US Public Support for Medicaid
Prominent among the things that the out of touch elite knows about regular Americans in, say Kansas where something is the matter, is that those people oppose means tested programs almost as much as they support Social Security old age and survivor benefits and Medicare.
(Another used to be that the didn’t support higher taxes on high income people. One of my angrybear obsessions was noting the solid to overwhelming majorities in all polls dating back to 1992 who have told Gallup that “upper income people” pay less than their fair share of taxes (search for Gallup here). For roughly a decade, I have been a voice crying out in a crowded room as the fact has become too obvious to deny.)
Now Kate Zernike & Abby Goodnough at the New York Times have noted the overwhelming support for means tested Medicaid (both the ACA expansion and legacy Medicaid).
update: I should write that I think the article is excellent. I object to one clause in the article.
End update:
But even when reporting the fact, they repeat the old falsehood asserting “The shift in mood also reflects a strong increase in support for Medicaid, ”
Now the mood certainly includes overwhelming support for Medicaid. The claim that this is an increase from previous lower levels is not supported by evidence presented in the article. There is the problem that, in plain English, high and increased are used as synonyms (that is people are generally innumerate about levels and changes). But, I think, it is also true that a plain fact clearly demonstrated in poll after poll has been denied by members of the out of touch elite. Here I think highly educated urban liberals assume most of our countrymen are savage reactionaries. Also political reporters talk to Republican operatives a lot and Republican operatives both live in the conservabubble and lie shamelessly.
In any case, US public support for Medicaid has been overwhelming for many years (always click and search for Medicaid)
In 2012 the fraction who found Medicaid cuts acceptable was a Kung Fu Monkey + 1 28%
“In order to strike a budget deal that avoids the so-called fiscal cliff, would you accept cutting spending on Medicaid, which is the government health insurance program for the poor, or is this something you would find unacceptable?” 12/13-16/12
Accept 28%
Unacceptable 68 %
Unsure 3%
On the stronger position “favor” not just “accept” Bloomberg found that cuts to Medicaid crushed the Kung Fu Monkey Crazification limit
“Cut Medicaid, which is government help for medical care for low-income people”
12/7-10/12
Favor 22 %
Oppose 74 %
unsure 4 %
McClatchy Marist found an almost Kung Fu Monkey crazy 26% in favor
“Cut spending for Medicaid”
12/4-6/12
Favor 26
Oppose 70
Unsure 4
With middle choice cut some but not a lot United Technologies got 35% support.
All these polls address the fiscal cliff. They were taken roughly four and one half years ago. They show support for cutting Medicaid very similar to support for the AHCA and BCRA in recent polls.
Back when the ACA passed, support for Medicaid expansion wasn’t as overwhelming as opposition to Medicaid cuts (it was a polarized debate and it is true that it is easier to refrain from giving than to take back once given). Still there was always at least plurality support for Medicaid expansion (even in the context of Medicare cuts).
23% support for Medicaid cuts (34% for increases when discussed in the context of the budget).
In particular, the pattern makes it very cleat that hatred of “welfare” isn’t hatred of welfare as defined by economists. I don’t know of much polling, but I certainly don’t know of much public opposition to disability pensions.
There has been overwhelming opposition to Medicaid cuts for many years. Public support for Medicaid is slighly lower than public support for Medicare, but basically feelings about the two programs are similar. This fact doesn’t fit the narrative, so the fact was surpressed.
The hatred of “welfare” is based on racism and not on any particular program or belief about incentives or anything else. In context “welfare” means “Money for black people”. The pattern in public opinion polling makes this almost undeniable.
I’m going to try to avoid discussing the implications for the argument that social insurance is politically feasible while redistribution isn’t. I can’t help noting that I consider this hypothesis to have been rejected by the data.
Robert:
Well I guess I am one of those out of touch elites because that overwhelming support for Medicaid you talk about in the general public did not play over into state legislatures. My own state senator Joseph Hune stated “I am sick to my stomach” with the expansion of Medicaid and the ACA. In most states being eligible for Medicaid meant having income less than 100% FPL.
How will the Medicaid Expansion for Adults Impact Eligibility and Coverage? Key Findings in Brief
In Michigan it did not matter the state voted Dem in National elections and mostly had Dem Senators in Congress. When it came right down to it, the governorship was mostly Repub since 1990, the Senate was Repub since 1990, the House was split between Dem or Repub control over the same time period, and the redistricting was controlled by Repubs since 1990 sending more Repubs to the Congressional House than Dems even though Michigan went Dem in national elections.
As this 2012 Kaiser brief discusses, 2/3rds of states or 33 states limited Medicaid Eligibility to <100% FPL. Most non-disabled single adults were excluded from Medicaid, regardless of their income, unless a state obtained a waiver to cover them and even then they had to be working to be eligible for Medicaid.
Maybe somewhere in the hearts and minds of people there was a thread of sympathy and decency for the poor; but, it damn sure did not show up in Michigan mostly with its black citizens and white citizens also. The ones who I believe you are referring to took the state tax cuts on the backs of those making <138% FPL. Hell, they did not have to fund Medicaid, they knew it, and as Kellyanne Conway said "they could always get a job with healthcare benefits.
Waldmann
there is so much i agree with you about that i hate to be grumpy. but your logic is based on “sounds like” therefore “is the same as.”
also, you don’t seem to understand the difference between “people like welfare” and “the people with political power don’t like welfare.”
the trouble, for me, is that the people with political power are no smarter than those without, so most of them apparently believe that Social Security IS welfare. Since the is almost universally believed I am not convinced that my insisting that it is not and it needs to remain not in order to prevent it from being turned into welfare as we knew it and quietly strangled where no one can see.
another problem, for you, is that people asked questions by pollsters are put into a mental space where they give one sort of answer. but get them in another mental space and they despise “welfare” (quite possibly thinking “welfare queens,” but also thinking about their lazy brother in law, and most especially, for me, basing their self respect on the fact that they are not “on welfare.”
we are probably talking at cross purposes because i am thinking of people i know who should know better who think a “little bit” of “tax the rich” won’t hurt Social Security, even after they wrote a book explaining why Roosevelt worked so hard to make Social Security “worker paid” and not “the dole.”
and I wouldn’t take those elite liberals very seriously. they like words, but they rarely actually think about them.
Coberly: Odd I agree with you more than you do. I think very few people think that social security pensions are welfare. The distinctioni between pensions and welfare is very very important politically. I think the true 3rd rail is the argument that OASDI & TANF are fundamentally two aspects of welfare.
My claim is that it is no longer necessary to disguise programs as social insurance. I think it is clear that the key is the age and race of recipients. This is just my reading of the polls.
run yes yes yes. There is a huge gap between public opinion and the opinions of those who should represent the public. Legislators hate hate hate entitlements. They hate the fact that so many dollars go to programs they can’t control. Normal people like programs which guarantee them something for life. The legislators desire to have dollars at their disposition clashes with the publics desire to have a right to those dollars.
In any case, my point, if any, is there is a huge gap between public opinion and politician’s opinion. Part of this is Democrats who just can’t face the fact that the public agrees with them and they don’t have to disguise themselves as moderate Republicans.
FDR made compromises which were necessary then. I think that the support for Medicaid and Medicare plans B and D show that they are no longer necessary.
Oh also in 2009 Medicaid was very very stingy in some states (the usual suspects) with basically no Medicaid for adults without children and Medicaid only for super poor parents. Medicaid was completely different in different states and totally utterly inadequate in, for example, Alabama. I will now google.
You will see that great care has been taken to reserve Medicaid for children and elderly people. Able bodied non elderly adults without children are shit ouf of luck. Parents get it if they are “the poorest of the poor” (that’s official text) based on the 1931 social security act not the Medicaid act. People who live in first world countries (including say California and New York) can’t imagine Alabama.
the official text
Medicaid Eligibility Groups in Alabama
Medicaid benefits eligibility depends on which mandatory eligibility groups the recipient falls into. The Alabama Medicaid Agency focuses on the categorically needy by assessing individual circumstances to make an application decision. Let’s take a look at the typical Medicaid benefits eligibility groups and what they entail:
• Former Foster Care Children – For a child to fall under these Medicaid eligibility requirements, he or she must have aged out of Alabama’s foster care system.
• SSI-Related – A disabled adult, widow/widower and mothers of SSI children will be categorized as SSI-related.
• Medicare-Related – Specified low income Medicare beneficiaries, as well as qualifying income individuals and qualified disabled working individuals, will be in this eligibility group.
• Parents and other Caretakers Relatives – The poorest of the poor families will be covered under Section 1931 of the Social Security Act.
• Pregnant Women, Children and Plan First – Plan First at 146% Federal Poverty Level and children aged 0-18.
• Optional Federal Categories – Optional services provided under the Home and Community Based Waivers program are designed to provide Alabama agencies with cost savings. They include Breast and Cervical Cancer Program, HIV/AIDS waiver, Technology Assisted waiver for Adults, and Persons with Intellectual Disabilities waiver.
• Other – Title IV-E covers adoption and foster care. AL optionally covers certain children up to age 21, but does not cover TB infected individuals.
Robert:
With trepidation, I wrote my comment as I was afraid I would piss you off. I have fought these bastards in Michigan rebutting their false arguments. You are going to force me to post two charts which detail much of what you said about income requirements before Medicaid could be given in the past. They are in the link I provided.
All this continuous nonsense (argument without end) just to have a for-profit skimming excuse for healthcare and, for some, retirement income. Lazy-ax shareholders should get off derrieres and get a job. Lusters after other people’s health and food don’t deserve citizenship.
Anna Lee
I had decided to stop arguing. But I can’t tell what your point is. Who is lusting?
As far as I can tell we got Obamacare because the insurance companies didn’t want to die. That is understandable. I think the “mandate” could have been handled better, and I think a Medicare for all solution is best as long as 1) the workers pay for it (flat tax with a cap) and 2) the government does an honest job of controlling costs.
I think (not sure) Waldmann disagrees with me because he thinks “government pays” (welfare) is “popular.”
He may not see that as “lusting after” someone else’s money. But I think both of us see the current situation is “the rich providers” lusting after the workers money which they can get with “your money or your life” pricing.
Coberly, You might be right but searching for greater quarter over quarter profits off people’s life and welfare looks like lusting for worker’s money from where I sit.
Anna:
The name is familiar to me. If you are discussing healthcare industrial complex, yes you are correct. If you are discussing healthcare insurance, it is a sideshow in minimizing the cost of healthcare. Bigger fish to fry in the healthcare industrial complex and we should not get sidetracked for another couple of years chasing something smaller.
AnnaLee
I certainly agree with you about that.
Cob, you need to think a lot before you agree with her.
Just like you should think before you say:
“As far as I can tell we got Obamacare because the insurance companies didn’t want to die.”
Which ignores who is responsible for insurance companies still being alive.
EMichael
it would help if you told me what you are talking about.
In a written statement after the vote, Obama hailed the House bill as one that would “make real the promise of quality affordable health care for the American people.”
But Republicans were equally sweeping in their condemnation of the bill. “This is perhaps the worst bill I have seen come to the floor in my 11 years in Congress,” said Wisconsin Rep. Paul Ryan.
The bill includes fundamental changes to the American health care system – creating a public health insurance option to compete with private insurers and for the first time, requiring employers to offer health insurance.
http://www.politico.com/story/2009/11/house-passes-historic-health-bill-029282
EMichael
well, i have to say i don’t see your point.
but as a shot in the dark: i said we got Obamacare because the insurance companies didn’t want to die. I meant that we got Obamacare as maintaining the present insurance structure with the addition that insurance companies would be required to take some customers they didn’t want, but the government would pay for them, by adding a new tax called a “mandate” and (i think) raising some taxes on “the rich.” this was instead of a single payer or ‘medicare for all” solution to the “health care (insurance) problem.
the latter solution(s) would have eliminated the need for insurance companies. “No solution” that is no change at all in the then-present business of health insurance would have led to the demise of insurance companies from costs too high for people to pay and too many “rejected claims” and “cancelled policies” or “denied policies” for people to put up with. all these choices would have lead to the “death of insurance companies.” So Obamacare, or Romneycare as it was called in Massachusetts where it was introduced under governor Romney (have I got that right?) was the choice of the insurance industry.
The Republicans knew it would be unpopular because of the “mandate” and the higher taxes, but they could pretend to be against it to throw the blame against the democrats and win elections. This had nothing to do with whether they thought Obamacare was a bad policy.
Not sure if this is correct, but maybe at least we know what we are talking about.
As for AnnaLee: I agreed with her that “searching for higher profits” by gouging the people in a “your money or your life” “free enterprise” model was “lusting for the workers money.” I can’t see where “thinking more” would have changed my opinion about that, or even where any sane person would disagree with that.
your last comment doesn’t even address any of this, but seems to be a recital of the political statements of the political parties, or perhaps your own view that Obamacare represented “a fundamental change.” I never disputed that. I never even addressed whether or not I thought it was a good change or a bad change., So I still don’t know what you were talkng about.
C’mon Cob.
We got Obamacare because not one Republican would even allow the public option to come to a vote.
This is ten time easier than SS, yet somehow you flounder around.