Empower states on Medicaid

Tim Huelskamp President, The Heartland Institute.
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It seems like every day America learns about another “unintended consequence” of President Obama’s health care law. Whether it is doubling the price tag, raiding $500 billion from Medicare, assaulting religious liberty, compromising patient privacy or granting special exemptions from the rules to politically connected labor unions and businesses, there is a multitude of reasons to expect the worst from Obamacare — and it is not even fully implemented yet!

However, not so unintended is the addition of millions of Americans to the Medicaid rolls. Even though the program is already dysfunctional — many Medicaid patients cannot find doctors, fraud is not uncommon and costs are skyrocketing and consuming budgets — states will have to provide Medicaid for an additional 17 to 25 million Americans at a cost of $118 billion. And, as the Congressional Budget Office recently announced, as many as 20 million Americans could lose their employer-based coverage, stretching Medicaid even further. Although states’ Medicaid programs will have to cover millions more, the president’s health care law does nothing to fix the inadequate access and substandard care that existing Medicaid patients already have to endure. In sum, it makes an already bad problem worse.

In March, Congressmen Todd Rokita, Jim Jordan and Paul Broun, M.D., and I introduced the State Health Flexibility Act in order to address these challenges. It will not only repeal the president’s health care law, but it will leave Medicaid in even better shape than before Obamacare became law. It will ensure that our most vulnerable citizens receive the care they need while guaranteeing that taxpayers receive the accountability and affordability that they deserve.

The State Health Flexibility Act recognizes that a one-size-fits-all, top-down Medicaid program is not the answer. In the same way that we know 50 states require 50 different education and transportation policies, we know each state has its own unique needs when it comes to health care. What is good for Kansas is not necessarily good for California or Minnesota or New York. About the only thing that ties states together is that in many Medicaid costs are outpacing how much is spent on K-12 education.

By converting Medicaid and the Children’s Health Insurance Program (CHIP) to a single block grant program, states will have the flexibility they need to provide for their most vulnerable citizens. States will have the sole authority to determine eligibility, benefits and provider reimbursement rates. Simultaneously, states will have the freedom to innovate and design their programs in ways that allow them to serve the people they know best. And, our providers will be given the flexibility they so desperately tell me that they need when they come to our office.

We know this approach works. In 1996, a Republican-controlled Congress and a Democrat president created the Temporary Assistance for Needy Families (TANF) block grant program for states to provide welfare assistance. The way this program was designed — with considerable flexibility for states — helped many families escape from poverty. We should all hope that as many people as possible can escape the reins of Medicaid.

Critics of transferring power from Washington to the states often argue that standards will not be met unless federal bureaucrats are involved. Such a claim could not be further from the truth. Voters are not stupid; if their governor receives a block grant and misuses the funds and/or fails to provide properly for his state’s most vulnerable citizens, then voters can choose to deny him re-election. What type of recourse do voters have for bureaucrats? None.

Congressman Tim Huelskamp (R-KS) is a lead sponsor of the State Health Flexibility Act. He represents Kansas’s First Congressional District.