The majority of the public—and a vast majority of program beneficiaries—view the Medicare and Medicaid programs positively, according to a report by the Kaiser Family Foundation, and prefer the status quo over major changes to the programs that would dramatically alter the way beneficiaries are served. Despite the aversion to change, more than half of the survey’s respondents say that changes are needed to keep the Medicare program sustainable.
Medicare and Medicaid were created on July 30, 1965 by President Lyndon Johnson with the goal of providing health insurance coverage for the low-income, disabled, and elderly. Medicare, which provides coverage for Americans 65 and older regardless of income and those under 65 with permanent disabilities, and Medicaid, which provides coverage for medical care and long-term services to low-income individuals and is one of the primary ways coverage was expanded under the Patient Protection and Affordable Care Act (ACA) (P.L. 111-148), cover a total of 111 million Americans at an estimated cost of $1,035 billion in 2015.
A large majority (77 percent) responded that Medicare is a very important government program, ranking similarly to federal aid to public schools (75 percent) and defense and the military (73 percent), but lower than Social Security (83 percent). Sixty percent of respondents said Medicare is working well for most seniors, with those who are covered by the program more likely to say so (75 percent for Medicare), and 91 percent of those currently covered reported positive experiences.
Seventy percent of respondents said that Medicare should continue to provide all seniors with the same defined set of benefits, and 26 percent said the program should guarantee each senior premium support, a fixed contribution to the cost of health insurance. However, 54 percent believe that Medicare will not be able to offer the same level of benefits to future enrollees, and 68 percent believe that changes are needed to keep Medicare sustainable.
According to the survey’s responses, the potential change to Medicare that would be most popular is allowing the federal government to negotiate with drug companies. Other popular changes are increasing Medicare premiums for wealthy seniors and reducing payments to Medicare Advantage Plans. Changes such as raising the age of eligibility from 65 to 67, raising premiums for all Medicare beneficiaries, and increasing cost-sharing for future Medicare beneficiaries were not as popular.
Sixty-three percent of respondents said that Medicaid is very important, ranking similarly to loans for college students (64 percent). Half of the survey’s respondents said that Medicaid is working well for most low-income people covered by the program, with 65 percent of those covered by Medicaid responding that it is working well. A large majority (86 percent) of those covered by Medicaid reported positive experiences. The public largely opposes changes to Medicaid that would change the program into a block grant to states, with 62 percent opposed.