While it\u2019s disappointing that big parts of Obamacare are left in place, it\u2019s definitely true that Medicaid desperately needs reform<\/a>,\u00a0ideally by shifting the program to the states<\/a>, thus replicating the success of welfare reform.<\/p>\n But critics are savaging this idea, implying that \u201cdeep cuts\u201d will hurt the quality of care. Indeed, some of them are even engaging in poisonous rhetoric\u00a0<\/a>about people dying because of cutbacks.<\/p>\n There\u2019s one small problem with the argument, however. Nobody is proposing to cut Medicaid. Republicans are merely proposing to limit annual spending increases. Yet this counts as a \u201ccut\u201d in the upside-down world<\/a> of Washington budgeting.<\/p>\n The Washington Post<\/em> contributes to innumeracy with a column<\/a> explicitly designed to argue that the program is being cut.<\/p>\n An article<\/a> in the New York Times<\/em> has a remarkably inaccurate headline, which presumably isn\u2019t the fault of reporters. Though the story has its share of dishonest rhetoric, especially in the first few paragraphs.<\/p>\n \u201cLoss of federal money\u201d?<\/p>\n I\u2019d like to lose some money using that math. Here\u2019s a chart showing the truth. The data<\/a> come directly from the Congressional Budget Office.<\/p>\n At the risk of pointing out the obvious, it\u2019s not a cut if spending rises from $393 billion to $464 billion.<\/p>\n Federal outlays on the program will climb by about 2 percent annually.<\/p>\n By the way, it\u2019s perfectly fair for opponents to say that they want the program to grow faster in order to achieve different goals.<\/p>\n But they should be honest with numbers.<\/p>\n Now that we\u2019ve addressed math, let\u2019s close with a bit of policy.<\/p>\n The Wall Street Journal <\/em>recently opined<\/a> on the important goal of giving state policymakers the power and responsibility to manage the program. The bottom line is that recent waivers have been highly successful.<\/p>\n \u2026center-right and even liberal states have spent more than a decade improving a program originally meant for poor women and children and the disabled. Even as ObamaCare changed Medicaid and exploded enrollment, these reforms are working\u2026 The modern era of Medicaid reform began in 2007, when Governor Mitch Daniels signed the Healthy Indiana Plan that introduced consumer-directed insurance options, including Health Savings Accounts (HSAs). Two years later, Rhode Island Governor Donald Carcieri applied for a Medicaid block grant that gives states a fixed sum of money in return for Washington\u2019s regulatory forbearance. Both programs were designed to improve the incentives to manage costs and increase upward mobility so fewer people need Medicaid. Over the first three years, the Rhode Island waiver saved some $100 million in local funds and overall spending fell about $3 billion below the $12 billion cap. The fixed federal spending limit encouraged the state to innovate, such as reducing hospital admissions for chronic diseases or transitioning the frail elderly to community care from nursing homes. The waiver has continued to pay dividends under Democratic Governor Gina Raimondo. \u2026This reform honor roll could continue: the 21 states that have moved more than 75% of all beneficiaries to managed care, Colorado\u2019s pediatric \u201cmedical homes\u201d program, Texas\u2019s Medicaid waiver to devolve control to localities from the Austin bureaucracy.<\/p><\/blockquote>\n By contrast, the current system is not successful.<\/p>\n It doesn\u2019t even generate better health, notwithstanding hundreds of billions of dollars of annual spending<\/a>.<\/p>\n Avik Roy explained<\/a> this perverse result in Forbes <\/em>back in 2013.<\/p>\n Piles of studies have shown that people on Medicaid have health outcomes that are no better, and often worse, than those with no insurance at all. \u2026authors of the Oregon study published their updated, two-year results, finding that Medicaid \u201cgenerated no significant improvement in measured physical health outcomes.\u201d The result calls into question the $450 billion a year we spend on Medicaid\u2026 And all of that, despite the fact that the study had many biasing factors working in Medicaid\u2019s favor: most notably, the fact that Oregon\u2019s Medicaid program pays doctors better; and also that the Medicaid enrollees were sicker, and therefore more likely to benefit from medical care than the control arm.<\/p><\/blockquote>\n In other words, I was understating things when I wrote above that there was \u201cone small problem\u201d with the left\u2019s assertion about Medicaid cuts hurting people.<\/p>\n Yes, the fact that there are no actual cuts is a problem with that argument. But the second problem with the left\u2019s argument is that Medicaid doesn\u2019t seem to have any effect on health outcomes. So if Republicans actually did cut the program, it\u2019s unclear how anybody would suffer (other than the fraudsters who bilk the program<\/a>).<\/p>\n Reprinted from International Liberty<\/a>.<\/em><\/p>\n Daniel J. Mitchell is a senior fellow at the Cato Institute who specializes in fiscal policy, particularly tax reform, international tax competition, and the economic burden of government spending. He also serves on the editorial board of the Cayman Financial Review.<\/p>\n This article was originally published on FEE.org. Read the original article<\/a>.<\/p>\n![\"\"](\"https:\/\/www.megalextoria.com\/wordpress\/wp-content\/uploads\/2017\/06\/Medicaid-Growing-Spending.jpg\")
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\u2026the Senate proposal includes significant cuts to Medaid spending\u2026the Senate bill is more<\/em> reliant on Medicaid cuts than even the House bill\u2026spending on the program would decline in 2026 by 26 percent\u2026That\u2019s a decrease of over $770 billion on Medicaid over the next 10 years. \u2026By 2026, the federal government would cut 1\u00a0of every 4 dollars it spends on Medicaid.<\/p>\n<\/blockquote>\n\n
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Senate Republicans\u2026took a major step\u2026, unveiling a bill to make deep cuts in Medicaid\u2026 The Senate measure\u2026would also slice billions of dollars from Medicaid, a program that serves one in five Americans\u2026\u00a0The Senate bill would also cap overall federal spending on Medicaid: States would receive a per-beneficiary allotment of money. \u2026State officials and health policy experts predict that many people would be dropped from Medicaid because states would not fill the fiscal hole left by the loss of federal money.<\/p>\n<\/blockquote>\n![\"\"](\"https:\/\/www.megalextoria.com\/wordpress\/wp-content\/uploads\/2017\/06\/Medicaid-Outlays-CBO-Senate.jpg\")
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\nDaniel J. Mitchell
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