|The American Cancer Society Cancer Action Network commissioned polls about the Medicaid expansion in seven states with Republican governors who oppose the policy or have expressed strong skepticism, like Iowa's Terry Branstad. (One of those governors, Susana Martinez of New Mexico, later embraced the Medicaid expansion.)
Lake Research Partners and GS Strategy Group surveyed 808 registered Iowa voters between December 13 and 22, producing a margin of error of plus or minus 3.5 percent. The pollsters conducted 562 phone calls via landline and 246 via cell phone. The full polling memo is here (pdf).
Respondents in all seven states supported the Medicaid expansion. The most important finding for the Iowa poll is that 57 percent of respondents supported taking federal funds to cover more people in our state through Medicaid. Only 27 percent would rather see Iowa turn down the funds. Here is the relevant question wording:
Next I'd like to ask you about an issue being talked about by the governor and the state legislature. Under the new federal health care law, 20,000 people in Iowa who are uninsured right now could get health care coverage through Medicaid starting in 2014. The governor and state elected officials can choose to accept federal dollars that have been allocated to cover these people in Iowa, or to turn the money down and not cover these people. The federal dollars cover 100% of the costs in the first few years, and 90% of the costs after that.
The table on page three of the memo shows that almost every subgroup favored the Medicaid expansion. A majority of men, women, respondents in all four Congressional districts, all income levels, below age 50 and over age 50. Only the self-identified Republicans wanted Iowa to turn down the federal funding by a 49 percent to 33 percent margin. Independents in the survey supported the Medicaid expansion by 58 percent to 25 percent, while Democrats overwhelmingly back the policy by 86 percent to 6 percent.
Branstad has argued that Iowa can't afford to expand Medicaid, because doing so will be costly in future years, and we can't rely on the federal government to keep its promises on funding. The survey tested that argument against the case for expanding Medicaid.
Respondents were presented with common arguments on both sides of the debate:
Here are two sides to the issue. (ROTATE)
Side A says we can cover more people in Iowa and save taxpayer dollars that are currently spent on treating uninsured people in emergency rooms. Covering more people gives hard-working families the security of knowing they can get preventive care and see a doctor when they need to. The alternative is people showing up in the emergency room when they are sicker. By accepting the money, we could cover more people and save taxpayer dollars.
Side B says Iowa will eventually have to pay 10% of the costs of covering these people, and even more if the federal government fails to follow through on its promises. We cannot afford to spend even more on health care coverage, which is already a big part of the state budget. We have too many other priorities in the state that need attention, like education and roads. By turning down the money, we could avoid future increases in state health care spending.
Which side do you agree with more?
After hearing these arguments, Iowa voters agree more with reasons for accepting federal funds by a 21-point margin (55% vs. 34%).
The new survey also showed,
A majority of registered voters currently have health insurance coverage (92%). A third (36%) of voters, however, have one or more close friends or family members who is currently uninsured.
Among those who are not currently receiving coverage through Medicaid, 40% say either a close friend, family member, or they themselves have received coverage through Medicaid.
I'm surprised that only 40 percent of respondents said they had a close friend or family member who has been covered through Medicaid. Some people may not realize that Medicaid is not only for low-income individuals and families. Many elderly people in nursing homes, children with special needs, or adults with expensive chronic illnesses are covered through Medicaid.
Now that the legislature is back in session, I'm sure lobbyists for the American Cancer Society, the Iowa Medical Society, the Iowa Hospital Association, and other groups are doing everything they can to persuade Iowa House members to support the Medicaid expansion. The Democratic-controlled Iowa Senate is already on board with the policy.
Any relevant comments are welcome in this thread. Here's a good read by Dylan Scott for Governing.com: Why GOP Governors Are Coming Around on the Medicaid Expansion. The math isn't complicated here.
Given the hatred for "Obamacare" among Republicans, though, I don't know whether Branstad can be convinced not to turn down the federal Medicaid funding. He had asked the U.S. Department of Health and Human Services whether Iowa could expand Medicaid somewhat, but not to the full extent foreseen in the 2010 Affordable Care Act. The federal government said no dice: "The law does not provide for a phased-in or partial expansion [...] As such, we will not consider partial expansions for populations eligible for the 100 percent matching rate in 2014 through 2016."
UPDATE: Here's more background on the organization that commissioned the poll, from their January 23 press release.
[American Cancer Society Cancer Action Network] is working in Iowa to support strong implementation of provisions of the ACA that enable people with cancer or at risk for cancer to access critical prevention measures such as mammograms and colonoscopies, treatments and follow-up care for cancer.
More information about the polling is available at www.acscan.org .
ACS CAN, the nonprofit, nonpartisan advocacy affiliate of the American Cancer Society, supports evidence-based policy and legislative solutions designed to eliminate cancer as a major health problem. ACS CAN works to encourage elected officials and candidates to make cancer a top national priority. ACS CAN gives ordinary people extraordinary power to fight cancer with the training and tools they need to make their voices heard. For more information, visit www.acscan.org .