Medicaid, Medicare in the middle as Utah Sen. Orrin Hatch, Rep. Jason Chaffetz back Rep. Paul Ryan's budget proposal

Published: Tuesday, April 5 2011 11:21 a.m. MDT

There may be a pretty significant disconnect between public opinion and that of elected officials over the importance of the federal Medicaid program, which is the nation's main health insurance for people who are very poor or disabled. The question is how it will all play out as Democrats and Republics tussle over the federal budget.

A public opinion poll by the Henry J. Kaiser Family Foundation found that while Washington debates balancing its budget in part by making major spending reductions in the Medicaid program, only 13 percent of the public would favor major reductions, although 39 percent would support minor reductions.

Just under half don't want to see any cuts at all.

The same poll asked for opinions on cuts to Social Security and Medicare (the nation's health insurance for the elderly). It found that 8 percent would favor major reductions to both programs, while 27 percent would be okay with minor cuts to Social Security and 35 percent would approve of minor cuts to Medicare. But 64 percent want Social Security and 56 percent want Medicare left alone.

Meanwhile, Rep. Paul Ryan (R-Wisc.), House Budget Committee chairman, on Tuesday rolled out a 2012 federal budget proposal that would "dramatically transform" both Medicare and Medicaid, according to a CBS News report. He calls it the "Path to Prosperity," and you can also find an overview featuring Ryan on YouTube.

To slash $6 trillion from the budget over the next 10 years, CBS says Ryan would change Medicaid from a government-run insurance program to a system of block grants that the states would get and assign out. Medicare, it says, would "essentially turn into a premium support program." It would be a voucher system with funds going to the insurer, which would be given a certain amount of money to cover seniors. That change, under the plan, would take place in 2022.

Utah's Sen. Orrin Hatch issued a statement regarding the Republican effort. In a release to media on Tuesday, he wrote, "In February, we saw the White House's response: a budget that taxes, borrows and spends too much — demonstrating a complete failure of leadership to confront our spending-fueled debt crisis. In contrast, Paul Ryan has put serious ideas on the table to reform Medicare and Medicaid, streamline our tax code, cut spending and confront our debt. He rightly includes a proposal to kick Fannie Mae and Freddie Mac off the government dole, fully repeal the budget-busting $2.6 trillion health law and extend the 2001 and 2003 tax relief permanently, while reducing our corporate tax rate."

He called the status quo "unsustainable."

"As ranking member of the Senate Finance Committee, we need to consider all ideas to fix our broken entitlements, cut spending and reform the overly-burdensome tax code. We know that the Medicaid expansion in the $2.6 trillion health law threatens to bankrupt both states and the federal government. We know that cutting over a half-trillion dollars from a nearly bankrupt Medicare system to create new entitlements and expand existing ones is the height of fiscal irresponsibility. We know that Social Security will not exist in the future if we fail to reform it now. We know our tax code is too complex, threatens our ability to compete in the world, and needs to be overhauled."

The status quo is not working, said Rep. Jason Chaffetz, R-Utah. He called the cuts important to create a trajectory to actually maintain the fiscal sanity in America. In a news conference available here on YouTube, Chaffetz asked for the restraint of explosive growth, an end to corporate welfare, restoring competition as a Department of Agriculture and Food focus and the need to take Freddie and Fannie Mae off the the backs of taxpayers, among other things.

What will happen as the debate unfolds is anyone's guess. But public opinion — Medicare is very popular with voting seniors — has protected that program. Will public opinion polls noting that John Average Joe thinks Medicaid is important matter, as well?

Drew Altman, president and CEO of the Kaiser Foundation, admitted in a blog that even he was surprised after hearing all the debates and "insiders" portraying the program as wildly unpopular. "I turns out that the insider's view of Medicaid is not the public's view at all. While not viewed as favorably as Social Security or Medicare, Medicaid is actually surprisingly popular with the American people, and they resist the idea of making big cuts to the program."

So the foundation asked why and found that 59 percent of Americans polls said Medicaid was either "very important" or "somewhat important" to them or their families.

Altman notes that he doesn't advocate following polls when it comes to making public policy, but "it seems important to at least note these preliminary findings. They suggest that the conventional wisdom that Medicaid is an unpopular program that would be much easier to cut or change than the other big public programs could be exaggerated if not simply wrong."

Regardless, there's no question a showdown of some sort is coming. Treasury Secretary Timothy F. Geithner on Monday told Congress in a letter addressed to Senate Majority Leader Harry Reid that if they don't raise the debt limit, it will create "severe hardship" for Americans as the government suspends services, such as Social Security payments. He wrote that America will reach the $14.29 trillion limit on its ability to borrow by May 16 unless Congress acts.

Email: lois@desnews.com

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