We’re Back on Block Grants


We’ve already been over how the GOP alternative to Obamacare would bring back pre-existing conditions, such as the pre-existing condition of being a woman, but according to the Center on Budget and Policy Priorities it also revives the conservative fantasy of block-granting Medicaid.

The plan apparently would convert most of Medicaid into a block grant and fold the Children’s Health Insurance Program into that block grant. States would receive fixed federal Medicaid funding to cover pregnant women, children, and low-income families and provide long-term care services and supports to seniors and people with disabilities.

Each state’s allotment likely wouldn’t reflect its actual spending needs. While total federal funding would be based on total states’ historical spending, each state’s share would reflect its number of poor people, not its Medicaid costs. Moreover, after the first year, federal funding for states would grow each year at the rate of overall inflation plus 1 percent — not enough to keep pace with the growth in health care costs.

That last part is particularly interesting because Republicans have alleged that expanding Medicaid will costs states too much money.

As you’re probably aware, the federal government will cover 100 percent of the cost of expanding Medicaid until 2016 and beyond that time it will cover 90 percent of the cost.

The Republican alternative unveiled this week would cost states far more money than the system established by Obamacare and it would cover fewer people at a higher cost to the state.

I know it goes without saying but Republicans are amazingly bad at policy. I suppose that’s the inevitable result when you derive policy from ideology rather than what the facts tell us.

I’m not sure how comfortable I am with referring to this plan as an “alternative” going forward because it would more or less repeal the law and implement elements of the Paul Ryan budget.

During their State of the Union rebuttals, each representative of the party made a point to say that we ‘shouldn’t go back to the old system,’ but that’s exactly what their alternative bill would do. Their alternative is actually worse than the old system.