As Congress debates potential changes to Medicaid in the federal budget, a new KFF Health Tracking Poll reveals that the vast majority of Americans do not support cuts to the program. Despite ongoing political discourse around Medicaid reform, only 17% of the public favors reducing Medicaid spending. Instead, a larger proportion of respondents—40%—prefer maintaining current funding levels, while 42% advocate for an increase.
Broad Support Across Political and Geographic Divides
Interestingly, support for Medicaid remains strong even among traditionally conservative groups. The poll found that only 33% of Republicans, 35% of Trump voters, and 23% of rural residents support cuts to Medicaid. Instead, majorities within these groups prefer maintaining or increasing funding.
This widespread backing likely stems from direct personal experience with the program. Over half of Americans report either having been covered by Medicaid themselves (18%) or having a family member who has (35%). Another 13% have a close friend who has benefited from Medicaid. The program’s reach extends across political affiliations, with 52% of Democrats, 57% of independents, and 44% of Republicans reporting personal or family experience with Medicaid. Notably, 44% of Trump voters and 51% of those who voted for former Vice President Kamala Harris say the same.
Medicaid’s Role in Local Communities
Medicaid is widely regarded as essential to local communities. Nearly three-quarters (73%) of the public say Medicaid is “very important” to their communities, including 75% of rural residents, 61% of Republicans, and 66% of rural Trump voters.
Among those currently enrolled in Medicaid or with a family member in the program, support is even stronger: 85% say Medicaid is “very important,” with 90% of rural enrollees echoing that sentiment. KFF President and CEO Drew Altman notes, “Medicaid is now up there with Social Security and Medicare on the public’s do-not-cut list.”
Perceptions of Medicaid Reform: Cutting Costs or Cutting Coverage?
While some Republican lawmakers argue that proposed Medicaid changes would improve the program, three-quarters (75%) of the public believe the push is primarily about reducing federal spending. Even among Trump voters, a majority (57%) share this view.
Shifting Views on Work Requirements and Medicaid Expansion
The public’s opinion on Medicaid reform is not fixed, particularly when it comes to work requirements and Medicaid expansion. Initially, 62% of Americans support requiring Medicaid recipients to work or seek employment. However, support drops to 32% when they learn that most Medicaid enrollees already work and that paperwork challenges could cause many to lose coverage. Conversely, support jumps to 77% when framed as a way to reserve Medicaid for the elderly, disabled, and low-income children.
A similar pattern emerges regarding cuts to Medicaid expansion funding under the Affordable Care Act (ACA). Initially, 59% oppose reducing federal funding for Medicaid expansion, while 40% support it. When told the change would save $600 billion over 10 years, support rises to 49%. However, opposition jumps to 75% when informed that states likely couldn’t cover the funding gap, potentially leaving 20 million people uninsured.
Public Awareness and Misconceptions About Medicaid
The poll also highlights widespread misconceptions about Medicaid.
- Work and Medicaid: Only 37% of the public correctly recognize that most working-age Medicaid enrollees are employed. Republicans (77%) and Trump voters (76%) are more likely to incorrectly believe that most Medicaid enrollees are unemployed.
- Immigrant Eligibility: Just over half (53%) of respondents correctly state that undocumented immigrants are not eligible for federally funded health insurance like Medicaid. Meanwhile, 28% are unsure, and 18% incorrectly believe undocumented immigrants qualify.
- Long-Term Care Coverage: Medicaid plays a key role in covering nursing home and extended care services for low-income elderly and disabled individuals. However, only 38% of respondents correctly identify Medicaid as the primary payer for these services, while 26% mistakenly believe Medicare covers them, and 31% are unsure.
Healthcare Shortages in Rural America
The poll highlights critical healthcare shortages in rural areas:
- 49% of rural residents say their communities lack enough primary care doctors.
- 71% report a shortage of specialists.
- 67% say there aren’t enough mental health providers.
- 34% believe their community does not have enough hospitals.
Conclusion
As Congress considers Medicaid reforms, public opinion remains largely opposed to funding cuts. The program’s widespread reach and its role in local communities make it a top priority for many Americans, regardless of political affiliation. However, perspectives on specific policy changes, such as work requirements and Medicaid expansion funding, can shift based on how the issues are framed.
With Medicaid playing a vital role in the lives of millions, policymakers must navigate these debates carefully, balancing cost concerns with the public’s overwhelming preference to preserve—and even expand—the program.