Medicaid by Any Other Name

• In Event: Trust Us? How Public Perceptions and Trust Impact Support for Health Policies

Abstract

Are citizens more likely to support means-tested public programs when the role of the federal government is obfuscated? Many states use state-specific naming con- ventions for their Medicaid programs (e.g., “MassHealth”). According to historical accounts, these were intended to reduce stigma perceived to be associated with the program. In a pre-registered survey experiment (n = 5, 810), we test whether state- specific names for Medicaid improve perceptions of the program. We find that replacing “Medicaid” with a state-specific name actually results in a large decrease in favorabil- ity among respondents. Instead, respondents are much more likely to have uncertain attitudes toward the program when it’s called something other than Medicaid. One implication from these findings is a puzzle for democratic accountability: state leaders ostensibly believe submerging the government’s role increases the popularity of Medi- caid and/or the likelihood of passing program expansions. However, when state-specific names are used, these leaders may be less likely to be rewarded by voters for actions taken to expand or improve the program. 1

Authors

• Adrianna McIntyre, Harvard T.H. Chan School of Public Health

• Josh McCrain, University of Utah