Medicaid Mandates

There has been a bit of a kerfuffle lately about selected governors looking to drop their Medicaid programs. The Wall Street Journal reported on Monday that the governors of Washington, Texas, South Carolina, Wyoming, and Nevada have all considered the idea to one degree or another. 

The liberal reaction to this, from Ezra Klein and others, has been to deride the governors in question, wondering why any governor would want to drop Medicaid. Now, nobody wants to see Medicaid harmed, and having states pull out of the program would be an undesirable result, but it is important to recognize that the Obama administration has put states in this situation.

First, the new health-care law has put extra pressure on the system by adding 16 million more people to the 62 million already on the Medicaid rolls — half of the newly covered people in the Obama plan will be covered via Medicaid. Second, as the WSJ piece notes, the federal government covers about 57 percent of Medicaid costs, but they do so at a price — federal mandates such as the refusal to allow states to lower eligibility levels. This means that the federal government gets to decide who is eligible for Medicaid, which is supposedly state-run, rather than governors and state legislatures.

Third, the federal government will increase funding to states in the short run to handle the new Medicaid enrollees, but savvy governors recognize that these short-term funding hikes could go away because of federal budget pressures, leaving states holding the bag.  The best way to protect Medicaid is to give governors more flexibility, but without that flexibility, the governors in question are exploring their options, which seems to be a sensible thing to do.

Tevi Troy — Tevi Troy is the President of the American Health Policy Institute. He is also the author of the best-selling book, What Jefferson Read, Ike Watched, and Obama Tweeted: 200 Years ...

Most Popular

Law & the Courts

Obstruction Confusions

In his Lawfare critique of one of my several columns about the purported obstruction case against President Trump, Gabriel Schoenfeld loses me — as I suspect he will lose others — when he says of himself, “I do not think I am Trump-deranged.” Gabe graciously expresses fondness for me, and the feeling is ... Read More
Politics & Policy

Students’ Anti-Gun Views

Are children innocents or are they leaders? Are teenagers fully autonomous decision-makers, or are they lumps of mental clay, still being molded by unfolding brain development? The Left seems to have a particularly hard time deciding these days. Take, for example, the high-school students from Parkland, ... Read More
PC Culture

Kill Chic

We live in a society in which gratuitous violence is the trademark of video games, movies, and popular music. Kill this, shoot that in repugnant detail becomes a race to the visual and spoken bottom. We have gone from Sam Peckinpah’s realistic portrayal of violent death to a gory ritual of metal ripping ... Read More
Elections

Romney Is a Misfit for America

Mitt’s back. The former governor of Massachusetts and occasional native son of Michigan has a new persona: Mr. Utah. He’s going to bring Utah conservatism to the whole Republican party and to the country at large. Wholesome, efficient, industrious, faithful. “Utah has a lot to teach the politicians in ... Read More
Law & the Courts

What the Second Amendment Means Today

The horrifying school massacre in Parkland, Fla., has prompted another national debate about guns. Unfortunately, it seems that these conversations are never terribly constructive — they are too often dominated by screeching extremists on both sides of the aisle and armchair pundits who offer sweeping opinions ... Read More
U.S.

Fire the FBI Chief

American government is supposed to look and sound like George Washington. What it actually looks and sounds like is Henry Hill from Goodfellas: bad suit, hand out, intoning the eternal mantra: “F*** you, pay me.” American government mostly works by interposition, standing between us, the free people at ... Read More
Film & TV

Black Panther’s Circle of Hype

The Marvel Cinematic Universe (MCU) first infantilizes its audience, then banalizes it, and, finally, controls it through marketing. This commercial strategy, geared toward adolescents of all ages, resembles the Democratic party’s political manipulation of black Americans, targeting that audience through its ... Read More