Topic: Medicaid Block Grants and Consumer-Directed Health Care

[jpatrickham]

Daily Policy Digest

 
Health Issues

September 15, 2011

"Medicaid is a health program for the poor and disabled funded by federal and state appropriations.  It is the largest and fastest growing publicly funded health program in the United States, says Linda Gorman, a senior fellow at the Independence Institute.

State and local government Medicaid spending is projected to rise rapidly from $130 billion in 2009 to $357 billion by 2020.
Federal Medicaid spending is projected to increase from $254 billion in 2009 to $574 billion by 2020.
Total Medicaid spending is expected to rise to $930 billion by 2020 and will account for 20 percent of all U.S. health expenditures.
There are two major reasons for this growth.

One is that the federal government matches all state spending on federally allowed Medicaid services -- this encourages excess spending. 
The second reason is the program's complexity.
States can also apply for federal Medicaid waivers that allow them to test policy innovations.  Waivers, state spending differences, coverage of mandatory and optional populations and services combine to ensure that no two states have exactly the same Medicaid program.

Turning Medicaid into a block grant program in which the federal government gave each state a set amount of money could improve patient care, restrain the growth in costs, reduce complexity and improve outcomes.

Block grants can change Medicaid incentives by eliminating matching fund finance. 
States satisfied with their current Medicaid program could continue without change just by meeting a negotiated budget. 
States that think they could do better would be free to try something else. 
The federal government would manage one Medicaid block grant program rather than 50 different state Medicaid experiments."

Source: Linda Gorman, "Medicaid Block Grants and Consumer-Directed Health Care," National Center for Policy Analysis, September 15, 2011.

For text:

http://www.ncpa.org/pub/ib102

For more on Health Issues:

http://www.ncpa.org/sub/dpd/index.php?Article_Category=16

[Libertas]

This is something I think Perry and others brought up in the debates, letting states cut Fed strings and better manage their states and control spending.  Frankly I would like to see all FDR era Ponzi schemes scrapped and everything privatized, but as a minimum effort this seems a no brainer.

[jpatrickham]

This is something I think Perry and others brought up in the debates, letting states cut Fed strings and better manage their states and control spending.  Frankly I would like to see all FDR era Ponzi schemes scrapped and everything privatized, but as a minimum effort this seems a no brainer.

The key is being able to cross State lines, make competition the magic bullet. Each State responsible for the Policing there own. Everybody wins!

[charlesoakwood]

Portability is the word they use which is a gobbledygook word for the problems incurred by changing residency from one state to another.  If a policy is written for state A and one moves to state B which has no policy similar to that person's original policy how are all parties satisfied?  Also, pre-existing conditions, if they have been met in state A is state B required to honor them?  And on and on.

Insurance companies never want to pay and congress always gets in and regulates things worse than they were.
It was a difficult problem in 1960, it has become exponentially worse.

[Libertas]

We all know how Ruling Class trash slams that shut don't we CO?

Yup, lets ride the Commerce Clause pony again and pull some more chits out our arses!