Medicaid Roulette

Posted March 2nd, 2011 in Updates and tagged , , , , by Hands Off Our Medicare

If the GOP has its way, states could take full control over health care for the poor (snip, snip).

By Suzy Khimm for Mother Jones

Republicans have a new target, and its name is Medicaid. A few weeks ago, at the sidelines of the budget debate, Republicans quietly began to float proposals to roll back this health care program for the nation’s most vulnerable. In Washington this week, those under-the-radar whispers grew to a roar as GOP governors called on Congress to let them have their own way with the program.

As it stands now, states receive a percentage of their Medicaid money from the feds—based on the size of their beneficiary pool, among other factors. In exchange, they must follow guidelines governing minimum benefits they must offer and who must be eligible. Under health care reform, more than 12 million Americans will join the Medicaid rolls, and states will no longer be able to skimp on benefits.

Republicans have responded by reviving an old idea. They are pushing for an alternate system of block grants wherein states would receive a fixed amount of federal money and be free to administer care as they see fit—which could include significantly scaling back their programs should they so chose.

Rep. Cathy McMorris Rodgers (R-Wash.), the fourth highest-ranking Republican in the House, is at the forefront of the push in Washington. She’s currently examining a proposal that would let states opt out of existing Medicare and into some such alternate setup. “The key is flexibility,” she told Mother Jones, employing the GOP’s latest buzzword. “Perhaps those who want to stay with the current system could do so,” the congresswoman adds. “Those states that want a different option could do so, with the flexibility. We need to work on it.”

The GOP has been pushing for Medicaid block grants ever since the Clinton era, but has been unable to overcome protestations from Democrats decrying their efforts as attacks on the poor. This notion of “opt-out/opt-in” may have a better chance of attracting support from conservative Democrats, and also Republicans concerned about cutting entitlements in states with politically significant numbers of Medicaid beneficiaries.

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