Health Advice



America worries about health costs -- and voters want to hear from Biden and Republicans

Julie Appleby and Phil Galewitz, KFF Health News on

Published in Health & Fitness

Both Medicaid and Medicare, the government health insurance programs that cover tens of millions of low-income, disabled, and older people, remain broadly popular with voters, said the Democratic pollster Celinda Lake. That makes it unlikely either party would pursue a platform that includes outright cuts to entitlements. But accusing an opponent of wanting to slash Medicare is a common, and often effective, campaign move.

Although Trump has said he wouldn’t cut Medicare spending, Democrats will likely seek to associate him with other Republicans who support constraining the program’s costs. Polls show that most voters oppose reducing any Medicare benefits, including by raising Medicare’s eligibility age from 65. However, raising taxes on people making more than $400,000 a year to shore up Medicare’s finances is one idea that won strong backing in a recent poll by The Associated Press and NORC Center for Public Affairs Research.

Brian Blase, a former Trump health adviser and the president of Paragon Health Institute, said Republicans, if they win more control of the federal government, should seek to lower spending on Medicare Advantage — through which commercial insurers provide benefits — to build on the program’s efficiencies and ensure it costs taxpayers less than the traditional program.

So far, though, Republicans, including Trump, have expressed little interest in such a plan. Some of them are clear-eyed about the perils of running on changing Medicare, which cost $829 billion in 2021 and is projected to consume nearly 18% of the federal budget by 2032.

“It’s difficult to have a frank conversation with voters about the future of the Medicare program,” said Lewis, the GOP pollster. “More often than not, it backfires. That conversation will have to happen right after a major election.”

Addiction Crisis


Many Americans have been touched by the growing opioid epidemic, which killed more than 112,000 people in the United States in 2023 — more than gun deaths and road fatalities combined. Rural residents and white adults are among the hardest hit.

Federal health officials have cited drug overdose deaths as a primary cause of the recent drop in U.S. life expectancy.

Republicans cast addiction as largely a criminal matter, associating it closely with the migration crisis at the U.S. southern border that they blame on Biden. Democrats have sought more funding for treatment and prevention of substance use disorders.

“This affects the family, the neighborhood,” said Blendon, the public opinion researcher.

Billions of dollars have begun to flow to states and local governments from legal settlements with opioid manufacturers and retailers, raising questions about how to best spend that money. But it isn’t clear that the crisis, outside the context of immigration, will emerge as a campaign issue.

©2024 KFF Health News. Distributed by Tribune Content Agency, LLC.


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