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Don't Mess with Medicaid, Most Americans Say

By John Reichard, CQ HealthBeat Editor

May 25, 2011 — Health policy insiders view Medicare as having more political support than Medicaid. But a new poll says the latter has many backers among the American people.

Sixty percent of Americans want to keep Medicaid as is and only 13 percent favor major cuts in the program as part of congressional efforts to reduce deficit spending, according to a poll released by the Kaiser Family Foundation.

Many Americans have a personal connection to Medicaid, reported the survey of 1,203 adults, conducted May 12 through May 17. The poll has a margin of error of plus or minus 3 percentage points.

About half of Americans said a friend or family member received assistance from Medicaid at some point and 49 percent said Medicaid is very or somewhat important to their own family.

"If you watch the debate about the deficit and entitlements, you would think that almost everyone has a problem with the Medicaid program and wants to change it, or cut it—or both," said Kaiser President Drew Altman in a news release accompanying the survey results. "The big surprise in this month's tracking poll is that one group who does not want to cut Medicaid is the American people."

Added Altman: "With about 69 million people expected to be covered by Medicaid this year, it is no longer the welfare-linked program it once was. Medicaid may not be the lower-hanging fruit that many who want to reduce federal entitlement spending have assumed it is."

Expansion of Medicaid under the health overhaul law (PL 111-148, PL 111-152) is viewed as unwise by many of its critics. Medicaid also has the reputation of delivering substandard care. But the survey found that 81 percent of adults said that if they were uninsured, needed health care, and qualified for Medicaid, they would enroll in the program, the survey said.

Raising taxes and cutting defense spending could ease the pressure for Medicare and Medicaid cuts but analysts nonetheless depict the two entitlement programs as financially unsustainable in their current form. Clearly, political leaders have far to go in educating the public about the nation's balance sheet and how it can be fixed.

The new survey found that 35 percent of those polled favor converting Medicaid into a block grant program so that states get a fixed sum of money and each state decides who to cover and which services to pay for.

That figure rises to 44 percent if respondents are told a block grant would "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," the foundation said.

But support for the block grant dropped from 35 percent to 25 percent if respondents were told that critics of the approach say it would "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 services, particularly during tough economic times," the foundation added.

The survey found little change in public opinion about the health law. Forty-two percent had a favorable opinion of the law and 44 percent had an unfavorable opinion. But by almost a two-to-one margin the public disapproves of cutting off funding for implementing the law, the survey found.

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