With Congress and the Administration dumping another 10M or so people on Medicaid who can’t afford Health Insurance. And not paying for the Medicaid Expansion, giving States another Unfunded Mandate. In the Affordable Care Act in 2010, the Health Care Law that I support for the most part. And now with the House GOP voting to Block Grant Medicaid allowing States to deny Medicaid Insurance to Low Income and disabled patients. Its time that we have a real Medicaid Reform plan before Before Washington has another opportunity to destroy it. I”ll take at Face Value that the Medicaid Reform in the AFA was well intentioned. To give more Low Income people Health Insurance. And I’ll also take Paul Ryan’s Medicaid Reform as well intentioned also. Giving States more flexibility as well. Fine I’ll accept that, but whether these reforms are well intentioned or not, is not the point. They are still bad ideas and when you have a Health Insurance provider as large as Medicaid, in the neighborhood of 50B$, wow thats a large neighborhood. Thats sole purpose to provide Health Insurance to Low Income people and the disabled. The most vulnerable amongst us. You have to get it right and its about reforming it correctly not intentions.
What I would do with Medicaid is turn it into another Non Profit Government Sponsor Enterprise or GSE for you acronym fans. That would be independent of the Federal Government but tightly regulated. It would be another Non Profit Health Insurance provider with its own Management and Board of Directors that they would select. That would have to follow the same rules as private Non Profit Health Insurers. But would have to accept all applicants that meet its requirements. Low Income, disabled people or both that can cover their share of their Health Insurance costs. From their job or if they are on Public Assistance. Low Income people would get a voucher to cover their Health Insurance costs for Medicaid. And their employer would cover the rest. While people on Unemployment, Welfare or Disability Insurance. Would get additional assistance to cover their Health Insurance costs for Medicaid as well.
Medicaid would then be a Self Sufficient Non Profit Health Insurer that would govern itself. That the FEDS and States would no longer have to worry about how they’ll pay for it. And then States would have the flexibility to set up their own Health Insurance System. Whether they want to create their own Public Option for everyone to be part of. Or develop a Single Payer System for Health Insurance or expanding private Health Insurance. Or some type of combination but they would no longer have to worry about how to finance Medicaid especially in tough budget times.