Bush Medicaid Initiative Would Give Governors More Control
February 14, 2003
To enable state governors to get their Medicaid programs under control, President Bush has suggested an optional 10-year plan employing a carrot-and-stick approach.
Medicaid now accounts for more than one-fifth of state outlays. State Medicaid spending now totals $258 billion a year and the Congressional Budget Office anticipates that will more than double to $578 billion by 2012.
- The carrot is that states receive an extra $3.25 billion in 2004 and $12.7 billion over seven years -- which they can use to maintain the nonmandatory benefits they now provide, such as prenatal care and childhood vaccines.
- The stick is that federal spending will be reduced over the final three years -- by which time states will be expected to have learned to live within their means.
- That might be accomplished if states started prioritizing, eliminating waste and developing models akin to those of professional insurers.
- Critics say that as things stand now, states which want to depart from rigid federal rules must apply for a waiver from Washington -- a slow and costly process.
Supporters of the Bush plan see it as Welfare Reform, Part 2. Liberal defenders of the status quo fear that is exactly what it is.
Source: Editorial, "Medicaid's Real Friends," Wall Street Journal, February 10, 2003.
For text (WSJ subscription required)
Browse more articles on Health Issues