Shock! Cutting Medicare, Medicaid Won't Be Popular

Government health benefits are a popular thing, and, as Medicare and Medicaid take center stage in the debate over a 2012 budget, Republicans may find it politically difficult to spend less on them.

House Budget Committee Chairman Paul Ryan (R-Wis.) unveiled a Republican budget plan today that would end those two programs as we know them. Medicare would be transformed into a voucher program, while Medicaid would become to a system of block-grants to states, which Ryan says will save a total of $1.12 trillion more than President Obama's budget proposal.

If voters think the proposed changes will take away benefits, they're not likely to be popular. At all.

A CBS poll this month showed respondents wanting to cut almost anything besides Medicare, as lawmakers and the president look to reduce spending:

Medicare willingness CBS March 22.jpg
A January poll showed respondents vastly preferred raising taxes to reducing Medicare benefits:

Reduce or raise - CBS January.jpg
Republicans already face a challenge in Medicare politics, according to a February Kaiser Family Foundation poll, which showed 44 percent of respondents trusted Democrats "to do a better job of handling Medicare going forward," while only 30 percent trusted Republicans.

While Medicare benefits are clearly established as popular, pollsters don't usually ask about Medicaid. Its constituency is different, but also the same: Medicaid accounts for 40 percent of all nursing-home spending in the U.S., according to the Center for Medicare and Medicaid Studies (CMS). So, while Medicaid covers mostly poor people and children, older Americans have a large interest in it too.

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Particularly given Americans' widespread fears about how to pay for retirement, Republicans would appear vulnerable as Democrats criticize Ryan's plan to change how post-retirement medical care is covered. According to an Associated Press poll released today, only a narrow majority of Americans (51 percent) are confident they will be able to live comfortably during retirement, while a significant chunk of respondents (48 percent) were not confident. Figures were about the same among baby boomers.

Medicare and Medicaid cover a substantial fraction of the population.

Medicare Part A (which covers in-patient hospital and hospice care, among other services) covered benefits for 46 million people (38 million old, 7 million disabled) in 2009, while Part D (the prescription drug benefit) covered 33 million in 2009, according to the Center for Medicare and Medicaid Studies (CMS).

Part A's covered population is greater than the combined populations of New York City, Los Angeles, and Chicago.

Medicaid covers even more people, about 60 million. In 2009, it covered benefits for 29.9 million children, 13.5 million adults, 4.4 million aged, and 9.1 million disabled Americans, according to CMS.

The last time CBS News asked its poll respondents about their health coverage, 13 percent said they were covered under Medicare, four percent under Medicaid, and 12 percent under both private insurance and Medicare. Combined, 29 percent of respondents got some benefit from Medicare or Medicaid.

As a segment of the voting public, that's enormous.