Poll: With More Than Half the Public Saying They or a Family Member Have Been Covered by Medicaid, Large Majorities Don’t Want Cuts, Including Most Trump Voters and Rural Residents

As Congress considers changes to the Medicaid program as part of the budget debate, relatively few (17%) in the public say they want to see a reduction in Medicaid spending, with larger shares saying they want spending to stay about the same (40%) or increase (42%), a new KFF Health Tracking Poll finds.

Support for Medicaid spending cuts is relatively low even among traditionally conservative groups, including Republicans (33% favor cuts), people who voted for Donald Trump (35% favor cuts), and people living in rural communities (23% favor cuts). Across each of these groups, larger shares say they want Congress to maintain or increase Medicaid spending.

More than half of the public say either  they themselves have ever been covered by Medicaid (18%) or that a family member has ever been covered (35%). An additional 13% say that they have a close friend who has ever been covered by the program.

Substantial shares of Democrats (52%), independents (57%), and Republicans (44%) say they or a family member has ever been covered by Medicaid, as do substantial shares of those who voted for President Trump (44%) and former Vice President Harris (51%), and those who live in rural areas (54%).

Perhaps relatedly, nearly three-quarters (73%) of the public say that Medicaid is “very important” to their local community. This includes a similar share of rural residents (75%), as well as majorities of Republicans (61%), Trump voters (61%), and rural Trump voters (66%).

Those who are currently enrolled in Medicaid or have a family member who is are even more likely to say the program is “very important” to their communities (85% overall, including 90% of those living in rural areas).

“I am about ready to say Medicaid is up there with Social Security and Medicare on the public’s do-not-cut list,” KFF President and CEO Drew Altman said. “That’s a real change since the beginning of the program, and one that Republicans in Washington are coming to grips with.”

While President Trump and some Republican lawmakers have described potential changes to Medicaid as efforts to make the program better, three-quarters (75%) of the public say potential changes to Medicaid are more about “reducing federal government spending,” three times the share (23%) who say they are more about “improving how the program works for people.”

Majorities across political parties, including most Trump voters (57%), say the changes are more about reducing federal spending than improving how the program works for people.

Views on Work Requirements and Medicaid Expansion Funding Can Shift with Arguments

While budget plans under consideration in Congress target substantial cuts to Medicaid, no specific changes have been formally proposed yet. The poll gauges the public’s views on two potential options that have been under consideration: work requirements and decreasing federal funding for the Affordable Care Act’s Medicaid expansion. The poll finds the public’s views are somewhat fluid and can change when presented with arguments that are made for or against them as would happen during a public debate.

For example, about six in 10 (62%) adults initially say they favor requiring nearly all adults to work or be looking for work in order to have health insurance through Medicaid. Support falls to just 32% when people are told that most Medicaid enrollees are already working and that many would be at risk of losing coverage because of paperwork challenges.

In contrast, support for work requirements grows to 77% when people hear the argument made by supporters that work requirements could ensure Medicaid is reserved for the elderly, people with disabilities, and low-income children.

Similarly, when asked about reducing the federal government’s share of the costs of covering low-income childless adults through the ACA’s Medicaid expansion, most (59%) initially say they would oppose it, while 40% say they would support it.

When told that such a change would reduce federal spending by $600 billion over 10 years, views shift slightly so that equal shares support (49%) and oppose (50%) such a policy. In contrast, opposition to the change grows to 75% when people are told states wouldn’t be able to make up the rest of the difference and that 20 million people could lose their Medicaid coverage and become uninsured.

Arguments made by proponents and opponents of policies may or may not be entirely accurate. KFF has long tested them to understand how public opinion may respond to actual debate.

Other findings include:

• Just over a third (37%) of the public are aware that most working-age adults with Medicaid coverage are working, while a majority (62%) incorrectly says they are unemployed. Republicans (77%) and Trump voters (76%) are more likely than others to be unaware that most working-age people with Medicaid are currently working.
• About half (53%) of the public correctly says that undocumented immigrants are not eligible for federally funded health insurance such as Medicaid, while the rest are either unsure (28%) or incorrectly say that undocumented immigrants are eligible for coverage (18%). Republicans are more likely than Democrats to incorrectly believe undocumented immigrants are eligible for federal health insurance programs (21% vs. 14%).
• Many are also confused about Medicaid’s role in paying for nursing home care and other extended long-term care services for low-income, elderly and disabled people. About four in 10 (38%) correctly identify Medicaid as the program that does this, while most either incorrectly believe Medicare pays for such care (26%) or are not sure which program does (31%).
• About half (49%) of rural residents say there are not enough primary care doctors in their community to serve local residents. Even larger shares say there are not enough specialists (71%) or mental health providers (67%). A third (34%) say there are not enough hospitals.

Designed and analyzed by public opinion researchers at KFF, the survey was conducted Feb. 18-25, 2025, online and by telephone in English and in Spanish among a nationally representative sample of 1,322 U.S. adults, including an oversample of rural adults (n=337). The margin of sampling error is plus or minus 3 percentage points for the full sample. For results based on other subgroups, the margin of sampling error may be higher.