Kaiser
Family Foundation survey
says public views Medicaid in favorable light,
reluctant to see State and Federal cuts
WASHINGTON, June 29 /U.S. Newswire/ -- The Kaiser Family
Foundation releases a National Survey of the Public's Views about
Medicaid:
-- Despite Concerns about State Budgets and Policymakers'
Frustrations with Costs of Medicaid, Americans View Program
Positively, Are Reluctant to See State and Federal Cuts --
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
http://www.kff.org/medicaid/pomr062905pkg.cfm .
While two-thirds of the public think their state has major
budget problems, a substantial majority are 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 Towards 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.
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.