It’s a harsh reality — the U.S. cannot afford to cover the current number of Medicaid recipients with the current level of benefits.
Just how expensive is Medicaid? Republicans in the U.S. House were able to find $834 billion in savings over 10 years by drastically cutting the federal insurance coverage for the poor in their now notoriously bad American Health Care Act.
President Donald Trump’s budget suggests paring down the program by (possibly another) $610 billion over 10 years. In all, the AHCA and Trump’s budget could cut around half of federal Medicaid spending, more than $1.4 trillion over 10 years, although the White House has said some of the president’s cuts overlap with the AHCA cuts.
That budget blood bath doesn’t even touch the substantial investments states make. Providing healthcare to America’s poor is expensive.
But for those struggling families (and yes, some single childless, able-bodied adults under the Obamacare expansion), plans to gut the nation’s health insurance safety net will be devastating. The uninsured would be forced to wait until they are at death’s door for dialysis treatment at a hospital, to forego insulin shots to save money, or to no longer manage mental health problems with medicine and treatment.
But there is hope that Republicans in the Senate can find a middle ground if they are indeed dead-set on using their new-found majority to bring the federal budget more in line with reality on the back of health care for the neediest while increasing spending for the military.
Sen. Cory Gardner, R-Colorado, is on a 13-member panel picked by Senate Majority Leader Mitch McConnell to work on repealing the Affordable Care Act and replacing it with something, well, better.
“We need to have a glide path that works for the states,” Gardner told The Denver Post’s Mark Matthews, saying he’d like to provide as much time as possible for Medicaid patients to transfer to private insurance.
A glide path could look like substantially reducing the proposed cuts to Medicaid and instead finding that savings in the many areas the AHCA spends money unwisely. (It’s clear from the AHCA that Republicans have a spending problem, too.)
For example, House Republicans proposed spending $375 billion over 10 years for new tax credits based not on income but on age.
Making insurance more affordable for older populations who face the highest premiums is a good goal. Giving the same tax breaks to a millionaire early-retiree with multiple homes and substantial investment income that are given to a working 60-year-old primary caregiver for three grandchildren making 175 percent of the federal poverty level is a terrible idea. Adding income restrictions to those tax credits could save money to be reinvested back in those who now qualify for Medicaid.
Instead of continuing a mandate that insurers cover pre-existing conditions, House Republicans suggested states could opt-out and get grants from a newly established $117 billion stability fund to establish the high-risk pools of old.
Additionally, the AHCA proposed spending $43 billion to increase Medicare payments to hospitals that serve a disproportionate share of low-income patients. It seems unreasonable to steal from Medicaid to pay for Medicare.
So now the nation’s hopes fall on the clever policy minds in the Senate — including our own Gardner, who seems to be working on the side of reason. Let’s hope that the 13 white men McConnell selected can do what Democrats failed to do the first time and fix America’s expensive and ineffective health insurance system without breaking the federal purse.