Republicans worry Medicaid cuts would hurt their communities, poll finds

Washington Post

14 hours ago

More than 4 in 10 Republicans worried significant cuts to Medicaid would hurt health-care providers in their communities and lead to people losing insurance, according to a KFF poll released Friday.
The findings illustrate the political perils of upending the public health insurance program as Senate Republicans feud over Medicaid cuts. As they face pressure to slash spending to finance President Donald Trump's sweeping tax and immigration legislation, they risk alienating their own supporters who depend on the program.
While most Medicaid enrollees identified as Democrats or independents, 27 percent said they are Republican, including 19 percent who identified as supporters of Trump's Make America Great Again movement.
About 3 in 4 GOP Medicaid recipients were worried federal cuts to the program would hurt their ability to receive and pay for health care for themselves and their families, the poll found.
Those concerns are not limited to people enrolled in the program. Nearly a third of all Republicans and 26 percent of MAGA Republicans had the same worries about their own access to health care if Medicaid is cut, the survey showed.
While Democrats and independents were far more likely to express concerns, the level of worry among Republicans reflects Medicaid's appeal across party lines.
'Medicaid is really a popular program, and a large majority of Americans do not want to see decreases in spending,' said Liz Hamel, director of public opinion and survey research at KFF, a health policy research organization. 'These findings reflect that many people, whether or not they rely on Medicaid, see it as vital to their communities.'
Medicaid is the nation's largest public health insurer, serving poor families, people with disabilities and nursing home residents, among others. It covers around one in five Americans, many of them in states and districts represented by GOP lawmakers. It also provides a crucial line of revenue for health-care providers such as rural hospitals.
Half of rural adults, including 37 percent of rural Republicans, were worried the cuts could affect their access to care, the poll found. They were even more worried about health care in their communities. Almost every Democrat and half of Republicans in rural areas worried Medicaid cuts would negatively impact their local hospitals, nursing homes and other providers.
Edwin Park, a health policy researcher at Georgetown University's McCourt School of Public Policy, said those findings about rural concerns are not surprising.
'We've done research showing that both children and non-elderly adults in rural communities disproportionately rely on Medicaid,' he said. 'And these are areas that tend to vote Republican and supported President Trump.'
The poll was conducted May 5 through May 26 and included 2,539 U.S. adults and had a margin of error of plus or minus 3 percentage points. The margin was slightly higher for findings about Republicans.
Senate Republicans wrestled this week over how deeply to cut Medicaid as they strive to pass their own version of a bill to extend Trump's tax cuts and reduce other spending by Independence Day.
The version passed by the House achieves nearly $800 billion in savings, primarily by requiring childless adults with low incomes to prove they are working, limiting a tax used by states to receive increased federal Medicaid funds and canceling new regulations proposed by the Biden administration to streamline enrollment.
About 7.8 million fewer people would be insured within a decade because of Medicaid changes in the House legislation, according to projections from the nonpartisan Congressional Budget Office.
The Senate aims to revise the House legislation, but Republicans are engaged in hot debate over whether to contract or expand the Medicaid cuts.
Senate Republicans, who hold a slim majority, can afford to lose only three of their members if all Democrats oppose the bill as expected. They're already likely to lose the vote of Sen. Rand Paul (R-Kentucky), who has raised concerns about the cost of a bill the CBO estimates would add $3 trillion to the national debt.
Most Republican senators are on board with adding work requirements to Medicaid, a measure polling has found most Americans favor. That includes senators who have expressed the most concern about Medicaid cuts, such as Sen. Josh Hawley (R-Missouri) and Susan Collins (R-Maine).
But there is growing concern around another provision in the House bill aimed at limiting the taxes states impose on hospitals and other Medicaid providers as backdoor way of increasing federal Medicaid payments. States pass the tax back to providers in the form of higher Medicaid payments, which are then partially matched by the federal government.
'I'm concerned about the impact on rural hospitals and how it all would work with a provider tax,' Collins told The Post this week. Hawley said 'it would hurt rural hospitals in my state.'
Sen. Jim Justice (R-West Virginia), whose state has one of the highest Medicaid populations in the country, worried this week about letting provider taxes 'get undermined,' according to Punchbowl News.
And in an April floor speech, Sen. Jerry Moran (R-Kansas) said he's focused on making sure 'the hospitals have the capability and the revenues necessary to provide the services the community needs — Medicaid is a component of that.'
Other Republican senators this week defended cuts to Medicaid, arguing the program would still be available to those most in need. Sen. Joni Ernst (R-Iowa) sparked an uproar last week after she flippantly replied 'Well, we all are going to die' to a town hall attendee who shouted people would die if they lose Medicaid coverage.