For years, Republicans have been hoping they could get their grubby hands on Medicaid and destroy it. Oh, they wouldn't out and out end the program—they’d call it "reform" while they turned it into a slowly deteriorating block grant program that would eventually fail. But it isn't going to be so easy for them, as the opposition is getting organized and sounding the alarm.
“A block grant would end the guaranteed access to care for millions of Americans who are eligible and instead provide a fixed amount of federal funding to each state for its Medicaid program, which may not take into account increases in actual cost or need,” AARP senior vice president of government affairs Joyce Rogers wrote members of the U.S. House Energy and Commerce Committee in a letter last week. [...]
“We oppose the end of the guarantee and are concerned that fixed federal funding to states will result in cuts to program eligibility, services or both–ultimately harming some of our nation’s most vulnerable citizens,” AARP’s Rogers wrote. “Moving from the current Medicaid financing structure to fixed federal Medicaid block grant funding would shift costs to states and state taxpayers.” [...]
“Block grants have been a policy idea for more than 20 years, and past proposals always translated to dramatic cuts to federal spending on Medicaid,” says Dr. Bruce Siegel, CEO of America’s Essential Hospitals, which represents the nation’s public health systems and hospitals. “Essential hospitals, which already operate with no margin on average, would have little choice but to scale back services dramatically or close, worsening access to care in already underserved communities.”
If you really want to draw the wrath of millions against you, go against AARP.
It’s also not a great idea to go against the hospitals, particularly when you’re a Republican representing a rural or underserved district that only has one hospital and you become the person responsible for its closing.
Because that’s what will happen—Republican governors are giving their congressional colleagues an earful about how bad it will be if they have to face steep Medicaid cuts. They’re not going to take the fall for it if it happens, either.