A huge section of the GOP bill undoing Obamacare isn't actually about Obamacare
By Max Ehrenfreund May 5 at 12:41 PM
Republicans celebrated on Thursday after successfully moving a health-care bill forward that they said would fulfill their promise to repeal President Barack Obama's Affordable Care Act. Yet one of the bill's most far-reaching sections is only tangentially related to repealing the law, also known as Obamacare.
The law would limit federal spending on Medicaid — the program that provides health insurance to the poor — to an index of inflation in medical prices. Since the program's costs are increasing more rapidly than that index, over time, the government would spend hundreds of billions less on Medicaid than it would under the current system. It would be up to states to decide how to make up the difference.
The provision will affect millions of Americans on Medicaid — many of them children, the disabled or patients in nursing facilities — whose coverage is not otherwise affected by Obamacare. The main provisions of that law expanded Medicaid to a broader population and established markets for people who were not eligible for insurance through the government or through an employer to buy coverage.
In the existing system, the government covers a share of each beneficiary's costs, regardless of how many enroll in each state or what their expenses are. That guarantee would end under the GOP plan.
How did a sweeping reform to the Medicaid program make it into a bill that is ostensibly about Obamacare? For Republicans, changing how Medicaid is financed has long been a chief priority, aside from undoing Obama's reforms. At a conference in March, Rep. Paul D. Ryan (R-Wis.), the speaker of the House, joked with Rich Lowry, editor of the conservative National Review, about how the two of them had been planning to limit federal Medicaid spending since partying together as much younger men.
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