GOP Leaks Preliminary Details on Medicaid Reform Plans

September 11, 2017
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A (very concise) Medicaid primer: states, in a partnership with the federal government, have to provide funds to support the delivery of healthcare services to potential patients who qualify. That care must be comprehensive, by law. The GOP — led by Speaker John Boehner (OH) — has the entitlement in its crosshairs.

House Republicans are planning to cut roughly $1 trillion over 10 years from Medicaid, the government health insurance program for the poor and disabled, as part of their fiscal 2012 budget, which they will unveil early next month, according to several GOP sources.

Further, there is the strong possibility that money given to the states would be in the form of block grants set by a fixed formula; this action would give individual states the “flexibility” they need, according to Republicans, to decrease Medicaid costs via increased efficiency. It’s a little difficult to see how states have more flexibility than they already have when it comes to providing their share of coverage to the some 15M beneficiaries nationwide, unless that “flexibility” means that governments can set caps on enrollments, adjust copays, raise minimum income requirements, etc.

It already seems that many health systems’ providers who are becoming increasingly frustrated with payments from the program would even be more so, as reimbursement cuts to physicians, hospitals, and ancillaries — the current mode of reform — would be little more than an afterthought if program enrollment were significantly slashed. All the while, essential coverage of services to the elderly disabled (currently the largest outlay under Medicaid) would be affected.

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Medicaid is, and will probably always be, a mixed bag emblematic of all the complexities surrounding government spending — but it is clear that the GOP are planning an all out assault on the entitlement aiming to convince states of the “proper” way to rein in spending on publicly subsidized healthcare delivery against the backdrop of strained states’ budgets. | LINK