Mitt Romney mentioned Medicaid last night in the course of avoiding questions on foreign policy. Medicaid is more than a debate tactic to millions of people, so I thought we could take a look at what Mitt Romney and Paul Ryan plan for Medicaid.
When Mitt Romney, Paul Ryan and opinion leaders say they want to “give Medicaid to the states” they’re not telling anyone anything they need to know about the plans for Medicaid. That’s deliberate. The plans are to cut Medicaid drastically by reducing the number of people who are covered by Medicaid. They all know this. That’s why they use phrases like “block grants” and “giving Medicaid to the states.”
So let’s look at some real numbers and the next time you hear Mitt Romney, Paul Ryan or their legions of fans in the punditry cavalierly toss off “block grant” or “send Medicaid to the states” you’ll have some idea what they’re not telling you.
There’s two ways to look at Medicaid. There’s Medicaid as it exists now and Medicaid with the planned expansion under the PPACA. Here’s how Mitt Romney and Paul Ryan would cut Medicaid under both scenarios:
The House Budget Plan would repeal the ACA and convert Medicaid to a block grant with significant reductions in federal spending. This proposal would make fundamental changes to the financing structure of the program that could shift costs to states and could result in large reductions in enrollment and payments to providers such as hospitals.
In aggregate, the proposal would reduce federal Medicaid spending by $1.4 trillion over the 2012 to 2021 period relative to spending under current law with ACA, a 34 percent reduction.
The repeal of ACA along with reductions in federal spending for Medicaid through the block grant would almost inevitably result in dramatic reductions in coverage and similarly dramatic increases in the number of uninsured in the country.
Cuts in federal spending would result in large scale reductions in enrollment in Medicaid. This outcome would hold even if states were able to achieve substantial efficiencies by adopting policies to reduce the rate of growth in spending. We examined different scenarios for state responses to reduced federal Medicaid spending and estimate, depending on the specific underlying assumption, that enrollment reductions could range from 31 to 36 million if enrollment cuts were spread across all groups. Under the assumption that there were no cuts in eligibility and enrollment of the aged and disabled, 44 million adults and children, 58 percent of the total (or 71 percent of adults and children) could be cut even assuming efficiency gains. Most of the people who would lose Medicaid coverage would become uninsured.
Pay particular attention to this next part if you live in the real world and are aware of how brutally inequitable our current health care system is, if you actually encounter people in your daily life who have no access to even basic health care, read this, because it’s going to get much, much worse under Romney-Ryan:
Of the $1.4 trillion reduction in federal Medicaid spending under the House Budget Plan, $610 billion is due to the repeal of the ACA, and $750 billion is due to the conversion of Medicaid financing to a block grant. The $750 billion reduction represents a 22 percent cut from what Medicaid spending would have been even without ACA.
Look around at our current health care system and then cut 750 billion dollars that would go to health care for working class and poor people over a course of years. That’s the plan. It makes my skin crawl when I hear Romney or Ryan mewling about “the poor”. That’s because I know what Mitt Romney and Paul Ryan are planning to do to them.