Paragon Institute: Survey Shows 81% of Voters Support Medicaid Work Requirements

The Paragon Institute recently published a survey focused on Americans’ attitudes regarding Medicaid reform. The survey found that Americans’ support for such reforms, like work requirements and moving one-half of Medicaid expansion recipients into the Obamacare exchanges, was high.

To read the Paragon Institute survey results in full, click here.

Lawmakers should take heed of these results. Medicaid reform should not be a scary topic – Americans support making this important program more efficient and tailored to those who need it.

This survey, including a representative group of 1,000 registered voters, was conducted by Public Opinion Strategies.

While Medicaid programs are, largely, designed and administered by states, the programs are primarily financed by federal taxpayers and must follow certain federal guidelines. In some states, the federal government covers nearly 80 percent of its costs.

Evidenced by this survey, Americans want to see this program reformed:

• 66% said Congress needs to “take a hard look at all federal health care programs to ensure taxpayer dollars are spent wisely,” weeding out waste, fraud, and abuse.
• 91% of voters say Congress should focus on eliminating waste, fraud, and abuse in federal health care programs.

Democrats, via the Affordable Care Act, expanded Medicaid eligibility to include any adult earning 138 percent of the federal poverty level (FPL) and below. Suddenly, in the 40 states (and DC) who have adopted Medicaid expansion, able-bodied adults of working age were eligible for a program designed to help the neediest among us.

As Nina Owcharenko Schaefer with the Heritage Foundation highlights, the enrollment of these able-bodied, working age recipients has rapidly outpaced enrollment of children, elderly people, and disabled people:

“Between 2013 and 2021, almost 20 million newly eligible able-bodied adults were added to Medicaid. During that same period, the number of children increased by 2.5 million, the number of elderly enrollees increased by 1.2 million, and the number of disabled enrollees declined by 400,000…This disproportionate increase in able-bodied adults suggests a serious misalignment of financial incentives—one that requires immediate correction.”

One proposal being considered for this year’s reconciliation bill is a requirement that able-bodied, adult recipients work a job, volunteer, or participate in educational activities for a certain number of hours per week.

According to the Paragon Institute’s survey, the support for work requirements is high:

“Do you support or oppose allowing states to implement a work requirement for able-bodied adult Medicaid recipients in their state?”

• TOTAL SUPPORT: 84%
  • Strongly support: 42%
  • Somewhat support: 42%
• TOTAL OPPOSE: 16%
  • Strongly oppose: 8%
  • Somewhat oppose: 8%

Do you support or oppose requiring able-bodied adult Medicaid recipients to work in order for them to continue receiving Medicaid benefits?

• TOTAL SUPPORT: 81%
  • Strongly support: 44%
  • Somewhat support: 37%
• TOTAL OPPOSE: 19%
  • Strongly oppose: 9%
  • Somewhat oppose: 10%

Further, 67% of voters agree with the following statement:

“Medicaid should be a temporary safety net, not a long-term entitlement for those who are able to work. Encouraging this population to work would improve their personal situation and help get them off Medicaid, saving money that could be directed toward those who need it most – children, seniors, and people with disabilities. Other public assistance programs like Food Stamps have work requirements and Medicaid should be no different.”

Another proposal in Congress is to move one-half of Medicaid expansion recipients (those earning over 100% of the FPL) into the Obamacare exchanges. This reform, too, is popular among voters:

“One proposal in Congress would move one-half of Medicaid expansion recipients into the Obamacare exchanges where they would have more choices for health insurance plans. The other half of Medicaid expansion recipients would remain in Medicaid, but states would receive the same funding for them as for all Medicaid recipients in their state. This policy would decrease federal spending, increase state spending, and move millions of people from Medicaid to private health insurance coverage with a generous subsidy to help pay their premium. It could increase the number of the uninsured if states decide not to keep the expansion. Do you support or oppose this proposal?”

• TOTAL SUPPORT: 68%
  • Strongly support: 13%
  • Somewhat support: 55%
• TOTAL OPPOSE: 32%
  • Strongly oppose: 8%
  • Somewhat oppose: 24%

For a long time, Medicaid reform has been treated as radically unpopular and politically “untouchable.” In reality, Americans are receptive to commonsense reforms designed to weed out waste, fraud, and abuse and ensure the program works for those who need it.