Jun 21, 2017

Republicans see Medicaid as welfare. Most Americans don't

Republicans want to roll back the Medicaid expansion, cap federal Medicaid spending increases, and add work requirements, drug testing, time limits, copays and premiums to some state Medicaid programs. But almost no one else wants to do these things. One poll finding goes a long way toward explaining why: Republicans view Medicaid as a form of welfare, and pretty much everyone else views it as a government insurance program.

Data: Kaiser Family Foundation Health Tracking Poll, May 16-22, 2017; Chart: Andrew Witherspoon / Axios

Why it matters: Welfare remains unpopular in our country; it's always popular to limit or cut "welfare". Whether it should be, and what this says about us, is a different question.

What the poll found: As the chart shows, Democrats (73%) and independents (62%) view Medicaid as an insurance program similar to others that help people pay for health care. But a slight majority of Republicans (52%), see it as more similar to welfare programs like food stamps.

Between the lines: One reason Medicaid limits are no slam dunk for Republicans in the Senate may be that not all Republicans view it as welfare: 46% see it as insurance, just as most Democrats and Independents do. Republicans who are more moderate are worried about the practical effects on citizens and states of rolling back the expansion or cutting federal Medicaid spending. One assumes they wouldn't worry as much unless they viewed Medicaid as valuable health insurance coverage.

Perceptions of Medicaid as welfare don't seem bothered much by facts, such as, for example, that two thirds of Medicaid spending goes for the low income elderly and disabled who don't fit the Ronald Reagan era image of the welfare king or queen. But it's not the majority view in any case. A little less than a third of voters identify as Republicans today, and about half of them see Medicaid as welfare.

It's this group and their perceptions of the program, and elected officials who share their views, that seem to be driving debate about Medicaid today.

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