The Unthinkable Option: Ending Medicaid

The unthinkable is receiving a lot of thought.

Ending Medicaid.

An option to balance state budgets.

Powerful lobbyists on one side.

Red ink on the other.

And medically fragile kids with special needs stuck smack dab in the middle.

But Medicaid has become one of the biggest items on state budgets, and states complain they don’t have enough flexibility to pare it without losing their federal matching funds. The federal government, on average, covers 57% of the cost of the program for states. In exchange, states must keep Medicaid open to all who qualify. (WSJ)

Utah hasn’t had much of a problem finding the flexiblity to pare down the state budget, and welcome the loss of it’s matching funds.

Increasing the Equity Grid Requirements does this rather nicely, as those who lost their spot on the Travis C. Waiver this year can attest.

Some states, in particular those led by Republicans, are calculating whether they’d be better off giving up the federal funding and replacing Medicaid with a narrower program of their own. Texas Gov. Rick Perry has proposed that his state get out of Medicaid in favor of a state-run system unburdened by federal mandates—including the one that prohibits states from reducing eligibility for the program if they want to qualify for the federal matching funds.

“We feel very comfortable that we could come up with a more equitable, a more efficient, and obviously a more cost-effective way to deliver health care,” he said. (WSJ)

Yeah.  About that.

I’ve spent hours trying to track down the warm body behind the decision to up the equity grid, only to be told that decisions such as this are ‘made by committee.’  Which translates into ‘How the hell are we supposed to know?”

Which is really, you know, reassuring.

I guess this is to insure nobody knows exactly who’s car to egg.

I’m all for making things more cost effective.

But I’d like to see a plan in place, before the federal funds are denied.  I’m thinking it could save a whole lotta lives.

Kinda like what Wyoming’s findings:

Wyoming’s report said the 2014 Medicaid expansion would strain the state budget. “However, the strain that will ensue should Wyoming determine to opt-out of participating in Medicaid without a solid plan to replace it is truly immeasurable,” the report said. (WSJ)

Strain being defined as the elderly losing their nursing home coverage, kids with special needs losing their waiver status, children of parents living below the poverty line losing insurance coverage.

Those of us with loved ones who depend on these programs may want to buckle up for what I believe is going to be a really rocky ride.

Now is the time to find out what is playing out in your state governments.

I know I plan on sitting in on every legislative session this year that has anything to do with health care and Medicaid.


  1. Barbara
    Nov 22, 10
    • Tammy & Parker Nov 22, 10
      • Barbara
        Nov 23, 10
  2. Claire Nov 23, 10
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