Medicaid mission creep threatens GOP’s ‘Obamacare’ repeal
The federal-state program for low-income people has long been stigmatized as substandard. But over time it has grown and changed to become a mainstay for hospitals, nursing homes, insurers, and now drug treatment centers confronting the opioid epidemic. With about 70 million enrolled, Medicaid covers more people than Medicare, from newborns to nursing home residents.
"We would see dramatic reductions in federal Medicaid funding, which would result in large budget gaps for the states," said analyst
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But Republican leaders are unlikely to retreat, due to political and practical reasons. Although the
—Phasing out the extra financing that former President
—Putting a limit on future federal financing for the entire program, through a per-beneficiary cap that would be adjusted for inflation. That would effectively end Medicaid's status as an open-ended entitlement, through which the federal government matches a share of what each state spends. The
On the Medicaid expansion, there's wide agreement among
More broadly, as a political principle, many
"The present system is unsustainable; we don't have enough money to continue what's being done," said Sen.
States would gain much greater flexibility over how to spend their Medicaid dollars under the Republican caps.
But liberals see another agenda. On the practical side, the Medicaid cuts in the
"Cutting Medicaid leaves more room to repeal some of these taxes," said
Facing a growing outcry, the
"In fact, this is slowing the growth of Medicaid and allowing governors more flexibility,"
"I'm not going to allow people and detractors and Trump haters to call me a liar because they don't want to do the homework and look at what is actually happening to Medicaid," Conway added.
The claim involves some budgetary sleight of hand that both parties have resorted to.
If a bill changes the rules to reduce what government was otherwise expected to spend, that meets the definition of a cut.
In fact,
But the argument worked in favor of
Manchin, Capito both oppose Senate health care bill
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