and Martha Heberlein
House Budget Committee Chairman Paul Ryan (R-WI) released a budget plan we’re guessing will sound pretty familiar to you as it looks much like the plan he released last year.
It would convert Medicaid to a block grant, deeply slashing federal funding by $810 billion over the next ten years (bigger than the $771 proposed last year) and presumably ending the guarantee of coverage to a defined set of benefits. With states facing massive declines in federal financial participation in the program, it would be nearly impossible for them to maintain their current Medicaid enrollment. And despite pronouncements that it increases state flexibility, a block grant is just a cost-shift to the states, makes the program less responsive to economic downturns and isn’t likely to produce any state savings. As my colleague Karina Wagnerman discussed yesterday, block grants lead to vulnerable populations like children, seniors in nursing homes, and others competing against each other for declining resources at the state level.
Like the 2012 budget, this proposal would also repeal the ACA and move Medicare into a privatized voucher system (although this year, Ryan is giving seniors a choice of sticking with the traditional program).
Overall, Ryan proposed $1.028 trillion in spending – almost $20 billion lower than the agreed-upon cap established during the negotiations to raise the debt ceiling. And as he directs several committees, two of which (Energy and Commerce and Ways and Means) have jurisdiction over Medicaid and health reform to find additional savings to offset the automatic reductions in defense spending under the sequestration agreed to last year, the potential for deeper cuts certainly exists.
If Congress can play their broken record, we’re going to rehash our favorite tune as well. Medicaid is a cost-effective program that together with CHIP has been a core component of the nation’s success in covering children and driving down the number of uninsured children to record lows. Their future is key to the future of our nation’s children.
