Sen. Richard Burr (R-NC) relied on a recent New England Journal of Medicine study — which found that children in Medicaid had a harder time accessing care than those with private insurance — to advocate for substantial reforms of the public health care infrastructure. “Now, the whole debate that we’re having, does Medicare, does Medicaid as currently constructed work?,” Burr asked during a hearing at the Senate Finance Committee today. “It can’t be something that’s working because all of the information is telling us that it’s not,” he said.
Republicans are proposing to transforming Medicaid into a block grant program and providing states with less federal funds and greater flexibility to cut their rolls and institute other benefit changes. Critics maintain that reforming the program by cutting care would only worsen the access problem. It’s a point former CMS head Bruce Vladeck made in responding to Burr:
VLADECK: Absolutely, Medicaid patients have great difficulty in access to care in some communities more than in others and one can only imagine what would happen to those problems in a block grant situation. That’s why CMS has finally belatedly issued regulations to begin to figure out how to define or enforce the access provisions in the statute.
Massachusetts Gov. Deval Patrick (D) — another witness at the hearing — also argued that his state could not maintain its Medicaid program under the kind of block grant structure Republicans are proposing. “There is about a $23 billion cost to us, in cost shifting, over 10 years. A state with a strong balance sheet like ours cannot absorb that and provide the same level of benefits. So you make a decision, you cut benefits or you cut people,” he said. Watch that exchange: