Washington, D.C., March 7, 2025 — As the U.S. Congress debates potential changes to Medicaid, a new survey from the Kaiser Family Foundation (KFF) reveals that the public largely opposes reducing funding for the program. The findings come amid ongoing discussions about how to balance the federal budget, with Medicaid potentially at the center of these discussions.
The KFF Health Tracking Poll, conducted in February 2025, shows that fewer than one in five Americans (17%) support a decrease in Medicaid funding. In contrast, a significant majority — 42% — believes funding should increase, while 40% think it should remain the same. The results indicate broad bipartisan opposition to cuts, with majorities of Democrats, Republicans, independents, and Trump voters all voicing support for either maintaining or increasing Medicaid funding. Notably, approximately one-third of Republicans favor a reduction in Medicaid spending.
Public’s Connection to Medicaid
The survey highlights that many Americans have a personal connection to Medicaid, which likely influences their stance on proposed cuts. About half (53%) of adults, including a similar share of those living in rural areas, report that they or a family member have benefited from Medicaid at some point. This includes about 44% of Republicans and 45% of Trump voters in the 2024 election.
Nearly all respondents (97%) say Medicaid is at least somewhat important for people in their local community, with three-quarters stating that it is “very important.” This sentiment is shared across partisan lines, including large majorities of rural residents and those who voted for President Trump. Furthermore, many Americans say Medicaid is important to their own families, including 40% of Republicans and Trump voters.
Impact of Medicaid Cuts on Rural Communities
The poll also sheds light on the potential consequences of cuts to Medicaid, especially in rural areas where healthcare access is already limited. According to the survey, 34% of rural residents report that there are not enough hospitals to serve their community, and nearly half (49%) say there are too few primary care providers. Rural residents also express a significant shortage of mental health providers (67%) and specialists (71%).
Medicaid plays a critical role in supporting healthcare services in these underserved areas, and cuts to federal funding could exacerbate existing challenges for rural hospitals and providers.
Support for Medicaid Reforms
While there is widespread opposition to Medicaid cuts, the public’s views on potential reforms are more mixed. Some of the proposals currently under discussion in Congress include implementing work requirements for Medicaid recipients and scaling back the Affordable Care Act (ACA)’s Medicaid expansion.
The poll found that a majority (62%) of adults support the idea of work requirements, which would mandate that nearly all adults on Medicaid either work or seek employment in order to maintain coverage. However, this support is not unwavering. When respondents were informed that most working-age adults on Medicaid are already employed, and that many could lose coverage due to the paperwork burden of proving eligibility, support for work requirements dropped sharply from 62% to just 32%. Furthermore, when respondents learned that implementing work requirements would increase state administrative costs, support dropped further to 40%.
Interestingly, when opponents of work requirements heard the argument that these measures could allow Medicaid to focus on vulnerable groups such as the elderly, people with disabilities, and low-income children, support increased from 62% to 77%.
Opposition to Eliminating ACA Medicaid Expansion Match Rate
Another contentious issue involves the proposal to eliminate the 90% federal match rate for Medicaid expansion under the ACA. The poll indicates that public opinion on this issue is also influenced by additional information. Support for this proposal drops significantly, from 40% to 24%, when respondents are informed that most states would be unable to compensate for the lost funding and that 20 million Americans could lose their health insurance.
Conversely, when opponents of the proposal are told that eliminating the match rate would reduce federal spending by $600 billion over ten years, support for the proposal increases slightly from 40% to 49%, though a majority (50%) of respondents still oppose it.
Public Confusion on Medicaid Coverage
The survey also reveals ongoing confusion among the public about who is covered by Medicaid. Nearly half (47%) of adults either are unsure or incorrectly believe that undocumented immigrants are eligible for Medicaid, despite the fact that they are not. Additionally, many Americans are unaware that Medicaid covers essential services such as nursing home care and other long-term care for low-income elderly and disabled individuals.
These misunderstandings are likely fueled by ongoing misinformation, including misleading claims about the program’s coverage of undocumented immigrants, which have been frequently touted by some politicians, including former President Trump and certain Republican lawmakers.
Conclusion
As Congress continues to grapple with Medicaid reform, the KFF Health Tracking Poll highlights the public’s overwhelming opposition to cuts in Medicaid funding and underscores the program’s importance in providing healthcare access to millions of Americans, particularly in rural communities. While some proposed reforms, such as work requirements and changes to the ACA expansion, receive mixed support, the survey suggests that any significant changes to the program will need to take into account public concerns about access, equity, and the potential impacts on vulnerable populations.
With federal and state budgets at stake, it’s clear that Medicaid remains a vital issue for policymakers — and one that continues to evoke strong opinions from voters across the political spectrum.
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