WASHINGTON — Add Medicaid expansion to the list of Obama-era health care provisions that Americans want to keep. A new poll finds that 8 in 10 say lawmakers should preserve federal funding that has allowed states to add coverage for some 11 million low-income people.
The survey released Friday by the nonpartisan Kaiser Family Foundation comes as the nation’s governors gather in Washington for their annual winter meeting, with Medicaid much on their minds. President Donald Trump and the Republican-led Congress want to repeal the 2010 health care law that expanded the program under former President Barack Obama.
Many congressional Republicans also want to rewrite the basic financial contract for Medicaid, the federal-state health insurance program covering low-income and disabled people. Republicans are proposing to limit future federal funding in exchange for allowing states much more leeway to run their programs. The poll raises new questions about both ideas.
The survey found strong support across party lines for keeping the Medicaid expansion funding, with 69 percent of Republicans saying lawmakers should continue to provide the money, along with 84 percent of independents and 95 percent of Democrats. Overall, 84 percent of Americans said it’s important that any replacement for the Affordable Care Act, or ACA, continue to fund Medicaid expansion.
In 16 states that expanded Medicaid and also have GOP governors, 87 percent of residents said they want the additional funding to continue.
On the more complicated issue of Medicaid’s future financing, nearly 2 in 3 said the program should continue as is. Currently the federal government matches a percentage of each state’s Medicaid costs, with no upper limit on funding.
“This is going to turn out to be one of the biggest political issues of (Republicans) reaching agreement on ‘repeal and replace,'” said Robert Blendon of the Harvard T.H. Chan School of Public Health, who reviewed the poll results.
“Republican House members can take criticism from Democrats, but they really cannot take criticism from their own governors,” added Blendon. “Republican governors are going to feel like they are left holding the bag.”
The Obama-era law expanded Medicaid for those making up to 138 percent of the federal poverty level, about $16,640 for an individual, or $28,180 for a family of three. Geared mainly to low-income adults with no children at home, the expansion was made optional for states by a 2012 Supreme Court decision that upheld the law. Thirty-one states, plus the District of Columbia have expanded their programs, taking advantage of a much more generous federal matching rate for the newly covered group. The federal government will pay about $67 billion this year for the expansion, according to the Congressional Budget Office.
States are worried about the cost of the added coverage, particularly as the ACA starts to gradually reduce some of their federal matching funds for the expansion. But overall, Medicaid shed much of its social stigma during the Obama years, as it grew to cover more than 70 million people. “Medicaid now covers more people than Medicare,” said Trish Riley, executive director of the National Academy for State Health Policy, a nonpartisan policy group that advises state officials.
The poll found that more than half of Americans said they had some personal connection to Medicaid, either because they have been helped directly, or a family member or close friend has.
Republican lawmakers have been getting an earful at town halls this week from constituents worried about losing coverage if the ACA is repealed. The poll found that the public is evenly split on repeal, but that favorable views of Obama’s law are on the rise, due mainly to a shift among political independents. Overall, 48 percent now view the law positively, while 42 percent have a negative perception.
The latest Kaiser poll was conducted from February 13-19 among a nationally representative random digit dial telephone sample of 1,160 adults. The margin of sampling error is plus or minus 3 percentage points for the full sample. For results based on subgroups, the margin of sampling error may be higher.