A significant portion of Americans, approximately one-fifth, are enrolled in Medicaid, yet some of them remain unaware that this program is funding their insurance. This lack of awareness is fueled by rebranded state Medicaid programs and the involvement of private insurance companies, making it difficult for beneficiaries to recognize that they are part of the Medicaid system. Dr.
Adam Brown, an emergency physician based in Washington, D.C., notes that terminology like “Medicaid” is not always present on insurance cards or paperwork. This leads many patients to be unaware of their enrollment in Medicaid. “People oftentimes do not realize either that they have it, or understand the value of what it does,” Brown said.
Medicaid is designed to provide health insurance to individuals with low incomes or specific disabilities, covering about 72 million people across the United States. The program is managed with a combination of state and federal funding, allowing each state to run its program within federal guidelines. This flexibility results in a diverse array of programs that can confuse even those who manage the system.
Confusion around Medicaid extends to the political arena. For instance, Robert F. Kennedy Jr., the U.S. Secretary of Health and Human Services, displayed a misunderstanding of the basic elements of Medicaid during his confirmation hearing.
This confusion is troubling as congressional Republicans consider significant cuts to federal Medicaid funding to balance proposed tax cuts. “Part of the problem is when we hear people talk on television or hear lawmakers, there are many people who don’t make the connection that they themselves are on Medicaid or that their hospital relies on Medicaid funding,” Brown emphasized.
Public confusion around Medicaid enrollment
Currently, about three-quarters of Medicaid enrollees are in managed care organizations (MCOs) often operated by private companies like UnitedHealth Group and Centene. The branding of these companies can obscure the public nature of the funds that support them. Dr.
Ben Sommers, a Harvard health economist and physician, highlighted this issue, pointing out that millions might mistakenly believe they are uninsured despite being enrolled in Medicaid. The confusion worsened during the pandemic due to rules that provided continuous Medicaid coverage without requiring re-enrollment. Experts warn that public misunderstanding about Medicaid complicates debates over its funding.
People may not voice informed opinions on Medicaid cuts if they don’t realize they are beneficiaries of the program. “It’s not a huge problem if people think they have one type of insurance and misclassify it, as long as they’re getting care,” Sommers said. “Politically, it can be tricky if people don’t recognize they have Medicaid and they’re trying to weigh in on policies that affect Medicaid.”
The debate over Medicaid’s future is intense, with conservatives arguing for a reduction in the program’s scope due to costs and misaligned priorities.
Despite these debates, Medicaid remains very popular; over three-quarters of the public support the program, including a significant portion of Republicans, according to a recent poll by KFF. Ultimately, Medicaid funding cuts could lead to broader repercussions, impacting not only beneficiaries but also the healthcare system at large. Brown pointed out that such cuts could result in longer wait times in hospitals and fewer available services, affecting those with all types of insurance.
“One of the important aspects of democracy is understanding what your representatives are voting for or against and how to advocate for yourself,” Brown said. “If you don’t fully grasp the benefits you have, then it’s harder to advocate.”
