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Despite Republican Claims, Beneficiaries Don’t Think Medicaid Is Broken

To justify their proposals for sweeping cuts to Medicaid, Republican congressional leaders and Trump Administration officials frequently claim that it provides poor quality and access to care. But these claims are false, as a new study underscores. Medicaid beneficiaries are highly satisfied with their Medicaid coverage: in fact, Medicaid receives similar ratings to commercial coverage and Medicare.

A new survey asked nearly 300,000 Medicaid beneficiaries to rank their health care from 0 to 10, from the worst to the best care possible. Medicaid beneficiaries ranked their overall care at an average of 7.9 out of 10, and nearly half of those surveyed rated their coverage at a 9 or 10. Some 84 percent reported that they had access to all of their needed care in the past six months, and 83 percent reported having a usual source of care.

These results are similar to the most recent surveys of health care access and satisfaction for people with commercial coverage and Medicare, and much higher than those for people who are uninsured. The study is also consistent with prior survey research showing that Medicaid offers comparable access and quality of care to commercial plans and Medicare, as we’ve explained.

The study’s findings also undermine recent claims that the Affordable Care Act’s (ACA) Medicaid expansion has adversely affected people with disabilities and seniors with Medicaid coverage. Medicaid expansion critics have wrongly claimed that the expansion has worsened access to care for individuals with disabilities. Similarly, Centers for Medicare & Medicaid Services administrator Seema Verma recently wrote that Medicaid should be “refocused” on seniors and people with disabilities. But older Medicaid beneficiaries were likelier to rate their coverage highly than younger beneficiaries, the new survey findings show. Those dually eligible for Medicare and Medicaid — individuals who also tend to be the oldest and most frail and need the most services — were most likely to rate their coverage a 9 or 10. The study also found no statistical difference between Medicaid beneficiaries’ health coverage ratings in states that expanded Medicaid under the ACA and those that didn’t.

The study comes as the Senate is poised to consider the new version of the Republican bill to repeal the ACA, which, as we explained about the previous version, would effectively end the ACA’s Medicaid expansion and radically restructure Medicaid by converting its federal funding to a “per capita cap” that would grow more slowly than actual per beneficiary costs. As a result, the Senate bill would cut federal Medicaid funding by $772 billion over ten years and reduce enrollment by 15 million by 2026, relative to current law, the Congressional Budget Office estimates. Lawmakers should look to their constituents’ overwhelming satisfaction with Medicaid and reject sweeping cuts that would only undermine the program’s success.