No big post today, just a gentle reminder courtesy of a piece from the Associated Press. We’re spending all this time arguing about Medicare, but some are (accurately) pointing out that Medicaid is the bigger conservative target. Thus, it’s worth mentioning that the current Medicaid landscape is no Disneyland joyride (emphasis mine):
Sandra Pico is poor, but not poor enough.
She makes about $15,000 a year, supporting her daughter and unemployed husband. She thought she’d be able to get health insurance after the Supreme Court upheld President Barack Obama’s health care law.
Then she heard that her own governor won’t agree to the federal plan to extend Medicaid coverage to people like her in two years. So she expects to remain uninsured, struggling to pay for her blood pressure medicine.
[…] Many working parents like Pico are below the federal poverty line but don’t qualify for Medicaid, a decades-old state-federal insurance program. That’s especially true in states where conservative governors say they’ll reject the Medicaid expansion under Obama’s health law.
In South Carolina, a yearly income of $16,900 is too much for Medicaid for a family of three. In Florida, $11,000 a year is too much. In Mississippi, $8,200 a year is too much. In Louisiana and Texas, earning more than just $5,000 a year makes you ineligible for Medicaid.
Again, in certain states, this is how Medicaid is administered right now. And this is what Ryan’s vision for the program was in his 2013 budget:
This is because, as many have noted, the program would be transformed into a block-grant with fewer restrictions and slower annual spending. From the CBPP (emphasis mine):
Block grant funding amounts would fall further and further behind state needs each year. The annual increase in the block grant amounts would average more than 3.5 percentage points less than Medicaid’s currently projected growth rate over the next ten years, which accounts for factors like rising health care costs and an aging population. In 2022, we estimate that federal Medicaid funding would be about 34 percent less than states would receive under current law. And the cuts would keep growing after 2022. The Congressional Budget Office (CBO) expects that, under the Ryan plan, federal Medicaid (and CHIP) spending as a share of the economy would fall by half by 2040, compared to spending levels in 2011.
I’m sure this idea appeals to those who don’t believe the federal government should be funding healthcare coverage for low-income adults, children, the elderly and disabled. That’s their prerogative – free country and all that – and in Mitt Romney they have a presidential candidate who supports that line of thought:
If, on the other hand, you believe that the federal government has a role to play in providing this service, then block-granting Medicaid is not a good idea. My feeling is that such a transformation for the program would lead some states (indeed, some of the poorest states) to “experiment” and “craft the approaches” that lets them cover the fewest number of people with least-helpful number of services.
Update: Just saw that ThinkProgress reported much the same thing. Yet being the fancy outfit that they are there’s a great graphic of state by state Medicaid ineligibility. Go check it out!