Empower the states to reform Medicaid — don’t punish them 

In tackling the challenges facing America’s health care system last year, President Barack Obama and the last Congress responded, in part, by expanding federal Medicaid and predictably passing the buck to states that were already struggling to keep up with the pre-existing conditions of Medicaid.

Now, state legislators and governors have to find a way to pay for nearly 25 million additional Medicaid enrollees who are expected to cost more than $400 billion over the next decade. On average, states cover about one-third of the federal government’s Medicaid mandates, so this will strain them even more.

Medicaid spending was already proving challenging for states. The number of Medicaid enrollees has grown from 35 million to 60 million over the past 10 years and Medicaid spending by the states soared 192 percent during the past 20 years.

There are times when people find themselves needing assistance from programs like Medicaid. However, Obamacare’s expansion of the eligibility threshold modifies Medicaid so that it is no longer about serving the poor and disabled, but about making Medicaid an open-access program serving middle-class Americans.

Those who earn 134 percent of the poverty level will be eligible for Medicaid come 2014.

In the Kansas state Senate, I was part of a Medicaid task force that evaluated how the Sunflower State could improve its Medicaid program. The biggest hurdles we found? Washington’s red tape.

States need flexibility to deal with Medicaid as they see fit. In the same way that one set of education standards does not work for all 50 states, neither does one set of standards for Medicaid. Kansas, New York and Nevada have little in common when it comes to meeting the needs of patients and providing the methods of delivery.

House Republicans have passed legislation to make Medicaid spending more efficient while simultaneously preserving access to Medicaid for those who need it. The House passed — with support of many of the country’s governors — a bill to change the way states receive Medicaid funding.

By changing to a system of block grants, folks closest to American citizens — governors, legislators and local officials — not bureaucrats sitting in Washington, D.C. — will make decisions best for their citizens and design programs that work best for their states and their people.

Rep. Tim Huelskamp is a Kansas Republican who serves on the House Budget Committee.

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