Republicans Want to Expand Medicaid, New Poll Shows

A recent survey indicates that Republican voters nationwide, even in states without expanded Medicaid, overwhelmingly support maintaining or increasing federal funding for the program. This challenges the assumption that Republicans endorse efforts by Congress to reduce the federal health insurance program for low-income Americans. Proposed Republican changes could potentially cause up to 20 million people to lose Medicaid coverage if the federal government reduces its 90 percent match for expansion states, according to a report by the non-partisan Kaiser Family Foundation (KFF) in February.

The University of Maryland’s Program for Public Consultation poll from April 2025 shows that approximately 75 percent of Republicans overall favor maintaining Medicaid spending, with 49 percent supporting an increase. Among Republicans in the ten states that have not expanded Medicaid, 69 percent support joining the expansion, compared to 83 percent in states that have already expanded it. The survey, conducted from April 4 to 9 with 1,195 adults nationwide, has a margin of error of plus or minus 3.1 percentage points.

Contrary to these findings, recent actions by Republican lawmakers in Congress suggest budget proposals that could lead to cuts in programs like Medicaid by up to $880 billion over the next decade. While President Trump has voiced support for Medicaid in the past, the current GOP budget framework might necessitate cuts to meet mandated savings levels, potentially affecting eligibility, benefits, or provider payments.

Many are concerned that Medicaid cuts could harm communities that heavily rely on the program, especially in poor rural areas of red states. Efforts to extend the Tax Cuts and Jobs Act may involve spending cuts, and while the House reconciliation bill does not propose cuts to Medicaid and Medicare directly, it could indirectly impact them through budget reductions to the Department of Health and Human Services.

Looking ahead, states may face pressure to offset lost federal funding or reverse Medicaid expansions if current budget proposals move forward. Republicans in office may seek cuts elsewhere to avoid alienating their base, particularly in regions where government assistance is significant and where promises were made not to reduce entitlements.