Academic journal article Generations

Medicare as Reflected in Public Opinion

Academic journal article Generations

Medicare as Reflected in Public Opinion

Article excerpt

In the fifty years since Medicare's passage, the public has been polled frequently on their opinions of the program and potential changes to it. A search of the Roper Center for Public Opinion Research archives reveals more than 6,000 individual survey questions about Medicare, asked since 1962 by academic, commercial, nonprofit, and media pollsters. Three key themes emerge: Medicare is a popular program; the public is concerned about Medicare's financial future; and, despite this concern, the public is resistant to most proposed changes, particularly to those that involve scaling back benefits.

Medicare's Popularity

Before delving into public opinion on Medicare today, it's helpful to examine the historical context of opinion before the program was launched. In the 1940s, there was widespread support for the idea of expanding Social Security to include paying for medical care for the nation's older adults. Surveys conducted in 1944 and 1945 showed that about two-thirds of the public were in favor of such a plan, and a majority supported it, even if it meant increasing taxes (Hamel, Deane, and Brodie, 2011).

The idea remained popular in the years leading up to Medicare's enactment; in 1961 about two-thirds of the public favored "having the Social Security tax increased in order to pay for old age medical insurance." About a year before its passage, when asked specifically about Congress's plans regarding Medicare, six in ten Americans said they approved. And, in 1965, a few months after Medicare was signed into law, a survey showed that about eight in ten Americans approved of the bill passed by Congress (Hamel, Deane, and Brodie, 2011).

Medicare's popularity has continued since its launch. Such reliably positive public opinion likely is due to its nearly universal impact; most Americans either are enrolled in the program themselves, know someone in their family who is enrolled, or will enroll at some point in their lives. Evidence of Medicare's popularity abounds in surveys. Since 1996, roughly seven in ten Americans have expressed a favorable view of the program (Hamel, Deane, and Brodie, 2011; Harvard School of Public Health, 2013). About three-quarters describe the program as important for themselves and their family, and nearly all say it is important to the country as a whole (Kaiser Family Foundation, 2009, 2014a).

As another measure of the program's popularity, in the years leading up to the passage of the Affordable Care Act (ACA), when the public was asked about different ways to expand health insurance coverage to the uninsured, expanding Medicare was among the most popular options. Surveys conducted between 1999 and 2009 showed consistent majorities, ranging from about six to eight in ten, saying they favored expanding Medicare to cover people between the ages of 55 and 64 as a way to cover more uninsured (Hamel, Deane, and Brodie, 2011).

Across most measures of Medicare's popularity, older adults express even more positive opinions than younger adults. Still, those younger than age 65 also place a lot of value on the program, with majorities saying they have a favorable opinion of Medicare and that it's important for their families. And while Medicare is popular across partisan groups, there are some differences in the intensity of that sentiment that are consistent with partisan differences on government programs in general. For example, Democrats are more likely than Republicans or Independents to say they have a "very" favorable impression of Medicare and that the program is "very" important for them and their families (see Figure 1, below).

In addition to thinking Medicare is important, a majority of Americans (including about eight in ten older adults) think it works well (Kaiser Family Foundation, 2012). This sense that Medicare is working well is borne out in surveys examining the experiences of people enrolled in the program. Compared with adults younger than age 65 with private health insurance, older adults enrolled in Medicare are more likely to rate their health insurance as "excellent," and more likely to say they are very satisfied with their insurance deductibles, co-pays, and choice of providers (Kaiser Family Foundation, 2014b). …

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