A Polling Experiment on Public Opinion on the Future Expansion of Medicare and Medicaid

Considerable polling has been conducted to better understand public opinion around the US government’s role in providing access to healthcare. Findings from these polls indicate much of the public consistently supports the idea that the federal government has a responsibility to ensure access to care. In response, policymakers have recently proposed plans that would extend the role of the government in the provision of healthcare. Two of these policy proposals, Medicare For All (MFA) and Medicaid Buy-In (MBI), would extend two popular and largely federally financed programs, Medicare and Medicaid, respectively, with the stated aim to achieve universal health insurance coverage. 

In a new journal article published in the journal Health Services Research, HCI Associate Director Mahesh Karra and Emma Sandoe conducted a polling experiment to test how the framing of these proposals, specifically how the naming of the proposal as “Medicare For All” or “Medicaid Buy-In,” could drive constituents’ views around and reasons for opposition to both MFA and MBI. For the experiment, 5,051 US adults aged 18 and older were recruited to participate in an online poll conducted between September 12-26, 2018. Participants were randomized to receive one of four polls: (a) a poll measuring respondent approval for MFA, with the name of the proposal stated with a description; (b) a poll measuring approval for MFA, with only a description of the proposal; (c) a poll measuring approval for MBI, with the name stated with a description; or (d) a poll measuring approval for MBI, with only a description.

Main findings:

• The names “Medicare For All” and “Medicaid Buy‐In” increase approval by 3.4 and five percentage points, respectively. 
• Support varies by age, where MBI is most strongly supported by Millennials, while Baby Boomers and those older than 65 are more likely to support MFA. 
• Constituents are more likely to support a proposal when given the names of the proposal. 
• Approval is also higher for health policies framed as expansions of existing policies, rather than as new programs.

Overall, the results reinforce the findings of previous studies that highlight the relative favorability and increasingly positive opinion of both proposals among the American public. The results also reinforce prior hypotheses speculating that renaming programs within Medicaid, which may serve to destigmatize the program in general, would likely increase support and possibly even take-up by reducing program confusion.