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Medicaid Surprisingly Popular With Americans, Survey
Finds
June
29, 2005 - Perhaps surprisingly, given years of debate about Medicaid,
frequent references to the program as the "Pac Man" of
 state budgets,
and periodic calls for reform, public attitudes toward Medicaid are
remarkably positive, and opposition to cuts is reasonably strong,
according to a new public opinion survey released today by the Kaiser
Family Foundation.
While two-thirds of the public think their state
has major budget problems, a substantial majority is reluctant to cut
Medicaid to balance state budgets, and a majority think the federal
government should maintain (44 percent) or increase (36 percent) federal
spending on Medicaid; only 12 percent of the public prefer seeing
federal funding of Medicaid cut.
Attitudes Toward Medicaid
Nearly three-quarters (74 percent) of adults say
Medicaid is a "very important" government program, ranking it close to
Social Security (88 percent) and Medicare (83 percent) in the public's
mind, equal to federal aid to public schools (74 percent), and above
defense and military spending (57 percent). About 8 in 10 Democrats (82
percent) and Independents (79 percent) view Medicaid as an important
government program, while fewer, but still 6 in 10 Republicans (61
percent) express that view.
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A majority of Americans (56 percent) report having
some interaction with Medicaid, either having been enrolled themselves
at some point (16 percent) or knowing a friend or family member who has
received health coverage or long-term care assistance through the
program (40 percent). Additionally, if they needed health care and were
eligible, nearly 8 in 10 Americans (78 percent) say they would be
willing to enroll in Medicaid. This view is consistent across different
party identifications.
"We expected Medicaid to be relatively unpopular
with the public, much like welfare was. But we found that Medicaid ranks
closer to popular programs like Medicare and Social Security in the
public's mind. The fact that so many Americans have had some kind of
contact with Medicaid themselves or through family and friends is one
factor that could help explain this result," said Mollyann Brodie,
Ph.D., Vice President and Director of Public Opinion and Media Research
for the Foundation.
Budgets and Medicaid
Almost two-thirds of the public think that their
state's budget is either in crisis or has major problems, and about a
third believe that Medicaid costs are a major reason for those budget
problems. However, half (52 percent) say they "strongly" oppose and
another 22 percent "somewhat" oppose cutting back on their state's
Medicaid program to balance the budget.
Just 2 in 10 either "strongly" (5 percent) or
"somewhat" (17 percent) support Medicaid cuts to help balance state
budgets. Majorities of Democrats (65 percent strongly, 16 percent
somewhat), independents (52 percent strongly, 23 percent somewhat), and
Republicans (36 percent strongly, 29 percent somewhat) say they would
oppose such cuts.
"This poll shows that Americans across the
political spectrum value the role Medicaid plays in our health care
system," said Diane Rowland, Executive Vice President of the Foundation
and Executive Director of the Kaiser Commission on Medicaid and the
Uninsured. "As with the rest of the health care system, much of the
political debate surrounding Medicaid these days focuses on controlling
costs, but proposals to cut funding for the program or scale back the
coverage it offers do not appear to be popular with the public."
While the public seems reluctant to see state
Medicaid funding cut, they are divided on the best way to grapple with
their state's budget problems. Nearly a quarter (24 percent) say their
state should cut funding for programs other than Medicaid (like
education, prison systems, and transportation); 21 percent say that
their state should raise taxes and the same number say that the state
should cut Medicaid funding to address the budget problems. Twenty-three
percent of the public volunteered that the budget problems should be
addressed in some other way.
Half (50 percent) of the public feels the federal
government should put more money into the Medicaid program to help
states with budget problems, but 43 percent think the federal government
cannot afford to do this right now given its own budget problems.
When asked more generally about approaches to
federal spending on Medicaid, 44 percent would retain current levels, 36
percent prefer to see an increase in spending, and 12 percent say that
federal Medicaid spending should be cut. Democrats (49 percent) are more
likely than Independents (35 percent) or Republicans (22 percent) to
support an increase in spending, while Republicans (54 percent) and
Independents (50 percent) are more likely than Democrats (36 percent) to
prefer that spending be maintained at its current level. About 1 in 5
Republicans (19 percent), and 1 in 10 Democrats (9 percent) and
Independents (9 percent) would cut federal spending on Medicaid.
Perceptions About A Medicaid "Crisis"
About 6 in 10 believe that the Medicaid program is
either in financial crisis (22 percent) or has major problems but is not
in a financial crisis (39 percent), while three in ten say it has minor
problems (27 percent) or no problems (3 percent). The public believes
rising prescription drug costs (83 percent), growing long-term care and
nursing home expenses (73 percent), and higher payments to doctors and
hospitals (70 percent) are major reasons why Medicaid spending has
recently increased. Many also believe that fraud and abuse in the
program (67 percent), greater enrollment (61 percent) and poor
management (61 percent) are major reasons for Medicaid spending growth.
Despite concerns about Medicaid's financial
problems, none of the proposals to address the program's problems that
the public was asked about garnered support from a majority of the
public. For example, about 4 in 10 say they favor reducing the number of
people qualifying for the program (44 percent), lowering payments by
Medicaid for prescription drugs (42 percent), lowering payments to
doctors and hospitals (41 percent), increasing co- payments and
deductibles that enrollees pay (41 percent), and eliminating the ability
of middle class elderly to transfer their assets to children in order to
qualify for Medicaid (37 percent).
One Medicaid restructuring proposal being discussed
by policymakers is increased state flexibility in determining which
benefits are offered in a particular state. Nearly 6 in 10 people (58
percent) believe that all states should be required to offer the same
set of core health care benefits to receive federal funding, while
nearly 4 in 10 (39 percent) say states should be able to decide their
own benefits. More than 8 in 10 people think that the following benefits
(some of which are optional under current law) are essential in Medicaid
coverage: hospital stays (87 percent), prescription drugs (87 percent),
medical equipment like wheelchairs and artificial limbs (85 percent),
mental health services (83 percent ), emergency room visits (82
percent), nursing home care (82 percent), physical therapy (81 percent),
and doctor visits (81 percent). Less than half of the American public
views coverage for chiropractor visits (43 percent) and travel to and
from doctor visits (38 percent) as essential. Public Knowledge About
Medicaid
While most Americans point to the importance of
Medicaid, and many have a basic understanding of this complex program,
about half tend to be less familiar with the program's specific details.
More than half (53 percent) do not know that Medicaid is the insurance
program for many low-income families regardless of their age, and more
than 6 in 10 (62 percent) do not understand its role for low-income
people who need nursing home care or home health care.
Nearly half the public (47 percent) does not know
that Medicaid is funded by both the federal and state government and
more than half (55 percent) don't realize that it covers more people
than Medicare. While low-income children and their parents account for
three-quarters of Medicaid's total enrollees, 54 percent of the public
does not know that low-income families make up most of Medicaid's
enrollees. Further, although 70 percent of program spending is for the
elderly and individuals with disabilities, 46 percent do not recognize
that most of program spending is for those groups.
For the complete report – (Click
Here)
The Kaiser Family Foundation is a non-profit,
private operating foundation dedicated to providing information and
analysis on health care issues to policymakers, the media, the health
care community, and the general public. The foundation is not associated
with Kaiser Permanente or Kaiser Industries.
Methodology
The Kaiser Family Foundation National Survey of the
Public's Views about Medicaid was designed and analyzed by researchers
at the Kaiser Family Foundation. Fieldwork was conducted by telephone by
Princeton Survey Research Associates between April 1 and May 1, 2005,
among a nationally representative random sample of 1,201 respondents 18
years of age and older. Results have been weighted to be representative
of the U.S. population by sex, age, education, race, Hispanic origin and
region.
The margin of sampling error for the survey is plus
or minus 3 percentage points for total respondents. For results based on
subsets of respondents the margin of error is higher. Note that sampling
error is only one of many potential sources of error in this or any
other public opinion poll.
Near the beginning of the survey, but after basic
knowledge questions were asked, all respondents were read the following
common definition of Medicaid: "Medicaid is a government program for
low-income people whose costs are shared by both the federal government
and state government. It provides health insurance and long term care
assistance to eligible children and their parents, elderly, and people
with disabilities." For complete question wording, please see the survey
topline document.
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