For all the Democrats’ posturing and campaigning against Republican plans for Medicare, the GOP budget actually makes more immediate and deeper cuts to Medicaid. But Democrats haven’t been blasting the GOP Medicaid plan with nearly the same fervor, even though Republicans would cut about $750 billion from the program during the next decade and end the guaranteed federal match for states.

Medicaid covers more than 50 million people, including low-income children and seniors in long-term care, but it doesn’t pack the same political punch as Medicare. Some observers say that’s due to the lingering perception that Medicaid is just a program for poor people that holds a much less broad-based appeal.

Medicaid also faces numerous GOP efforts to slash program spending as states grapple with massive deficits and leaders in Washington try to hammer out a budget deal. Republicans have pushed block grants and easing maintenance-of-effort requirements as their preferred methods of controlling Medicaid costs. Last year’s health care reform law raised the stakes for Medicaid even higher, because the program is expected to add 16 million to its rolls in 2014.

While advocates say Democrats have drawn a clear line against the GOP’s Medicare plan, they’re less certain of the party’s stance on Medicaid. At this point, they’re unsure what will come out of the Biden negotiations on the debt ceiling, but they believe cuts are on the way.

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