Fixing Medicaid means empowering the states, not punishing them
If only Washington could check itself in for treatment. It is addicted to overspending, responds to another special interest "problem" with another federal program, and passes the buck on to someone else. These compulsions need immediate attention.
In tackling the challenges facing America's health care system last year, President Obama and the last Congress responded by throwing astronomical amounts of money at the problem -- without any real accountability for how it is spent. It responded, in part, by expanding an existing federal program -- Medicaid -- and in expected fashion, passed the buck to states.
When Obamacare became law last spring, states were already struggling to keep up with the pre-existing conditions of Medicaid.
Now, states are expected to do Obama's dirty work in fulfilling these huge Medicaid mandates. State legislators and governors have to find a way to pay for nearly 25 million additional Medicaid enrollees who are expected to cost the federal government and states more than $400 billion over the next decade. Given that on average, states cover about one-third of the federal government's Medicaid mandates, this will strain states even further.
Medicaid spending was already proving challenging for states. How couldn't it when the number of Medicaid enrollees has grown from 35 million to 60 million over the past 10 years and when Medicaid spending in the states has soared by 192 percent over the past 20 years?
There are times when people find themselves needing assistance from programs like Medicaid. However, Obamacare's expansion of the eligibility threshold modifies Medicaid so that it is no longer about serving the poor and disabled, but about making Medicaid an open-access program that serves middle-class Americans. Those who earn 134 percent of the poverty level will be eligible for Medicaid come 2014.
In the Kansas state Senate, I was part of a Medicaid task force that evaluated how the Sunflower State could improve its Medicaid program. The biggest hurdles we found? Washington's red tape.
States need flexibility to deal with Medicaid as they see fit. In the same way that one set of education standards does not work for all 50 states, neither does one set of standards for Medicaid. Kansas, New York and Nevada have little in common when it comes to meeting the needs of patients and providing the methods of delivery.
House Republicans have not only passed legislation to roll back these onerous requirements on the states by eliminating Obamacare, but have also passed legislation to make Medicaid spending more efficient while simultaneously preserving access to Medicaid for those who need it.
The House has passed -- and with the support of many of the country's governors -- a bill to change the way states receive Medicaid funding. By changing to a system of block grants, folks closest to American citizens -- governors, legislators and local officials -- not some bureaucrats sitting in Washington, D.C. -- will make decisions best for their citizens and design programs that work best for their states and their people.
It is time to check in Medicaid for a much-needed treatment, an update to a 46-year-old program. Failing to embrace this alternative treatment of Medicaid only enables a spending-addicted Washington.
Rep. Tim Huelskamp is a Republican who represents the 1st Congressional District of Kansas. He serves on the House Budget Committee.
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