The Corner

Replacing Obamacare: What to Do About Medicaid?

After the election, congressional Republicans quickly came up with a strategy on Obamacare: They would pass a bill early in 2017 to repeal the law’s tax-and-spending provisions but not its regulations, have this partial repeal take effect in a few years, and use the time in between to figure out what to replace it with. In a recent article for the magazine, I argued against this strategy and in favor of an alternative one. NRO is running that article today. In my view, Obamacare’s regulations are its heart and Republicans’ first move should target them.

Ed Kilgore very reasonably points out that the article does not discuss how Republicans should handle the law’s Medicaid expansion, which is responsible for most of the increased coverage the law has achieved. This report lays out a series of options for reforming the program (on pages 27 to 36); my preference among the options is to go as far as the political system will tolerate in moving the non-disabled, non-elderly portion of the Medicaid population into the individual market.

Some states have taken up Obamacare’s invitation to expand eligibility for Medicaid, and some states have not. Here I think the right path is to find an eligibility level in between the ones these two sets of states have established, and gradually move to that new compromise level.

Ramesh Ponnuru is a senior editor for National Review, a columnist for Bloomberg Opinion, a visiting fellow at the American Enterprise Institute, and a senior fellow at the National Review Institute.