Donald Trump – Medicaid under state control
Obamacare has been widely criticized since its inception. Despite being substantially similar to Republican Presidential hopeful Mitt Romney’s 2006 Massachusetts healthcare reform, Obamacare received a lot of negative attention from the right side of the political spectrum.
Obamacare has been widely criticized since its inception.
Despite being substantially similar to Republican Presidential hopeful Mitt Romney’s 2006 Massachusetts healthcare reform, Obamacare received a lot of negative attention from the right side of the political spectrum. Critics claim that premiums and deductibles are increasing along with emergency room wait times. These criticisms have some validity to them- the average premium rose 22% between 2014 and 2017, but that does not take into account subsidies which have actually lowered the amount the average consumer pays towards their premium. Additionally, President Obama told people they could stay on their health care plan, but an estimated 2.6 million Americans lost their coverage because their old policies did not meet the standards set by the new law.
In addition to the legitimate criticisms, there have been a number of false concerns ranging from mistaken to absurd.
Many libertarian-leaning Republicans are ideologically opposed to the idea of government interference with healthcare and believe any regulation of insurance companies or providers damages the ability of the free market to pick winners and losers. The unpopularity of Obamacare is exacerbated by the fact that President Obama’s name is attached to it, as evidenced by this video of people basing their preference on Obamacare vs. the Affordable Care Act on their opinion of Obama.
From cabinet appointments to executive orders, President Trump has seemingly spent his first few weeks in the White House trying to honor certain campaign promises.
During the campaign, President Trump was very vocal about his intent to reverse Obamacare, and, as part of his healthcare reforms, has recently announced plans to turn Medicaid into a block grant. Currently, the states and federal government work together to provide health coverage to low-income individuals and children. Under the block grant plan, states would get a lump sum and then administer Medicaid however they saw fit. This idea was first proposed by Ronald Regan in 1981 and is popular on the Right because it’s congruent with the ideals of state’s rights and the reduction of federal oversight.
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Critics of the idea believe it would inevitably lead to a reduction in funding.
Federal funding accounted for two-thirds of Medicaid spending. Critics believe block grant style funding would allow the federal government to push off funding responsibilities on the states, which in turn would be forced to reduce benefits. Whether or not total funding would actually decrease depends on the specifics of the program, but since one of the stated aims of the program is to reduce federal expenditures, it is likely there would be cuts. Additionally, allowing states to have greater control over their Medicaid programs would increase variances in the program between states. Also, because block grants are a one-time payment, critics believe they are less responsive to changes in the economy.
Proponents believe that block grants will reduce overall administrative costs and save the federal government money.
Kellyanne Conway, President Trump’s advisor on the issue, has stated: “Those who are closest to the people in need are really administering it, you can really cut out the fraud, waste and abuse, and you get help directly to them.” The move to block grants is estimated to reduce federal spending on Medicaid and CHIP by 22%. Advocates of the new proposal believe block grants increase flexibility, allowing states to adjust programs to their specific needs.