MANY conservatives worry that once an entitlement programme exists, it is all but impossible to pare back. They will be disheartened by the postponement, on June 27th, of a Senate vote on the Republicans’ health-care bill. The party’s moderates cannot tolerate the proposed cuts to Medicaid, the federal and state health-insurance programme for the poor. Under the bill, which will now be amended or rewritten, Medicaid’s budget would have been 26% lower in 2026 than currently forecast. “Medicaid cuts hurt [the] most vulnerable Americans,” noted Senator Susan Collins of Maine, announcing her opposition. Conservative justifications for cuts—that Medicaid has grown too big, and is ineffective—must compete with the fact that one in five of Ms Collins’s constituents use the programme. But are the right’s complaints about Medicaid justified?
When Medicaid began in 1965, it served two groups: those who also received cash welfare from the government, and whomever states deemed to be “medically needy”. That mostly meant elderly residents of nursing homes. But it could be much broader. New York included almost half its population. Because the federal government picked up over half the tab, in 1976 Congress tried to control costs by limiting coverage to the poor and nearly-poor.
In the 1980s, however, Washington oversaw a gradual broadening of...Continue reading
Source: United States http://ift.tt/2sqvQZ6
EmoticonEmoticon