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BRIDGE BRIEFING: Ryan And Medicaid

The Ryan Plan Would Block Grant Medicaid To States And Cut Medicaid Spending By $800 Billion Over 10 Years

Ryan Plan Slashes Medicaid By Making It A State Block Grant. According to Sun-Sentinel, “The Ryan budget plan would cut federal spending on Medicaid, which provides health care for the poor, and begin distributing money by block grant to states. The plan would do away with Medicare’s direct payment for health care for seniors, replacing it with a voucher system in which recipients choose private insurers. The Congressional Budget Office found that part of the plan, which would take effect in 2022, could nearly double out-of-pocket costs for seniors.” [Sun-Sentinel, 4/16/11]

Ryan Budget Would Cut Medicaid By $800 Billion Over Next Ten Years, And Steadily More After That Until Cuts Extended To Over Half Of The Program. According to the Center For Budget And Policy Priorities, “The Ryan plan would cut Medicaid by more than $800 billion over the next ten years and steadily larger amounts after that (on top of the Medicaid reductions that would result from Chairman Ryan’s call to repeal health reform). After several decades, Medicaid would be cut by more than half. Yet Medicaid already costs substantially less per beneficiary than private insurance because it pays health providers rock-bottom rates and has low administrative costs. In addition, its per-beneficiary costs have been rising more slowly than private-sector health care costs. Assertions that Medicaid costs are highly inflated and that states can provide comparable health care for much less money may serve as convenient rationales for severe cuts in health care for some of the nation’s most vulnerable people, but they do not reflect reality. Last year, the Urban Institute estimated that a very similar Ryan Medicaid block-grant proposal would likely cause 14 to 27 million low-income Americans to lose coverage by 2021 (in addition to the 17 million people who no longer would gain coverage due to the repeal of health reform and its Medicaid expansion).” [Center for Budget and Policy Priorities, 3/21/12]

Block Grants For Medicaid Would Cost 14 – 27 Million People, Half Of Them Children, Their Health Care

Plan To Block Grant Medicaid Would Force Between 14 Million And 27 Million People Off Medicaid By 2021. According to the Boston Globe, “Like House Republicans, Romney promises to transform Medicaid into block grants for states and shed federal supervision of it. He would cap the program’s annual growth to inflation plus a percentage point. His campaign says the approach would unshackle states to innovate and, by the end of a decade, cut costs by more than $200 billion a year. Advocates for the poor say the inevitable result will be that millions of people will be bounced from the program. An Urban Institute study last year estimated that Ryan’s cuts would force between 14 million and 27 million people off of Medicaid by 2021. Romney’s budget would make deeper cuts.” [Boston Globe, 4/22/12]

Children Made Up Half Of Medicaid’s Beneficiaries So Cuts Would Make Medicaid Unavailable To Some Children. According to The Huffington Post, “Children make up about half Medicaid’s 62 million beneficiaries. The rest is a mix of the parents of some of those kids, pregnant women, people with disabilities, and the elderly. Predicting the exact number of children who would be dropped from Medicaid under a block grant scheme isn’t possible, but taking away that much money means some would, said Robert Block, a pediatrician from Tulsa, Okla., who is president of the American Academy of Pediatrics. ‘The simple math is: You subtract that from the total Medicaid available and there’s a lot less for kids,’ Block said.” [The Huffington Post, 8/22/12]

Romney And Ryan’s Medicaid Plan Block Granting Funds Would Let States “Pick And Choose” What Would Be Covered. According to Mother Jones, “Medicaid, which provides an even bigger chunk of funding for family planning centers than Title X, would also take a serious hit under Romney and Ryan—at least if Ryan’s budget proposal is any indication. Ryan’s plan suggests slashing Medicaid by $810 billion over the next decade. States would then receive fixed federal grants and would get to pick and choose who and what they would cover.” [Mother Jones, 8/17/12]

The Medicaid Cuts Would Jeopardize Nursing Home Coverage

Ryan Plan Slashes Medicaid, Jeopardizing Nursing Home Coverage. According to National Journal, “Perhaps more jolting, the Republican budget would cut spending on Medicaid—health care for the poor—much of which goes to long-term care for the elderly. Some 9 million seniors qualify for both Medicare and Medicaid benefits, and about two-thirds of all nursing-home residents are covered by Medicaid. The GOP budget proposes cutting some $744 billion from Medicaid over 10 years by turning the system into block grants that limit federal contributions and give states more choice in structuring benefits. No one knows exactly which Medicaid services states would choose to cut back, but senior citizens account for a disproportionate share of Medicaid outlays and would almost certainly bear some of the burden.” [National Journal, 6/6/11]

The Ryan Plan Would Reduce Spending On Medicaid Services For Low-Income Patients; Would Not Increase The Amount Of Federal Funding To States When They Add More Medicaid Recipients During A Recession. According to The Arizona Republic, “Ryan’s plan also would reduce spending on Medicaid services for low-income patients. The federal government would send a set amount of block-grant money to Arizona and other states to provide Medicaid services. It would not increase the amount, as is currently the case, when a state adds more Medicaid recipients to its rolls during a recession.” [The Arizona Republic, 4/13/11]

Ryan Plan Medicaid Cuts Would Strain State Budget

Ryan Budget Would Force States To Either Increase Spending Or Reduce Scope Of Medicaid And Children’s Health (CHIP). According to the Center For Budget And Policy Priorities, “As CBO explains, the magnitude of the cut in Medicaid and CHIP ‘means that states would need to increase their spending on these programs, make considerable cutbacks in them, or both. Cutbacks might involve reduced eligibility for Medicaid and CHIP, coverage of fewer services, lower payments to providers, or increased cost-sharing by beneficiaries — all of which would reduce access to care.’” [Center for Budget and Policy Priorities, 3/20/12]

The CBO Reported That States Would Be Faced With A Difficult Challenge If The Ryan Plan Was Passed. According to the Chicago Tribune, “The nonpartisan Congressional Budget Office concluded this year that states would find the challenge very difficult under the House budget proposal by Rep. Paul Ryan, R-Wis., which would turn Medicaid into block grants and cap spending growth. ‘Even with significant efficiency gains, the magnitude of the reduction in spending … means that states would need to increase their spending on these programs, make considerable cutbacks in them, or both,’ budget analysts wrote. The Romney campaign, which has backed Ryan’s plan, has refused to provide details about how Romney would deal with these trade-offs.” [Chicago Tribune, 7/31/12]