Latest Tracking Poll Shows Little Support for Changing Medicaid

The latest tracking poll (May 2011) conducted by the Henry J. Kaiser Family Foundation found that overall there is little public support for cutting Medicaid spending or changing the program to a block grant to reduce the federal deficit. Only 13% of Americans say they would support major reductions in Medicaid spending to help reduce the deficit; only 3 in 10 say they would support minor reductions in the program. More than half (53%) say they want no reductions in Medicaid spending. By a nearly 2-to-1 margin, the public prefers the current Medicaid program to a system of block grants. After being informed of the current program and the proposed changes, 6 in 10 would prefer to “keep Medicaid as is, with the federal government guaranteeing coverage and setting minimum standards for benefits and eligibility,” while 35% would prefer to “change Medicaid so that the federal government gives states a fixed amount of money and each state decides who to cover and what services to pay for.” There are partisan differences in the public’s reaction to questions about Medicaid funding and block grants. Seven in 10 Democrats (69%) and 54% of independents want no reductions in Medicaid spending to reduce the deficit; 44% of Republicans would support minor reductions and 2 in 10 would support major reductions. When asked about block grants, 79% of Democrats want to “keep Medicaid as it is,”while 57% of Republicans favor the proposed change. Independents mirror the public overall, with 6 in 10 preferring the current Medicaid system and 36% wanting to change it to a block grant system. Support for keeping the program as it is may be due in part to the public’s personal connections to Medicaid as well as a strong sense of Medicaid’s importance. Fifty-one percent of Americans say they have some level of personal connection to Medicaid, either having received healthcare coverage, long-term care, or Medicare premium assistance, or having a friend or family member who has gotten this type of assistance. Nearly half (49%) of responders say Medicaid is “very” or “somewhat” important for them and their family. Healthcare Costs for Families Doubled over 10 Years The 2011 Milliman Medical Index, a measure of the total cost of healthcare for a typical family of 4 covered by a preferred provider organization, found that the rate of increase over 2010 was 7.3%, the lowest annual rate of increase in >10 years. However, the increase in total dollars is the highest in the history of the study. The total cost for 2011 is $19,303, an increase of $1319 over the 2010 amount. The healthcare costs to American families have doubled in <9 years, and represent a larger and larger portion of a family’s budget. Of the $1319 increase since 2010, employers incurred $641, while the remaining amount was the responsibility of the employees—$403 in payroll contributions and $275 in additional cost-sharing. According to a press release from Milliman, Inc, “employees are paying a larger share of the cost increase than their employers.” The press release added, “That said, in absolute dollars, both employers and employees have shouldered approximately the same amount of additional costs since 2006, with employers absorbing $3023 and employees absorbing $2988.” Emergency Departments Closing at Alarming Rate According to a study reported in the Journal of the American Medical Association, emergency departments (EDs) in urban and suburban areas have closed at “an alarming rate,” a New York Times article states. In 1990, there were 2446 hospitals with EDs in nonrural areas, a number that dropped to 1779 in 2009. During the same time period, the total number of visits to EDs nationwide increased by approximately 35%. Risk factors associated with the closing of EDs were serving larger numbers of the poor, being at commercially operated hospitals, being in hospitals with small profit margins, or operating in highly competitive markets, the study found. The Times article concluded by noting that conditions in EDs may be worsened and the expansion of Medicaid eligibility included in the healthcare reform law may increase the use of EDs. While EDs are required to provide treatment regardless of ability to pay. Sandra M. Schneider, MD, FACEP, president of the American College of Emergency Physicians, cautioned that, “People will have coverage, but there’s a concern that there will be nowhere for them to go.”