Republican vice presidential nominee Paul Ryan's plan to replace the
Medicaid entitlement program with a system controlled by states would
cut federal funding by $1.7 trillion and reduce enrollment by 50
percent, according to a new report released Tuesday.
Under the Ryan plan to cap federal spending on Medicaid and repeal President Barack Obama's health care reform law, 37.5 million fewer people would
receive benefits, the Tuesday Urban Institute report concludes.
Wisconsin Rep. Ryan, chairman of the House Budget Committee, shepherded
his plan to passage in the Republican-led House in 2011 and 2012.
Republican presidential nominee Mitt Romney also supports cutting federal Medicaid spending.
proposed changes and reductions in federal financing for Medicaid under
the House Budget Plan would almost certainly worsen the problem of the
uninsured and strain the nation’s safety net," the Urban Institute
report says. "Medicaid's ability to continue these many roles in the
health care system would be significantly compromised under this
proposal, with no obvious alternative to take its place."
Ryan's plan would reduce federal funding to states by $810 billion from
2013 to 2022, according to the new report. In addition, Romney and Ryan
support scrapping health care reform, which the Congressional Budget
Office projects will add 14 million people to Medicaid and
the Children's Health Insurance Program, a related benefit, by 2022.
Health care reform repeal would take an additional $932 billion out of
Medicaid compared to what would be spent if all states expand Medicaid as the law allows.
Medicaid spending over those 10 years would be $4.6 trillion under
current law and $2.8 trillion under Ryan's plan, which represents a 38 percent cut.
is a limit to how innovative states could be if federal funding were
cut by 38 percent, however, partly because states already are containing costs in their Medicaid programs, according to the Urban Institute.
the past decade, per enrollee Medicaid spending grew by less than 3%
per year, below the growth in per capita gross domestic product," the
report says. "Controlling Medicaid spending growth much below levels
experienced in the past may be difficult to achieve."
Medicaid is jointly funded by the federal government and the states,
each of which runs its program under federal guidelines about who must
be covered and what benefits they receive.