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Republican Voters Support Medicaid but Want Work Requirements, Poll Finds

Last updated: March 7, 2025 5:03 am
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Republican Voters Support Medicaid but Want Work Requirements, Poll Finds
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As Congressional Republicans weigh major cuts to Medicaid, most voters do not want to see the public health plan’s funding dialed back, according to a poll released Friday by KFF, a nonpartisan health research firm.

Just 17 percent of respondents said they supported cuts to Medicaid, the government health insurance program that covers more than 70 million people. Forty percent said they wanted to keep spending unchanged, and 42 percent said they would like it increased.

But at the same time, the poll found significant support for certain policies that would limit the program, such as requiring enrollees to work. More than 60 percent of voters — and 47 percent of Democrats — supported a work requirement, the poll found.

That change, which has been championed by some congressional Republicans, is estimated to cut about $100 billion from Medicaid, as those who were unemployed — or could not file the paperwork showing they had a job — would no longer be covered. The program’s cost was $584 billion in 2024, or about 8 percent of total federal spending.

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The poll also illustrated Medicaid’s wide reach, with just over half of respondents saying that either they or a family member had at one point had Medicaid coverage. There was nearly universal agreement that Medicaid mattered to voters’ local communities, with 98 percent of Democrats and 94 percent of Republicans saying they thought it was somewhat or very important.

Republicans in Congress are considering several changes to Medicaid as they look for ways to pay for President Trump’s tax cuts. Last month, the House passed a budget that, if approved by the Senate and signed by the president, could trim as much as $880 billion from the program over the next decade. That could happen with work requirements, caps on federal spending for the program, or reducing the share of costs the federal government pays.

Although poll respondents were generally in favor of work requirements, they held misconceptions about the policy: Sixty-two percent of voters thought that most Medicaid enrollees are unemployed, when in fact a vast majority have jobs.

Republican voters also expressed an openness to cutting funding for the Affordable Care Act Medicaid expansion. Right now, the federal government pays 90 percent of the costs for participants in the expansion, who tend to be healthy adults. That is a higher share than what it covers for other enrollees, such as children or disabled people.

Sixty-four percent of Republican voters — and 40 percent of voters overall — said they would support reducing the federal government’s contribution to Medicaid expansion. House Republicans continue to weigh this option, even though Speaker Mike Johnson said last week it was not on the table.

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Voters’ opinions on reducing Medicaid expansion funding seemed malleable, however, in the face of additional information.

When respondents were given more information about the policy, including the fact that millions could lose coverage, Republican support fell to 43 percent. But being told that the change would cut federal spending by about $600 billion increased support to 73 percent.

The polling looks similar to what Americans felt during the Affordable Care Act repeal debate in 2017, when Republicans failed to roll back the law in large part because of political opposition to Medicaid cuts. Back then, 70 percent of voters supported work requirements and 36 percent favored cutting Medicaid expansion funding.

“Medicaid is a very popular program among a wide swath of the public including Republicans,” said Mollyann Brodie, KFF’s executive director of survey research.

But, she added, “opinions could be quickly moved in the context of debate where people learn more information and feel their coverage is threatened.”

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