Wisconsin Republicans, such as Speaker of the Assembly Robin Vos, R-Rochester, and Gov. Scott Walker, are licking their chops at the possibility of moving Medicaid from an entitlement to block grant funding, a move that will end up taking away health care coverage from those who truly need it.
Medicaid is a means-tested entitlement, which means that people under a certain income automatically qualify for and receive Medicaid benefits. The benefit is health insurance for, primarily, low-income parents with dependent children, pregnant women and elderly individuals.
Funding for this program comes jointly from individual states and the federal government, which essentially allows for states to set the threshold, based on a percentage of the federal poverty line, for people they cover.
Medicaid coverage varies greatly from state to state. Some states took Obamacare’s Medicaid expansion that covers all adults with incomes up to 138 percent of the federal poverty level, while other states elected to undergo partial expansion, meaning they would set their own Medicaid eligibility standards but therefore lose out on some federal funding.
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A move to block grants for Medicaid would not, as Walker’s spokesman suggested, “Help end the one-size-fits-all Washington mandates that do not work for Wisconsin and result in worse outcomes and higher costs to taxpayers.”
Block grants are federal funds granted to states to accomplish broad federal goals. A move to block grants from entitlement in Medicaid would most likely lower the amount of funding overall, taking health insurance away from poor, needy Americans.
This statement by Walker’s aid is untrue for a whole host of reasons, but my favorite is the outcome leading to “higher costs to taxpayers.”
When Obamacare was passed, challenged in court and ultimately upheld, the ruling contained a provision that allowed states to opt out of expanding Medicaid to 138 percent of the poverty level meaning some states, including Wisconsin, chose to forgo the expansion because of fears about high costs and an overreaching federal government.
Under the brilliant leadership of Walker, Wisconsin decided to forgo the Medicaid expansion. This was a particularly idiotic decision.
First off, the federal government is paying 100 percent of the costs incurred by the Medicaid until the end of this year, and after that, drop to paying 90 percent of the costs.
I’m not so sure about you, but when I am offered free money, I take it, and this was a hefty chunk of change. Walker let the state do without $12.3 billion over the next decade in federal funds for Medicaid.
It’s not like moving to cover all people making below 138 percent of the poverty level would have changed Medicaid in Wisconsin that drastically. Under former Gov. Jim Doyle, Wisconsin expanded our state-sponsored health care to one of the most robust in the nation, covering adults making up to 100 percent of the federal poverty level If Wisconsin were a state with incredibly minimal state Medicaid coverage, the money left on the table would have been much greater — like Texas, which decided not to take $65.6 billion from the federal government.
So instead of accepting federal money to pay for the burgeoning cost of Medicaid, with the Wisconsin Department of Health requesting an additional $450 million in the 2017 to 2019 budget to cover increasing health care costs, Wisconsin Republicans want the flexibility to use block grants to fund Medicaid.
This is not just a conjecture — moving from entitlement to block grants in the past has left people in the dust.
Under President Bill Clinton, traditional welfare was reformed from an entitlement program to a block grant. The current welfare system, Temporary Assistance to Needy Families, promised to lift people out of poverty by incentivizing work, allowing states the flexibility to create their own programs to get people to work and out of poverty.
This idea was not realized.
While average income, and wages improved after welfare reform, TANF has done little to lift families out of poverty. One thing is certain though, welfare caseloads have vastly decreased due to vast cuts in funding, leaving needy families out in the dust.
While there are many uncertainties with Republicans in power, one thing is certain — health care in the U.S. will be reformed, leaving many without the means to afford the growing costs.
Aaron Reilly ([email protected]) is a sophomore majoring in social work and economics.