May 26, 2011

New Poll Finds Americans Oppose Medicaid Cuts

A new Kaiser Health Tracking poll finds that more than half of Americans are against any reductions in Medicaid spending.

The survey found that 60 percent of U.S. adults oppose converting Medicaid to block grant financing to reduce the federal deficit, preferring to keep the program as it is, with the federal government guaranteeing coverage and setting minimum standards for benefits and eligibility. 

Just 35 percent said they would support changing the program so that the federal government gives states a fixed amount of money, with each state deciding who to cover and what services to reimburse.

Only 13 percent of Americans said they would support major reductions in Medicaid spending as part of Congress' efforts to reduce the deficit, while 30 percent would support minor reductions and 53 percent want to see no reductions at all in Medicaid spending.

The findings come amid intense public debate about the future of the nation's entitlement programs, as policymakers work to address rising public concerns about the skyrocketing federal budget deficit.

Although other recent public opinion polls suggest that significant changes in Medicare would be politically unpopular, the Kaiser poll's findings indicate that making major changes to Medicaid could also be difficult.

Support for maintaining the current program may be due, in part, to the public's personal experiences with Medicaid, and a strong sense of the program's significance.  Indeed, about twenty percent of U.S. adults have received Medicaid benefits over time, with most reporting a positive experience.  However, one-third reported problems finding a doctor that accepted Medicaid patients

Roughly one-half of Americans (51%) said they or a friend or family member has received Medicaid assistance at some point, with nearly that many (49%) saying Medicaid is "very" or "somewhat" important for them and their family.

"Medicaid is a complex program that varies considerably from state to state, but the public's initial reaction upon hearing about proposed spending reductions and structural changes is negative," said Mollyann Brodie, a senior vice president and director of the Public Opinion and Survey Research group at the Foundation. 

"Such concerns reflect the fact that the program is important not only to those who have been directly enrolled in it but those with friends and family who have received Medicaid benefits as well."

As with other surveys, the Kaiser poll found that public opinion about switching Medicaid to block grant financing is flexible once common arguments for and against it are presented.  For example, when the 60 percent who initially oppose the changes are told that supporters say it will "help reduce the federal budget deficit and give states greater flexibility to tailor their Medicaid programs to match their residents' needs and their own state budgets," 14 percent of respondents changed their position, so that support for the Medicaid changes rose from 35 percent to 44 percent.  That results in a more mixed opinion overall, with 44 percent supporting the block grant plan and 49 percent preferring to keep Medicaid as it is.

On the other hand, when the 35 percent who initially supported the block grant proposal are told that opponents say it will "increase the number of uninsured, increase financial pressure on states and health care providers, and cause more low-income people to go without health care and long-term care services, particularly during tough economic times," 26 percent of them changed their position, resulting in an increase in the percentage of respondents who want to keep Medicaid as is --  from 60 percent to 69 percent. In this scenario, the share supporting a block grant falls to 25 percent.

The poll also revealed partisan differences, with 69 percent of Democrats and 54 percent of independents saying they want no reductions in Medicaid spending to reduce the deficit, while 44 percent of Republicans saying they would support minor reductions, and 20 percent preferring major reductions. 

On the block grant question, 79% of Democrats said they prefer to keep Medicaid as is, while 57% of Republicans support the proposed changes.  Independents mirror the public overall, with 60% preferring the current Medicaid system and 36 percent wanting to change it to a block grant.

The Kaiser survey included telephone interviews conducted between May 12 and May 17, 2011, with a representative random sample of 1,203 adults. 


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