Is Medicaid The New ‘Third Rail?’ History Suggests It Has Been For Some Time

As President Trump and Congressional Republicans regroup following the collapse of their efforts to repeal and replace the Affordable Care Act they should look not only at what went wrong with their legislation but also past efforts to reform American health care. While many things went wrong, the biggest stumbling block to the GOP efforts this year was the attempt to dramatically change the Medicaid program, which serves some 70 million Americans. Both the House-passed and pending Senate bills would have replaced the 52-year-old entitlement program with capped federal spending and a state-run block grant. The federal government would continue to share in the program’s costs but annual growth would be tightly limited, leaving states with the job of balancing the health needs of their citizens with the new fiscal realities. While only tangentially related to the ACA, the Medicaid caps and block grants were too much to swallow for many moderate Republicans. For most of its history, Medicaid took a back seat to Medicare, the health benefits program for seniors and others. But now, due to its growth in size and cost Medicaid has gained so much clout that it should be considered the new “third rail” of American politics. To be sure, some politicians have long seen Medicaid as target ripe for cutting federal spending. But many more are leery of touching the program and facing the wrath of the people who elected them. The difficulties encountered by the President, House Speake...
Source: Health Affairs Blog - Category: Health Management Authors: Tags: Following the ACA Medicaid and CHIP ACA repeal and replace Henry Waxman Source Type: blogs