American Bridge

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]

BRIDGE BRIEFING: Romney’s Medicaid Block Grants Would Hurt Children

Romney Wanted To Block-Grant Medicaid

Romney And Ryan Would Block Grant Medicaid In An Effort To Cut Federal Spending. According to The Huffington Post, “About 30 million children, or one-third of America’s kids, get their health care from Medicaid, a program that serves the poor. Under plans to dramatically cut federal funding backed by Republican presidential candidate Mitt Romney and his running mate, Rep. Paul Ryan (R-Wisc.), that number would have to shrink. Romney and Ryan both support transforming Medicaid from an entitlement with an open-ended budget and a guarantee of coverage into a ‘block grant’ program that would provide states a set amount of money to spend on health care services for the needy each year. But it’s not just about giving states more flexibility: It’s about slashing $810 billion in federal spending on a vital component of the safety net — without a plan for making up the difference.” [The Huffington Post, 8/22/12]

Romney Wanted To Convert Medicaid To A Block Grant Administered By The States. According to Forbes, Avik Roy wrote an op-ed noting that Romney’s economic plan “…spends a bit more time on Medicaid reform—by which I mean a lengthy paragraph—promising that, ‘as president, Romney will push for the conversion of Medicaid to a block grant administered by the states. This approach could save the federal government over $200 billion each year by the end of the decade, while also providing states with the flexibility to develop innovative and effective approaches best suited to their needs.’” [Forbes, 9/7/11]

Steelman “Never Voted For A Tax Increase”?

On Monday, Republican Senate candidate Sarah Steelman made a sweeping (and incorrect) claim about her voting record in the Missouri state senate when she stated that she “never voted for a tax increase.” This has sparked a heated back and forth between Steelman and one of her primary opponents, John Brunner, who took a swing and missed when the attack spiraled downward into an argument about semantics. Brunner argues that Steelman voted to make a temporary tax permanent. Steelman counters that Brunner “does not understand the legislative process.”

And while that may be true, it is less because he is mischaracterizing the vote Steelman cast and more because there is a much clearer example of Steelman voting to raise taxes.

In 2002, Steelman voted to create a brand new tax. Here is text from the legislation Steelman supported:

“In addition to all other fees and taxes required or paid, a tax is hereby imposed upon licensed retail pharmacies for the privilege of providing outpatient prescription drugs in this state. The tax is imposed upon the Missouri gross retail prescription receipts earned from filling outpatient retail prescriptions.”

“A tax is hereby imposed.” Maybe Brunner should run with that one instead of arguing about the difference between “increasing” and “extending.”

Steelman Voted To Create Retail Pharmacy Tax In Order To Fund Medicaid Pharmacy Program. On May 15, 2002, Steelman voted for the Senate Substitute version of the Senate Committee Substitute version of HB 1898, a bill that created a retail pharmacy tax “for the privilege of providing outpatient prescription drugs.” The bill imposed a new retail pharmacy tax upon all licensed retail pharmacies in Missouri in order to fund the state’s Medicaid Pharmacy Program. The retail pharmacy tax was limited to 6% of a pharmacy’s monthly gross retail prescription receipts. According to the Missouri House of Representatives, “This act imposes a tax upon licensed retail pharmacies in Missouri for the privilege of providing outpatient prescription drugs. The tax rate of up to [sic] will be based on monthly gross retail prescription receipts of pharmacies, not to exceed 6%… All revenues from the tax will be deposited in the Pharmacy Tax Fund, created in the act. Moneys in the fund will be used to provide payments for services related to the Medicaid pharmacy program.” The bill was passed by a vote of 24-9. [Missouri State Senate, Daily Journal of the Senate, Day 73, 5/15/02, Page 1655; Missouri House of Representatives, Official Summary, HB 1898]

Romney Not Sure What Medicaid Was

Today on the campaign trail, Mitt Romney made the odd claim that he didn’t understand what Medicaid was until he ran for office.

“Medicaid — you wonder what Medicaid is, those that are not into all this government stuff,” Romney says. “I have to admit, I didn’t know all the differences between these things before I got into government, and then I got into it and understood that Medicaid is the health care program for the poor, by and large.”

This video was captured by an American Bridge tracker in Sioux City, IA, on December 16, 2011.