It’s funny when the GOP expresses its undying commitment to protecting the “most vulnerable” among us. It’s even funnier when it does so in the name of “reforming” or “modernizing” Medicaid.
That’s because what makes the most vulnerable most vulnerable is the way the GOP wants to revamp Medicaid. It’s probably safe to assume that the “most vulnerable” are the nearly seventy million Medicaid recipients, more than ten million of whom are disabled adults and children. Disabled adults must also be dirt poor to be eligible for Medicaid. And they must make every effort to stay dirt poor for the rest of their lives, otherwise they’ll be cut off from assistance. That’s pretty damn vulnerable.
The GOP has a document entitled A Better Way, in which it broadly proclaims how it will make access to quality health care more abundant and affordable for all Americans. The document says this grand plan will “bring Medicaid into the 21st century” by empowering states “to design Medicaid programs that best meet their needs, which will help reduce costs and improve care for our most vulnerable citizens.”
What they’re talking about here is Medicaid block grants. How Medicaid works now is that the state and federal governments split the cost of providing Medicaid-covered services to all who are eligible for the program. But under block granting, the federal government would allocate a fixed amount to each state each year to cover Medicaid expenses.
What happens if the grant isn’t enough to cover the federal government’s portion? Well, that’s the kind of nitpicky question you’re not supposed to ask when analyzing GOP policies.
If you must know, smarty pants, that’s where the empowering states “to design Medicaid programs that best meet their needs” part comes in quite handy. Block grants would rid state governments of the obligation to meet the needs of all Medicaid recipients in the state, regardless of cost. So when times get tough, state governments could arbitrarily decide to cut off disabled people or seniors or children or anybody else deemed to be too expensive.
Block grants would rid state governments of the obligation to meet the needs of all Medicaid recipients regardless of cost—so states could arbitrarily decide to cut off anybody deemed to be too expensive.
And those tough times inevitably will come. According to the Center on Budget and Policy Priorities, block granting would cut federal Medicaid spending by $1 trillion over the next ten years.
Block grants are just a cowardly way for federal lawmakers to force state lawmakers to make politically unpopular massive cuts to Medicaid. House Speaker Paul Ryan loves the idea of block grants, as do Health and Human Services Secretary Tom Price and that squatter in the White House, whose name I shall not utter.
The only thing that can stand in their way of making block grants a reality is enough people raising hell about it.
Block grants will make the most vulnerable even more vulnerable, which is a pretty good trick. There’s no such thing as more than most, right? I guess we’ll have to come with a new word when referring to those who will lose help from Medicaid due to block grants. We’ll have to call them the mostest vulnerable.