The GOP Attack on Medicaid: More Ammo for Dems?

| Fri May 27, 2011 9:14 AM EDT

Still giddy about their political victory in the special congressional election in upstate New York, Democrats have resolved to put the GOP plan to phase out Medicare at the heart of their 2012 election strategy. But they may have more to thank Rep. Paul Ryan for. Though the Medicare provision in Ryan's budget, which has been embraced by House and Senate Republicans, has dominated headlines, his plan to roll back Medicaid dramatically is another essential element of the GOP budget, and a new poll has found that Americans are loath to support this effort to gut Medicaid. As NPR's Julie Rovner explains:

This month's health tracking poll from the nonpartisan Kaiser Family Foundation finds that only 13 percent of those polled support major reductions in Medicaid spending as part of congressional efforts to reduce the deficit. At the same time, 60 percent want to keep Medicaid as it is…

Perhaps even more striking, although maybe it shouldn't be given how much Medicaid has grown in recent years, is that more than half of respondents said they had a personal connection to the Medicaid program. That was defined as the respondent or a friend or family member having received assistance from the program at some point.

Medicaid has often been characterized as a program for the very poor, yet the economic downturn has put a record number of Americans into the program. What's more, senior citizens also receive a big proportion of Medicaid dollars through nursing homes, as even middle-class Americans have resorted to the program as their savings have run out. Medicaid is serving a larger and more diverse group of Americans than before, making the GOP proposal to eviscerate the program all the more unpopular—and politically dangerous for the Republicans.

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But the Dems may not be positioned to unleash a full-fledged offensive against the Rs on Medicaid. While Democratic opposition to the Ryan plan for Medicare has been nearly unanimous, there's more of a split within the party concerning Medicaid, which state governments have to pay for as well. Squeezed by state budget crises, some Democratic officials have joined Republicans in pushing the Obama administration to give states greater leeway to reduce benefits and cut down the Medicaid rolls. 

Though most Dems oppose the Ryan plan for Medicaid—which would radically reduce the amount of money in the program—they're more inclined to support some reductions to the program. Consequently, Democratic-supported cutbacks to Medicaid are still possible, and this could undermine the Democrats' ability to use the draconian GOP Medicaid rollback against the Republicans. Still, when Gene Sperling, the director of the White House national economic council, appeared at a conference on fiscal issues this week in Washington, he made it a point to note that the Republican budget's Medicaid "reform" was perhaps even more severe than its Medicare provision. He emphasized the fact that much of Medicaid covers nursing home patients. It was perhaps the clearest sign yet that the White House sees an opening.

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