and Martha Heberlein
House Budget Committee Chairman Paul Ryan (R-WI) released
a budget plan we’re guessing will sound pretty familiar to you as it looks
much like the plan he released last year.
It would convert Medicaid to a block grant, deeply
slashing federal funding by $810 billion over the next ten years (bigger than
the $771 proposed last year) and presumably ending the guarantee of coverage to
a defined set of benefits. With states facing massive declines in federal
financial participation in the program, it would be nearly impossible for them
to maintain their current Medicaid enrollment. And despite
pronouncements that it increases state flexibility, a block grant is just a
cost-shift to the states, makes the program less responsive to economic
downturns and isn’t likely to produce any state savings. As my colleague Karina Wagnerman
discussed yesterday,
block grants lead to vulnerable populations like children, seniors in nursing
homes, and others competing against each other for declining resources at the
state level.
Like the 2012 budget, this proposal would also repeal the
ACA and move Medicare into a privatized voucher system (although this year,
Ryan is giving seniors a choice of sticking with the traditional
program).
Overall, Ryan proposed $1.028 trillion in spending –
almost $20 billion lower than the agreed-upon cap established during the
negotiations to raise the debt ceiling. And as he directs several committees,
two of which (Energy and Commerce and Ways and Means) have jurisdiction over
Medicaid and health reform to find additional savings to offset the automatic
reductions in defense spending under the sequestration agreed to last year, the
potential for deeper cuts certainly exists.
If Congress can play their broken record, we’re going to
rehash our favorite tune as well. Medicaid is a cost-effective program that
together with CHIP has been a core component of the nation’s success in
covering children and driving down the number of uninsured children to record
lows. Their future is key to the future of our nation’s children.