exists, but persistent barriers—especially for younger people, those with private plans, and among certain demographic groups—remind us that access and affordability remain crucial fights.
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