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?

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