The U.S. Capitol in Washington, D.C., on Thursday, April 18, 2024. (Photo by Jennifer Shutt/States Newsroom)

WASHINGTON — Republicans and backers of President Donald Trump’s Make America Great Again platform support the party’s “big, beautiful bill” as passed by the U.S. House, though Americans overall view the legislation unfavorably, according to a poll released Tuesday by the nonpartisan health research organization KFF.

The survey shows that nearly two-thirds of those polled, or 64%, don’t support the tax policy changes and spending cuts Republicans have included in the sweeping House version of the bill that the Senate plans to take up this month.

When broken down by political affiliation, just 13% of Democrats and 27% of independents view the legislation favorably. Those numbers are in sharp contrast to Republicans, with 61% supporting the bill and 72% of those who identify as MAGA supporters.

But those views fluctuated when the people surveyed were asked specific questions about certain elements of the package and the real-world impacts of the legislation:

• The overall percentage of those surveyed with an unfavorable view of the bill increased from 64% to 67% when they were told it would lower federal spending on Medicaid by more than $700 billion, an estimate by the nonpartisan Congressional Budget Office.
• Dislike of the legislation rose to 74% when those polled were told policy changes would lead to 10 million people losing their health insurance coverage, another estimate from the CBO analysis.
• Opposition rose to 79% when people were told the legislation would reduce funding for local hospitals.

“The public hasn’t had much time to digest what’s in the big, beautiful, but almost incomprehensible bill as it races through Congress, and many don’t have a lot of information about it,” KFF President and CEO Drew Altman wrote in a statement. “Our poll shows that views toward the bill and its health-care provisions can shift when presented with more information and arguments about its effects, even among MAGA supporters.”

Senators wrestling with what to do

The House voted mostly along party lines to approve its 11-bill package in late May, sending the legislation to the Senate.

GOP senators have spent weeks internally debating which parts of the House legislation to keep, which to change and which to remove, while also conducting closed-door meetings with the parliamentarian to determine which parts of the bill comply with the rules for the complex reconciliation process.

Senate Majority Leader John Thune, R-S.D., plans to bring his chamber’s version of the package to the floor next week, though that timeline could slip. Before the Senate can approve the rewritten bill, lawmakers will spend hours voting on dozens of amendments during what’s known as a vote-a-rama.

Significant bipartisan support for Medicaid

The KFF poll released Tuesday shows that 83% of Americans support Medicaid, slated for an overhaul and spending reductions by GOP lawmakers.

That support remains high across political parties, with 93% of Democrats, 83% of independents and 74% of Republicans holding a favorable opinion of the state-federal health program for lower-income people and some with disabilities.

Those surveyed appeared supportive of a provision in the House bill that would require some people on Medicaid to work, participate in community service, or attend an educational program at least 80 hours a month.

The change is supported by about two-thirds of those surveyed, though the numbers shift depending on how the question is asked.

For example, when told that most adults on Medicaid already work and that not being able to complete the paperwork associated with the new requirement could cause some to lose coverage, 64% of those polled opposed the new requirement. 

Planned Parenthood

There was also broad opposition, 67% overall, to language in the House bill that would block any Medicaid funding from going to Planned Parenthood for routine health care. There is a long-standing prohibition on federal funding from going toward abortion with exceptions for rape, incest, or the life of the pregnant patient.

Opposition to the Planned Parenthood provision increased to 80% when those polled were told that no federal payments to Planned Parenthood go directly toward abortion and that ending all Medicaid payments to the organization would make it more challenging for lower-income women to access birth control, cancer screenings and STD testing.

Republicans are more supportive of that change, with 54% backing the policy and 46% opposing the new block on Medicaid patients going to Planned Parenthood. But 78% of independent women and 51% of Republican women oppose the change.

Food assistance program

Those surveyed also had concerns about how changes to the Supplemental Nutrition Assistance Program, or SNAP, would impact lower-income people’s ability to afford food, with 70% saying they were either very or somewhat concerned.

Democrats held the highest level of concern at 92%, followed by independents at 74% and Republicans at 47%.

Overall, Republicans hold the highest share of people polled who believe the dozens of GOP policy changes in the “big, beautiful bill” will help them or their family.

A total of 32% of Republicans surveyed believe the legislation will benefit them, while 47% said it will not make much of a difference and 21% said it will hurt them or their family.

Thirteen percent of independents expect the legislation will help them, while 39% said it likely won’t make a difference and 47% expect it will harm them or their family.

Of Democrats polled, just 6% said they expect the GOP mega-bill to help them, while 26% said it wouldn’t matter much and 66% expected it to hurt them or their family.

When asked whether the bill would help, not make much of a difference, or hurt certain groups of people, the largest percentage of those polled expect it to help wealthy people.

Fifty-one percent of those surveyed said they expect wealthy people will benefit from the bill, 21% believe it will help people with lower incomes and 20% said they think middle-class families will benefit.

Seventeen percent think it will help immigrants, 14% expect it to help people who buy their own health insurance, 13% believe it will help people on Medicaid, 13% think it will help people on SNAP and 8% expect it will benefit undocumented immigrants.

KFF conducted the poll June 4 – 8, both online and by telephone, among a nationally representative sample of 1,321 U.S. adults. The margin of error is plus or minus 3 percentage points for the full sample size. 

From left, parents Jessica Seawright and Brooke Wampole talk with Sen. Tammy Baldwin about their concerns over the impact of Medicaid cuts on families with children such as theirs who have disabilities. (Screenshot/Zoom)

As members of Congress continue to debate the Republican budget reconciliation bill that includes hundreds of billions of dollars in cuts to Medicaid, Jessica Seawright ponders what that could mean for her young son.

Seawright is a social worker in Southeast Wisconsin. She’s also the mother of a 9-year-old boy with complex medical needs resulting from a genetic condition.

She and her husband — a college professor — have medical coverage through work, but with her son’s condition, which includes cerebral palsy, their health plans could never cover the degree of care he requires.

Medicaid has made the difference, Seawright said Wednesday. It’s helped through the Katie Beckett  program, which enables children with disabilities to have Medicaid coverage while living at home instead of being in an institution; the Medicaid children’s long-term support coverage; and Medicaid support that public schools receive to cover certain services that students with disabilities require.

Her son has been able to thrive living with her and her husband, Seawright said — but worry clouds the future.

“We look toward his adulthood, knowing that disability and aging programs that would support him staying in the community — where we, our family and our community, know he belongs — are being dismantled and defunded,” Seawright said. “Forcing us and others like us into medical bankruptcy is not a solution.”

Seawright was one of two parents who said Wednesday that their lives and their children’s lives could be profoundly upended by the Medicaid reductions that are included in the budget reconciliation proposal.

They spoke during a webinar conducted by Sen. Tammy Baldwin (D-Wisconsin), who has been an outspoken critic of the budget bill’s Medicaid cuts.

“Our neighbors, our friends and our colleagues at work who rely on Medicaid and are scared, really scared,” Baldwin said. She cited estimates produced by Democrats on the Joint Economic Committee that with cuts to Medicaid as well as to the Affordable Care Act, the legislation could reduce health care for nearly  14 million Americans, including almost 230,000 Wisconsin residents.

The money saved, she added, would be used to extend and expand tax cuts enacted in 2017, during the first Trump administration. The Center on Budget and Policy Priorities has said the tax cuts primarily favor the wealthy and corporations.

“It’s giveaways for their wealthy friends at the cost of Americans’ health and lives,” Baldwin said. “That’s the deal.”

Baldwin said the choice that U.S. House Republicans made to advance the bill in committee in the early hours of Wednesday morning was a sign that “Republicans know what they’re doing is deeply unpopular.”

She dismissed claims that the objective of the bill’s authors was to address waste, fraud or abuse in Medicaid and other safety net programs.

“I would be happy to come to the table to write a bill that truly gets at fraud and abuse,” Baldwin said. “We want that out of Medicaid. We want that out of Medicare. But that is not what this bill does. This bill terminates health care for Wisconsin families.”

Besides being a mother of a child who has been helped by Medicaid’s programs, Seawright has experienced Medicaid through two other lenses.

When she and her sister were growing up, their mother was relying on Medicaid for the family’s health care. That helped give the family stability so that her mom could go to community college, become a medical assistant and get full-time work in health care with insurance through her employer, Seawright said.

In her own job as a social worker, she added, some of the clients she works with have Medicaid.

Both her childhood experience and her role as a mental health provider have made her critical of proposals to cut Medicaid, Seawright said — especially one to add work requirements as a condition for adults considered “able-bodied” to enroll in Medicaid.  

“Creating more barriers for people to access the care they need … individuals losing their primary care providers and their specialists, from my perspective, is just a cruel response that is steeped in distrust of those of us who are doing the work day to day,” Seawright said.

Also on the webinar was Brooke Wampole, who lives in northern Wisconsin. She and her husband have a 4-year-old son who was found to have long delays in his development.

About two years ago he was screened and qualified for services and therapies covered by Medicaid programs for children with disabilities, and over time, his clinicians helped him first to “exist, to self-regulate, to see the world around him and not find it to be a threat,” Wampole said.

The family’s regular health insurance “could never cover the cost” those treatments required. “ Medicaid programs “have been absolutely instrumental in our lives.”

In the last year, her son has begun speaking one-syllable words. “My favorites or Mommy and Dada,” Wampole said, then added with a smile, “however, he is pretty partial to talking about trapezoids. And raisins.”

The thought of losing Medicaid coverage “is terrifying,” Wampole said — both because of the loss of services for her son, but also because of its impact on other families.

“I worry what our world looks like without Medicaid,” Wampole said. “Other families, they could be way worse off … and cutting Medicaid could hurt them even more than my family. I don’t want to be part of a system that contributes to that.”