Block grants: The best medicine for Medicaid

Fortunately, the Republican budget unveiled Tuesday reverses this trend. While some have called the Path to Prosperity a “political kamikaze” mission for Republicans hoping for a second term, I see it as anything but.

My colleagues and I – especially my fellow freshmen – were sent here to get America back on track. We were sent here to defend the American Dream, and to ensure that future generations have access to it. If striving to ensure access to the American Dream for future generations means I’m here for only two years, so be it.

One item that I am particularly supportive of in the Republican budget is the change in the way states receive Medicaid funding. If left untouched, costs of Medicaid will soar, and the program will continue to overtake a larger share of the budget with no regard to efficiency, effectiveness, and innovation.

When serving in the Kansas State Senate in 2003, I had the privilege of working on a Medicaid task force. We looked at the ways the state could improve Medicaid services as well as how it the state could spend money more efficiently. One of the challenges we encountered continually was that the State of Kansas was limited in what it could do with the money it received from Washington - and restricted how Kansas spends its own taxes as well.

Whether Republican or Democratic administrations were in charge, too much red tape kept us from improving Medicaid. Kansas and the 49 other states have been locked into Washington’s dictums when it comes this program, instead of having the essential flexibility they need to administer the program in the states’ unique and best interests.

Governors from across the country have expressed their desires to have more flexibility with Medicaid funding, and this budget offers exactly that.  In converting all federal spending on Medicaid to block grants, governors, state legislators, and other state-level health administrators will have the ability to direct funds in a manner that works best for their states and their citizens. It is a step in the direction of restoring the federalism our Founding Fathers intended, reserving powers and privileges to the states and empowering Washington as a last resort.

Some states have already received waivers from traditional Medicaid burdens and have served as laboratories for the innovative block grant model.  One example is Rhode Island. A year and a half after the state convinced the federal government to grant flexibility to Medicaid, the program is in better health than it has ever been. The Wall Street Journal reports that after the state received a waiver and simultaneously agreed not to drop anyone’s coverage, spending has decreased by a little more than a billion dollars and there is considerable evidence of improvement of healthcare services.

Finally, this budget assumes a complete repeal and defunding of Obamacare, and that is a good thing. Obamacare, also if left untouched, places an even larger burden on states. Obamacare forces states to expand Medicaid eligibility. According to the American Legislative Exchange Council, Obamacare results in 15 states seeing their rolls grow by 30% and another seven states seeing a 40% expansion. 

Meanwhile, the federal government demands the states take on more, but leaves it up to them how they will pay for it. This was a bad policy to begin with, and proposing that we just spend more on Medicaid is not and should not be the solution.

Those who oppose Medicaid reforms will try to label those who support them as uncaring about low-income Americans or those who find themselves on hard times. Such a judgment couldn’t be further from the truth. By lifting the heavy hand of Washington on these programs, we make them more effective and more efficient for the states who manage these programs and recipients who truly need assistance.

Rep. Tim Huelskamp (R-Kan.) is a member of the House Budget Committee.

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