My, How The Times Have Changed!


Last week, Congressional leaders shared an outline of their plan to repeal Obamacare and rebuild our health care system. Among those proposals were two reforms to strengthen the Medicaid program – per capita allotments and optional block grants.

Last Sunday, in a response bordering on the absurd, The New York Times Editorial Board wrote:

“Next, the Republicans want to slash spending on Medicaid over all by giving states the option of a block grant or a per capita allotment. The current program pays for the health care of everyone who is eligible. During recessions, when the number of people in poverty increases, the government spends more. Without the flexibility that was built into Medicaid, Congress would have to vote to give states more money when health care costs rise. Politically, that is in the ‘impossible dream’ category, which is why most experts believe that, over time, states would cover fewer people and cut benefits.”

Perhaps The Grey Lady should have checked her own archives. Because, in 1997, The New York Times Editorial Board wrote in gushing, full-throated praise of then-President Bill Clinton’s call for reforming Medicaid through per capita allotments:

“…Mr. Clinton has mostly made sound, compassionate decisions to mitigate the worst harshness.”

“The President offers an important reform of Medicaid, proposing to control future spending by placing a cap on the amount of Federal spending per enrollee and allowing states to place enrollees in managed care without going through the frustrating process of begging for Washington’s approval.”

What’s changed in the past 20 years? Well for one thing, Medicaid is now three times larger and cost three times as much as it did under President Clinton. But reforming the Medicaid program through a per capita allotment is still a bipartisan proposal, and one that now has been around for decades.

The Medicaid program today is a critical lifeline for some of our nation’s most vulnerable patients. House Republicans will not pull the rug out from anyone as we work to give states the flexibility they need to take care of those most in need. Strengthening Medicaid through bipartisan reforms intended to put the program on stable fiscal footing while prioritizing our nation’s most vulnerable is not an “impossible dream,” it is an achievable goal, and one that all Americans – even editors of The New York Times – should want to achieve.