House Budget Committee Chairman Diane Black on Monday called the House GOP health care bill a “good start” but said she wants to overhaul Medicaid, the government insurance program for the poor, even further in the Republican budget for the coming year.
The GOP bill to repeal and replace Obamacare allowed states to impose work requirements on Medicaid recipients, though Ms. Black, Tennessee Republican, says those requirements should be mandatory.
“I will continue to push for that, whether in our upcoming budget or in future legislation,” she wrote in commentary for Real Clear Politics. “Work is a fundamental part of the American Dream. It’s a reasonable expectation in exchange for getting a hand-up from the government, and we should do everything in our power to help everyone in America get and keep a job.”
Ms. Black also argued the program is spending too much money to cover able-bodied adults above the poverty line when it should be focused on children and the disabled who are living “well below” the poverty line.
“That’s wrong. States shouldn’t be able to use federal Medicaid dollars as a revenue stream to prop up their budgets,” she wrote. “I intend to push for a change in the Medicaid reimbursement rate in our upcoming budget resolution to ensure that Medicaid dollars are used to properly support our most vulnerable citizens.”
Her push to write changes into the GOP’s fiscal 2018 budget, which are nonbinding unless they are written into spending bills that become law, comes on top of sweeping changes to Medicaid in the House-passed bill to replace the Affordable Care Act, which is now being debated in the Senate.
As written, the plan would morph Medicaid to a per-capita or block-grant model that will pay states a lump sum, then ask them to experiment with their rolls. That saves nearly $900 billion over the next decade, marking the biggest entitlement reform in history.
GOP lawmakers say entitlement programs are key drivers of the nation’s debt and must be overhauled, even though President Trump promised not to touch them during the campaign.
“I was the first & only potential GOP candidate to state there will be no cuts to Social Security, Medicare & Medicaid. Huckabee copied me,” Mr. Trump said on Twitter in May 2015, shortly before hopping into the GOP primary race against a crowded field that included former Arkansas Gov. Mike Huckabee.
House Speaker Paul D. Ryan signaled on Friday that budget-writers will likely including long-sought changes to Medicare, the government insurance program for people 65 and older.
In past years, Mr. Ryan’s budgets would morph Medicare from an open-ended benefit for seniors to a “premium-support” model, though reforming the program at all is considered politically perilous.
“The question is, can we get everyone else to agree? And that’s the conversation we’re having,” Mr. Ryan, Wisconsin Republican, told WISN Radio.
Mr. Trump’s health secretary, Tom Price, told senators during a courtesy hearing on his nomination in January that overhauling the popular Medicare program was “absolutely not” a priority for the new administration.