Medicaid (was RE: Walzer on the Left)

[Jim Westrich]

I think the reason Medicaid is on more solid foundation politically has a 
lot to do with its state-administration and its funding.  Even while 
serious deficits in this fiscal year, the cuts in Medicaid are not as 
pronounced as in other areas.  Because of federal matching 50%-75% on basic 
health care and even more in some other budget areas, a state needs to cut 
$1 million in programs to save around $500 thousand in the state 
budget.  Also, that is a loss of $1 in revenue for industries (hospitals, 
doctors, nursing homes, etc.) that usually is pretty well connected.  I 
have heard several Medicaid directors and researchers of all political 
stripes that mention this.

This, of course, does not explain why the Feds do not complain but again 
they are just doling out part of the money and no administration.  They do 
not like to be cheated by the states and raise a stink when certain funding 
streams get out of wack (hospital share stuff and uncompensated care pools) 
but have left a lot alone.

There is also the argument that Medicaid essentially subsidizes all 
people's health care.  That is, to the extent that Medicaid actually pays 
for care received by the poor (instead of given away for free) then that 
reduces the need to share the costs of people who cannot pay.  I do think 
some people intuit this in their support of Medicaid.

Jim

Max Sawicky wrote:
>Another possibility is they hate programs that
>provide money to able-bodied people who don't work.
>The EITC is means-tested, in its own way, and the
>only ones who hate it are some extreme-right Repugs.
>Senator Boren, about as far to the right as you can
>get for a Democrat, once proposed a new WPA.
>The public doesn't seem to hate means-tested
>Medicaid.  (Food stamps, maybe.) Against all
>apparent odds, it has been
>growing like Topsy for 15 years.   --mbs

So Topsy isn't the stunted one.  I guess it's just Flopsy and Mopsy that 
are stunted.

"For I'm not bound
and I never will
be to a wrinkled crinkled wadded dollar bill."

                 -Mac Wiseman