More Than Words? How Highlighting Target Populations Affects Public Opinion About the Medicaid Program

• Published in: Journal of health politics, policy and law policy and law, 2023-10, Vol.48 (5), p.713-760
• Main Authors: Haeder, Simon F, Sylvester, Steven M, Callaghan, Timothy
• Format: Article
• Language: English
• Subjects: Animosity; Beneficiaries; Citizenship; Demographics; Descriptions; Discourse; Government programs; Health care industry; Health care policy; Health insurance; Insurance coverage; Low income groups; Medicaid; Opinion polls; Partisanship; Perceptions; Policy making; Populations; Priming; Public opinion; Public opinion surveys; Racial differences; Respondents
• ISSN: 0361-6878; 1527-1927
• DOI: 10.1215/03616878-10637708

The Medicaid program provides health insurance coverage to a diverse set of demographics. We know little about how the policy community describes these populations in places like Medicaid-related websites, public opinion polls, and policy writings, and whether and how these descriptions may affect perceptions of the program, its beneficiaries, and potential policy changes. To investigate this issue, we developed and fielded a nationally representative survey of 2,680 Americans that included an experiment that primed respondents by highlighting different combinations of target populations of the Medicaid program as found in the Medicaid policy discourse. Overall, we find that Americans view Medicaid and its beneficiaries rather favorably. However, there are marked differences based on partisanship and racial animosity. Emphasizing citizenship and residency requirements at times improved perceptions. Racial perceptions and partisanship are important correlates in Americans' views about Medicaid and its beneficiaries. However, perceptions are not immutable. In general, the policy community should shift towards using more comprehensive descriptions of the Medicaid population that go beyond the focus on low income and include citizenship and residency requirements. Future research should expand this work to descriptions in the broader public discourse.