We must provide needed services
Challenge for government, healthcare: Helping poor without going broke
As I write this essay, our national leaders just concluded contentious negotiations related to raising the debt ceiling. There was high anxiety in all quarters because both parties agreed that deep cuts must be made in government spending. Even previously protected programs were “on the table,” such as Social Security, Medicare and, especially, Medicaid.
Medicaid—a collaboration between federal and state governments to provide health insurance coverage for the poor and disabled—has grown so much and become so costly for state governments that it is under attack. Medicaid now covers about 67 million people in the U.S., more than one-fifth of our population.
Serious, though disparate, efforts are already under way to “reform” Medicaid. Many Democrats see Medicaid as part of the solution to addressing the problem of individuals. For example, in my state, Utah, the federal share for the newly eligible would increase from 70% to 100% for 2014 and 2015, and would be phased down to 90% by 2020. But many worry that after 2020, the federal government will not keep up with the enhanced payments and the states will be left holding the bag.
Most Republicans see Medicaid as costly and complex and want to repeal current regulations related to determining eligibility. Sen. Orrin Hatch (R-Utah) has introduced legislation that would repeal requirements that states must maintain current levels of service to those already enrolled in the program. Recently, 29 governors signed on to a letter addressed to Hatch and Rep. Fred Upton (R-Mich.) asking for repeal of the Afford-