As policymakers at the state and national level struggle with rising entitlement costs, overwhelming numbers of Americans agree that, over the years, Social Security, Medicare and Medicaid have been good for the country.
But these cherished programs receive negative marks for current performance, and their finances are widely viewed as troubled. Reflecting these concerns, most Americans say all three programs either need to be completely rebuilt or undergo major changes. However, smaller majorities express this view than did so five years ago.
The public’s desire for fundamental change does not mean it supports reductions in the benefits provided by Social Security, Medicare or Medicaid. Relatively few are willing to see benefit cuts as part of the solution, regardless of whether the problem being addressed is the federal budget deficit, state budget shortfalls or the financial viability of the entitlement programs.
The latest national survey by the Pew Research Center for the People & the Press, conducted June 15-19 among 1,502 adults, finds that Republicans face far more serious internal divisions over entitlement reforms than do Democrats. Lower income Republicans are consistently more likely to oppose reductions in benefits – from Medicare, Social Security or Medicaid – than are more affluent Republicans.
On the broad question of whether it is more important to reduce the budget deficit or to maintain current Medicare and Social Security benefits, the public decisively supports maintaining the status quo. Six-in-ten (60%) say it is more important to keep Social Security and Medicare benefits as they are; only about half as many (32%) say it is more important to take steps to reduce the budget deficit.
Half (50%) of Republicans say that maintaining benefits is more important than deficit reduction; about as many (42%) say it is more important to reduce the budget deficit. More independents prioritize maintaining benefits over reducing the deficit (by 53% to 38%). Democrats overwhelmingly view preserving current Social Security and Medicare benefits as more important (by 72% to 21%).
The public also opposes making Medicare recipients more responsible for their health care costs and allowing states to limit Medicaid eligibility. About six-in-ten (61%) say people on Medicare already pay enough of their own health care costs, while only 31% think recipients need to be responsible for more of the costs of their health care in order to make the system financially secure.
When it comes to Medicaid, just 37% want to allow states to cut back on who is eligible for Medicaid in order to deal with budget problems, while 58% say low-income people should not have their Medicaid benefits taken away. And most say it is more important to avoid future cuts in Social Security benefits than future increases in Social Security taxes (56% vs. 33%).
On Social Security and Medicare, there are substantial differences of opinion by age. People age 65 and older are the only age group in which majorities say these programs work well; seniors also overwhelmingly say it is more important to maintain Social Security and Medicare benefits than to reduce the budget deficit. Those 50 to 64 also broadly favor keeping benefits as they are. Younger Americans support maintaining Social Security and Medicare benefits, but by smaller margins than older age groups.
Lower income people are more committed to maintaining benefits across all three major entitlement programs. This income gap is particularly wide when it comes to allowing states to cut back on Medicaid eligibility: 72% of those with family incomes of less than $30,000 oppose allowing states to limit Medicaid eligibility to deal with budget problems, compared with 53% of those with higher incomes.
GOP Base Divided over Entitlement Changes
The GOP’s internal divisions over entitlement changes are seen particularly in views of whether it is more important to maintain Social Security and Medicare benefits or to take steps to bring down the deficit.
Among Republicans and Republican-leaning independents, 63% of those with family incomes of $75,000 or more say it is more important to take steps to reduce the budget deficit; a nearly identical percentage (62%) of Republicans with incomes of $30,000 or less say it is more important to maintain Social Security and Medicare benefits as they are.
The income gap among Republicans and Republican leaners is about as large as the difference between GOP supporters of the Tea Party and non-supporters. Among Republicans and Republican leaners who agree with the Tea Party, 57% view deficit reduction as more important than preserving Social Security and Medicare benefits as they are. Among Republicans and leaners who do not agree with the Tea Party, just 36% say that reducing the deficit is more important than maintaining benefits.
Democrats face no such internal divisions, as both high- and low-income Democrats prioritize maintaining benefits over deficit reduction; there also are no ideological differences among Democrats over this issue. Notably, the balance of opinion among low-income Republicans is similar to how Democrats view the issue.