Congressional Republicans keep dodging questions about cuts to Medicaid, the federal-state entitlement that covers nearly 80 million people. But they should not be shy about their plans to reform the entitlement. New polling shows that many of the GOP’s ideas for Medicaid aren’t just smart policy. They’re popular.
A survey of registered voters conducted by Public Opinion Strategies for the Paragon Health Institute last month indicates that people broadly want to pare back federal healthcare spending while preserving coverage for the most vulnerable.
Nearly two-thirds of voters agreed that “the government has a responsibility to taxpayers as well as legitimate Medicaid recipients to ensure that only those who are eligible can enroll in Medicaid, even if that means some Americans are left without health insurance coverage.”
Republicans can act in accordance with that polling by championing frequent eligibility checks as part of their fight against waste, fraud, and abuse in Medicaid.
Or consider voters’ opinions on the discrimination embedded in Medicaid’s funding formula. The federal government covers a smaller share of the cost of coverage for the program’s original beneficiaries — the destitute, disabled, children, and pregnant women — than for able-bodied adults who received coverage via Obamacare.
Nearly two-thirds of voters believe that’s wrong. Just 36% of voters said that “Medicaid should cover as many people as possible, even if that makes accessing care harder for those Medicaid was meant to serve — pregnant women, children, the disabled, and the elderly.”
Those are arguments for reducing the federal matching rate for expansion enrollees to match that for legacy enrollees.
Work requirements, another GOP-suggested reform, are even more popular. More than eight in 10 supported “allowing states to implement a work requirement for able-bodied adult Medicaid recipients in their state,” and over half backed a federal work requirement.
REPUBLICAN HOUSE PANEL CHAIRMAN OPPOSES MEDICAID CUTS BUT SAYS IT HAS ‘INEFFICIENCIES’
Still, some lawmakers haven’t gotten the message. As Sen. Josh Hawley (R-MO) recently said, “Beyond work requirements, if it’s something that results in reductions in [Medicaid] benefits to folks who depend on it and who are qualified and are working, I’m not going to vote for that.”
Hawley should check out Paragon’s polling data. When people hear the truth about progressive health policies, they demand commonsense reforms. It’s time for Republicans to deliver on their promise to preserve Medicaid for those who truly need it.
Sally C. Pipes is president, CEO, and Thomas W. Smith fellow in healthcare policy at the Pacific Research Institute. Her latest book is The World’s Medicine Chest: How America Achieved Pharmaceutical Supremacy — and How to Keep It (Encounter 2025). Follow her on X @sallypipes.