If I had to guess, a lot of it is class derived, and by extension, class-related behaviors that drive a lot of the hate.
I mean, what I’ve heard is more that people (white, middle class) don’t like the idea of paying for other groups’ illegitimate children, don’t like paying for people who smoke like chimneys, or use drugs/drink to excess, or who eat ridiculously unhealthy diets, etc…
Of course, there’s a LOT of overlap between those behaviors and socio-economic class, and unfortunately race. The gotcha is that most of these things they are so theoretically averse to paying for in a single payer system are things that we ARE paying for in our current system. I mean, if a poor person eats poorly, smokes and gets diabetes, they’re getting cared for on the government nickel one way or the other, and it’s often worse care, and more expensive than a single-payer system would provide.
But that would run afoul of a certain punitive mentality in the American middle class. There’s a real mentality that people who don’t follow ‘the rules’ (as defined by how a white, middle class person should behave) should be punished- by having shit jobs, shit housing, shit healthcare, etc… The problem here is that in many cases, the poor culture is not one that knows about ‘the rules’, or if they do, they don’t feel like they apply in their corner of Appalachia/inner city/barrio/rural small town/etc… where there is little opportunity, little money, and lots of drugs and poor food. So because they didn’t study in high school/got pregnant early/eat poorly/abuse drugs/whatever, there’s a strong mentality that they deserve what they get, and there shouldn’t be efforts made to cushion that fall, because that’s “encouraging” it.
Now I’m not saying there’s not racism, but in my experience what I’ve seen is more the overlap of race with these other things. I haven’t heard anyone say that they’re against single-payer healthcare because it would mean that blacks and hispanics would get it. They’re almost always against “coddling” or “encouraging” what they perceive to be bad behavior.
There’s also a big personal-choice argument that’s made by the more politically aware ones, that runs something like “I shouldn’t be compelled to participate in the healthcare system by the government”, regardless of whether it’s a good idea or not, or what have you. It’s the same dumb-assedness that is cropping up with regard to masks right now.