Four-fifths of low-income adults surveyed in three southern states favor health reform’s Medicaid expansion, a new Harvard School of Public Health study finds. The first quantitative analysis of potential enrollees’ views on Medicaid, the survey included residents of Kentucky (which has adopted the expansion), Texas (which hasn’t), and Arkansas (which has expanded under a waiver that allows it to enroll the expansion population in private marketplace coverage).
The survey was conducted in December 2013, during health reform’s first open enrollment period (and before implementation of the Medicaid expansion), to maximize the likelihood that respondents were familiar with the concepts in the survey.
Large majorities of respondents also said they believe that Medicaid’s quality of care, access to physicians, and affordability rival or outperform private coverage.
Roughly two of every three uninsured low-income adults surveyed in each state planned to apply either for Medicaid or subsidized marketplace coverage, the survey also found.
State policymakers should take into account this strong support for Medicaid among low-income adults as they debate whether to take up the expansion. Twenty-three states (including Texas) haven’t expanded Medicaid. In addition, Arkansas’ private-option expansion may not get the funding needed to continue, despite covering some 200,000 low-income Arkansans.
While the Harvard survey found that low-income adults value Medicaid highly and would enroll if eligible, it also found that many residents didn’t know whether their state has adopted the expansion. So, achieving the full benefits of the expansion will require not just convincing more states to adopt it but also making more low-income eligible adults aware of it so they enroll.