While there has been lots of focus on the Paul Ryan budget’s proposal to end Medicare as we know it, the proposal also proposes a similarly radical change to Medicaid–even if the substance is different.
As Ezra Klein reports, there has been some concern that the focus on Medicare might make Medicaid more vulnerable. But he highlighted the defense of Medicaid by top White House official Gene Sperling.
“There is enormous discussion about the revenue side and the Medicare side. But from a policy perspective, from a values perspective, we should be very deeply troubled by the Medicaid cuts in the House Republican plan. . . . After they completely repeal the Affordable Care Act, which would take away coverage for 34 million Americans, according to the Congressional Budget Office. After they’ve completely repealed that, they do a block grant that would cut Medicaid by $770 billion. In 2021, that would cut the program by 35 percent. Under their own numbers, by 2030, it would cut projected spending in Medicaid by half. By 49 percent.”
It’s not just a policy perspective. It’s a political perspective: voter don’t like the attack on Medicaid either:
This month’s Kaiser Health Tracking Poll found that 60 percent of poll respondents say they want to keep Medicaid as it is, with minimum standards set by the federal government. Only 13 percent would support major reductions in Medicaid spending. As Politico Pulse reported, “The poll calls into question the conventional wisdom that cuts to the program will be more easily accepted than cuts to Medicare.”
“Fifty-three percent of respondents said they favored “no reductions” to Medicaid, while 59 percent said the same of Medicare. And Kaiser’s research shows a much larger majority oppose the House-passed plan for Medicaid than Medicare. People were asked: Which would you prefer: keep Medicaid as is (60 percent) or change it (35 percent)? How important for you and your family is the Medicaid program? Not important at all (31 percent); very important (27 percent); somewhat important (22 percent) and not too important (18 percent).”
As the Kaiser Health Tracking Poll said itself: The findings come at a time of intense public debate in Washington about the future of entitlement programs such as Medicare and Medicaid as policymakers attempt to address rising public concerns about the federal deficit. While conventional wisdom and recent public opinion polling has suggested that dramatic changes in Medicare would be politically unpopular, the poll findings illustrate that major alterations to Medicaid also could strike a negative chord with many Americans. Support for maintaining the current program may be due at least in part to the public’s personal connections to Medicaid and a strong sense of the program’s importance. About half of Americans say they or a friend or family member has received Medicaid assistance at some point, and a similar share say the program is important to their family.
It’s an important lesson to protect Medicare *and* Medicaid.