NCPA - National Center for Policy Analysis


December 5, 2005

Medicaid, the joint federal-state health program for the poor, is a welfare program, says health policy expert Merrill Matthews. "So why isn't the goal to get people off the Medicaid rolls and into private-sector insurance?"

In order to reduce the number of uninsured, several state governors have vastly expanded their Medicaid welfare rolls in the past few years. For example:

  • Gov. John Baldacci of Maine's 2003 Dirigo Health Plan expanded the number of people covered by Medicaid by about 78,000 -- a 32 percent increase.
  • Gov. Rod Blagojevich of Illinois has expanded the state's Medicaid rolls by 310,000.
  • Massachusetts Gov. Mitt Romney, a Republican has proposed to expand the Medicaid rolls by 106,000.

While the main cash welfare program has been reformed to tie benefits to work requirements, Medicaid asks nothing of its beneficiaries: there are no premiums and practically no copayments.

The National Governors Association has asked for the flexibility to require copays from working Medicaid recipients. Better yet, Florida Gov. Jeb Bush and South Carolina Gov. Mark Sanford plan to reform Medicaid by giving beneficiaries more control over how their health care dollars are spent. Their proposals include Health Savings Accounts (HSAs) and "customized benefits packages" tailored to individuals.

Source: Merrill Matthews, "Medicaid is still welfare; let's not forget that," USA Today, December 5, 2005.


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