Concerns are mounting among Americans regarding the future of two critical safety-net programs: Social Security and Medicare. A recent survey conducted by the West Health–Gallup Center on Healthcare indicates that approximately 40 percent of U.S. adults—around 110 million people—doubt these programs will exist in their current form within the next decade. The survey, which included responses from nearly 20,000 adults across all 50 states and Washington, D.C., was conducted between June 9 and August 25, 2023.
Historical Context and Current Challenges
Social Security was established during the Great Depression, with President Franklin D. Roosevelt signing it into law on August 14, 1935. The program aimed to prevent poverty among older Americans by providing a federal support system funded through payroll taxes. Over the years, it expanded to include benefits for disability and survivors. Today, over 73 million people rely on Social Security.
Despite its widespread use, Social Security faces significant financial challenges. The latest report from the Social Security Trustees warns that the Old-Age and Survivors Insurance (OASI) and Disability Insurance (DI) trust funds could be depleted by 2034. Should Congress fail to take action, beneficiaries could see an automatic reduction of about 21 percent in their benefits, relying solely on incoming payroll taxes.
Similarly, Medicare is under financial strain. The trust fund for Medicare’s Hospital Insurance (Part A) is projected to be depleted by 2033. While the program would continue to operate, it would only be able to cover approximately 89 percent of scheduled hospital and skilled nursing care.
Public Sentiment and Political Divide
The apprehension regarding the future of these programs is particularly pronounced among younger Americans. More than half of individuals under 50 believe that Medicare and Social Security are “not too” or “not at all” likely to still exist in 10 years. Those without health insurance and individuals relying on Medicaid report even higher levels of concern.
Political affiliations also influence perceptions about the sustainability of these programs. Republicans generally exhibit more confidence than Democrats and independents in the long-term viability of Social Security and Medicare. Among Republicans aged 50 to 64, 65 percent are confident that the programs will remain available in a decade. This figure rises to 75 percent among Republicans aged 65 and older. In contrast, only 39 percent of Republicans aged 18 to 49 share this optimism, highlighting a generational divide.
The survey also revealed that 91 percent of Medicare recipients consider the program either extremely important (62 percent) or important (29 percent) for affording healthcare. Similarly, 84 percent of Social Security recipients express the same sentiment, with 52 percent stating it is extremely important.
With nearly 60 percent of adults reporting increased anxiety about potential changes to Medicare (58 percent) and Social Security (61 percent) compared to a year ago, these programs remain a focal point of public concern. As the financial pressures on these vital safety nets continue to grow, the future of Social Security and Medicare hangs in the balance, prompting urgent discussions about their sustainability and the implications for millions of Americans.
