Republicans seem to be preparing for a major overhaul of Medicaid, the healthcare program for the poor.
Medicaid has grown in recent years with ObamaCare extending coverage to millions of low-income people never before covered. Republicans warn of the program’s growing costs and are pushing a “block grant” program to the states, a concept President-elect Donald Trump endorsed during the campaign.
In a recent ABC interview, Vice President-elect Mike Pence said that the incoming administration planned to keep Medicare as it is but is looking at ways to change Medicaid.
Pence told ABC, “I think President-Elect Trump made it very clear in the course of the campaign that, as president, we’re going to keep our promises in Social Security and Medicare. With regard to Medicaid, though, I will tell you, there’s a real opportunity, there’s a real opportunity as we repeal and replace ObamaCare to do exactly what the president-elect also said on the campaign, and that is block granting Medicaid back to the states.”
Block grants would mean limiting federal Medicaid funds to a set amount given to the states, rather than the current federal commitment, which is more open-ended. Pence implemented policies as governor of Indiana that would require Medicaid enrollees to pay a small monthly contribution towards their coverage into a health savings account.
The idea may be implemented on a national level, and Trump’s nominee to run the Centers for Medicare and Medicaid Services, Seema Verma, helped Pence develop the changes to Medicaid in Indiana.
Republicans have called block grants a fiscally responsible way to limit federal spending and give the power back to the states, which could allow them to innovate. A second proposal, also backed by Republicans, called “per capita caps” would limit federal spending on each Medicaid enrollee, rather than overall.
Republicans say their plans would also allow states to make changes to the Medicaid program easier and they wouldn’t have to go through a lengthy federal waiver process.
Democrats argue that block grants or per capita caps would ultimately lead to harmful cuts to Medicaid, causing people to lose coverage if states eventually can’t afford the tab and wind up capping enrollment and start turning people away.
A professor at Indiana University, Kosali Simon, has studied the Medicaid program in the state and said that “Indiana has seen strong enrollment in its modified Medicaid program, with more than 400,000 people joining.”
As far as implementing the Medicaid changes in other states, Simon asked, “Would it be the same everywhere else? It’s hard to know because other places have gotten used to having Medicaid without any cost sharing.”
Simon said the level of cuts to Medicaid would depend on how much federal money is included in a block grant or per capita cap proposal, something Republicans have not yet to determine.
Simons speculated, “What happens if that number is low, but expenses turn out to be high?”
H/T: The Hill
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