Public Attitudes toward Premiums in the Medicaid Program: The Role of Race, Ethnicity, and Deservingness

Recently, several states renewed efforts to implement Medicaid premiums. If implemented, premiums will substantially reduce enrollment. To explore the role that race/ethnicity and deservingness of beneficiaries may play in shaping public opinion towards Medicaid premiums, and how ideology and racial resentment may affect public attitudes, this study relied on a national survey (N=4,177) that contained an experiment using racially/ethnically identifiable names and different life circumstances of potential beneficiaries. The experiment highlighted the malleability of public attitudes related to Medicaid, identifying consistently lower levels of support for Medicaid premiums for people with a disability and single mothers compared with people with substance use disorder and single women across various analyses. No differences based on the race/ethnicity of the beneficiary presented were found. Liberals and those low in racial resentment were consistently less supportive of premiums than their counterparts. The findings help elucidate the continuing struggle over the nature of Medicaid.