All four Republican presidential candidates want to save money by block-granting Medicaid funding back to the states. The House-passed budget included this necessary entitlement reform as a step on the way to tackling the nation's debt crisis. Until now, however, there was no legislative vehicle to make it happen. So a conservative coalition of House Republicans filled the gap with a bill that would give states flexibility to run their own health care programs for the poor.
Members of the Republican Study Committee introduced a measure Wednesday that combines the funding for Medicaid and the State Children's Health Insurance Program into a single block grant starting in fiscal 2013. The current, broken system encourages states to spend more in order to get the matching funds from Washington, which range from 50 percent to 74 percent. The combined annual spending is more than $400 billion a year.
"We did bold things last year, but we didn't follow up on them," the bill's lead sponsor, Rep. Todd Rokita, told The Washington Times in an interview. "So this is a commitment to follow through." The Republican freshman came to Washington from Indiana to tackle the $15.5 trillion debt. Social entitlement programs are the largest source of red ink, accounting for 64 percent of spending.
Conservatives want to conserve federal dollars by setting funding for health programs at current levels for the next 10 years, saving the United States from borrowing and spending $1.8 trillion. The concept is modeled after the successful welfare reform of the mid-1990s, which kept funding flat to encourage states to reform and innovate.
Mr. Rokita, the former Hoosier State secretary of state, said, "No inflator will surely be a bone of contention. But as a state official, I didn't have an increase in my budget, and that forced us to be creative and leverage technology to use taxpayer property most efficiently."
At the state level, Medicaid is the biggest expenditure, growing at a faster pace than even Medicare. Making matters worse, Obamacare mandates will increase the Medicaid rolls by an estimated 17 million to 25 million people. In order to give states flexibility to deal with this, the House rank-and-file GOP would eliminate the one-size-fits-all mandates for the federal funds. This also would provide better care.
"We can improve health care if states can decide how to allocate medical resources. We're losing health care providers because of the focus on how much to spend per service," freshman Rep. Tim Huelskamp, Kansas Republican and a co-sponsor, said in an interview with The Washington Times. "People in Kansas know better what Kansans need than a bunch of bureaucrats at [the Centers for Medicare and Medicaid Services] in Baltimore." This bill would let states decide how the money is spent to provide health care, including provider reimbursement, benefits and eligibility.
Democrats will be quick to demagogue this common-sense idea by saying Republicans are trying to kill health care programs for the poor. Liberals freak out every time money is taken out of Uncle Sam's hands and returned to the taxpayers.
Already, 29 Republican governors have asked for these Medicaid reforms. With this much demand by the states, House Republican leaders should expedite this legislation to a floor vote. The American people should know what they can expect if they choose to give the GOP both branches of government in 2013.
Emily Miller is a senior editor for the Opinion pages at The Washington Times.
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