Nearly three-quarters of U.S. adults believe Medicaid is a "very important" government program and a substantial majority say state and federal Medicaid funding should not be reduced, according to a new survey released Wednesday by the Kaiser Family Foundation, AP/Long Island Newsday reports. Conducted between April 1 and May 1, the survey involved telephoning 1,201 U.S. residents ages 18 and older (Freking, AP/Long Island Newsday, 6/29). The margin of error for the survey is plus or minus three percentage points for the entire sample and fieldwork was conducted by Princeton Survey Research Associates (Bloomberg News, 6/29). According to the survey, the percentage of U.S. adults who believe Medicaid is very important is close to the percentage who rate Social Security and Medicare as very important, at 88% and 83%, respectively (AP/Long Island Newsday, 6/29). While nearly two-thirds of adults say their state is facing major budget problems, a "substantial majority" do not favor cutting Medicaid to balance state budgets, the survey says (Kaiser Family Foundation release, 6/29). In addition, about half of U.S. adults believe the federal government should earmark more money for Medicaid to help states with budget problems, but 43% do not believe the federal government can afford to do so right now (Bloomberg News, 6/29). Only 12% of adults would like to see federal Medicaid funding reduced, the survey finds (Kaiser Family Foundation release, 6/29). In addition, the survey finds that 56% of adults have had some interaction with Medicaid, either by being enrolled themselves or knowing a friend or family member who has received coverage through the program (AP/Long Island Newsday, 6/29). Seventy-eight percent of U.S. residents say they would enroll in Medicaid if they needed health coverage and were eligible, the survey finds (Kaiser Family Foundation release, 6/29).

State Budgets
More than one-third of U.S. adults believe Medicaid costs are a major contributor to state budget problems, according to the survey (Reuters, 6/29). However, 52% "strongly" oppose and 22% "somewhat" oppose reducing state Medicaid spending to balance state budgets. Only 5% "strongly" support and 17% "somewhat" support reducing Medicaid spending to balance state budgets (Kaiser Family Foundation release, 6/29). The response was "decidedly mixed" when respondents were asked how states should resolve their budget problems, the survey finds, the AP/Newsday reports. Twenty-four percent of adults say programs other than Medicaid should be cut, while 21% said Medicaid should be cut (AP/Long Island Newsday, 6/29). An additional 21% of adults believe their state should raise taxes, and 23% believe state budget problems should be addressed in another way, according to the survey.

Medicaid Finances Are a Concern
The survey also finds that 22% of U.S. adults believe Medicaid is in a financial crisis, 39% believe it is not in a financial crisis but has major problems and 27% believe it has only minor problems. A majority of respondents say each of the following are main reasons for Medicaid's financial problems: rising prescription drug costs and long-term care expenses, higher payments to providers, fraud and abuse, greater enrollment and poor management. Still, none of the proposals to address Medicaid's fiscal problems received support from a majority of the public, according to the survey (Kaiser Family Foundation release, 6/29). According to the survey, only about four in 10 adults say they favor stricter eligibility rules, lower Medicaid payments for prescription drugs, lower payments to providers, and higher copayments and deductibles (O'Rourke, Scripps Howard/Times Record, 6/28). In addition, about four in 10 favor reducing asset transfers (Kaiser Family Foundation release, 6/29). With respect to a proposal to allow states flexibility to determine Medicaid benefits, nearly six in 10 U.S. adults say all states should be required to offer the same set of core benefits to receive federal funding. In addition, more than 80% of the public believes the following benefits should be essential parts of Medicaid coverage: hospital stays, prescription drugs, medical equipment, mental health services, emergency department visits, nursing home care, physical therapy and doctor visits. Fewer than half of adults believe coverage for chiropractor visits and travel to and from the doctor is essential, according to the survey (CQ HealthBeat, 6/29).

Comments
"We expected Medicaid to be relatively unpopular with the public, much like welfare was," Mollyann Brodie, vice president and director of public opinion and media research for the Kaiser Family Foundation, said, adding, "But we find 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" (AP/Long Island Newsday, 6/29). Diane Rowland, Kaiser Family Foundation executive vice president and executive director of the Kaiser Commission on Medicaid and the Uninsured, said the survey "shows that Americans across the political spectrum value the role Medicaid plays in our health care system" (Scripps Howard/Times Record, 6/28). She added, "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."

Reaction
Sen. Max Baucus (D-Mont.) during a Senate Finance Committee hearing on Medicaid on Wednesday said the survey shows "we ought to be careful and look before we leap" (Bloomberg News, 6/29). A spokesperson for the National Governors Association said he is pleased with the survey respondents' views on the importance of Medicaid. However, he added, "Without some common-sense changes to the current program now and in the near future, Medicaid will not survive." CMS spokesperson Gary Carr added, "Medicaid is indeed important, and reforms that would give the states flexibility to cover more people at a lower cost will help maintain this vital program for years to come" (CQ HealthBeat, 6/29).


The survey is available online.