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Republican Health Care for Lower-Income People

March 10, 2017
Plain English Version

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The Medicaid program pays for health care for poor people in every state. Federal and state governments pay for the program.

The Affordable Care Act

(ACA, Obamacare) expanded the Medicaid program. It made more people eligible for the program. Medicaid is the largest health insurance program in the nation. It covers about 70 million Americans.

The U.S. Supreme Court said the states did not have to adopt the new program. Some Southern and Western states chose not to be part of the program.

Why would a state turn down the chance to help lower income residents? Two reasons. First, some states run by Republicans rejected the idea of the expanded Medicaid program. The reason was that Obama was for it. It did not matter that some of their people got less health care.

Second, the expanded Medicaid program gives states money to pay for medical costs. But it does not give states 100 percent of medical costs. States have to come with the difference in costs. That gave some states an excuse to not expand their programs.

The result is that your health care depends on where you live.

Republican Plan

Republicans have a new idea about Medicaid. Today, the funding for Medicaid is open-ended. Republicans’ want to limit the total amount of money going to the states. They call it a block grant.

They say it will give the states more control over how they spend money on health care. The states will decide who gets care. And how much care each person can get. It is hard to see how this will help lower-income people.

Will other states add to the federal funds? They can add people to the program. Or they can add services. Or just make sure the program keeps running through the year.

The new program will replace the expanded Obamacare Medicaid program by 2020.

The Future

What would be the effects of such a change in Medicaid? What will happen if Congress enacts the proposed Republican program? Will some states tell people they are out of luck because there is no money left? Will Americans in need of medical care go to emergency rooms or will they just get less care?

Source: The New York Times March 9, 2017

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