The GOP’s Rationing Health Care Plan

Given the relative disfranchisement of Medicaid beneficiaries, elected officials have historically been much more prone to view the Medicaid program in economic terms and justify any proposed reduction in federal or state spending as budgetary necessities. And so it is not surprising that this latest GOP attempt to take away coverage from some 400,000 Medicaid recipients — who are most in need of and least likely to afford health coverage — is being framed as an economic decision rather than legislation that would literally take away medical care from the most vulnerable among us:

With their proposal to turn Medicaid into block grants all but dead, Republicans now are pushing legislation to let states tighten eligibility rules for the health program for the poor and disabled.

The move, which would affect Medicaid as well as the Children’s Health Insurance Program, would help cash-strapped states save money but could also cause hundreds of thousands of people to lose health coverage.

While Democrats strenuously oppose the proposed Medicaid change, some advocates and physician groups worry that the issue could wind up as a bargaining chip in the partisan wrangling over the debt limit. [...]

Medicaid covers about 56 million Americans, with states sharing the costs with the federal government. States have been barred from cutting eligibility for the program since 2009 when economic stimulus legislation gave states billions to prop up their Medicaid program on the condition they didn’t tighten eligibility standards. The 2010 health law extended this requirement until 2014.

According to a Congressional Budget Office analysis, the House Republican proposal to repeal the requirement [which currently prevents states from throwing people off the rolls] would save $2.1 billion from 2012 through 2021. If it became law, approximately 400,000 people – about two-thirds of whom are children – would lose their Medicaid and Children’s Health Insurance Program coverage in 2013. About 100,000 of those people would enroll in employment-based insurance, according to CBO.

That’s right, after mercilessly attacking the Affordable Care Act and Democrats for breaking their promise of “if you like the coverage you have you can keep it,” Republicans on the House Energy and Commerce Health Subcommittee have already approved and many others are lining up to endorse a measure that would permit states to deny coverage to thousands of beneficiaries, effectively rationing their care. Republicans are doing this while trying to repeal the Affordable Care Act and block grant the Medicaid program in order to provide states with less federal dollars to cover people. It turns out that this is the “repeal” in their “repeal and replace.”