Essential to the Romney/Ryan budget, and to any health care plan that they would call reform, is shoving off all responsibility for health care to low-income and elderly Americans on the states. They would do this by turning Medicaid funding to states into block grants. They say this would give states the kind of flexibility they should have and get the federal government off their backs. One of the primary bills to do this, Rep. Todd Rokita's (R-Ind.) H.R. 4160, is even titled the "State Health Flexibility Act."
There's one glaring exception to that whole flexibility argument, though, and of course it's part of the War on Women. Nick Baumann writes at Mother Jones that the 17 states that have programs allowing state funding to help low-income women obtain abortions would be essentially forced "to either discontinue programs that help low-income women pay for abortions, or spend a lot more money to purchase new insurance plans for those women."
The Republican measure would give states more say over how they spend Medicaid funds, but it forbids them from covering abortions, even with state money—unless they purchase separate abortion-only plans or buy plans that include abortion coverage entirely with state funds. Either option could potentially cost these states millions of dollars. [...]
Rokita's bill "would be a significant change from how current law operates today," adds Judy Waxman, the vice president for health and reproductive rights at the National Women's Law Center. Timothy Jost, a health law expert at Washington & Lee University's law school who identifies as pro-life, also believes the bill would change the status quo. "Current law allows states to spend their own money on medically necessary abortions if they do not spend [federal matching funds] on it," Jost wrote in an email. "This doesn't seem to be what the provisions…say."
This would require states to set up entirely separate systems for reimbursing abortion providers. It would probably require staff not paid under the block grant program which receives federal support and have to be administered outside of state health agencies that received the federal money. All in the name of flexibility for the states. But as Baumann says, when it comes to abortion, Republicans want to "give the federal government the final word: no."