Newt Gingrich — who introduced his own block grant proposal in 1995 — endorsed the Republican effort to reduce federal Medicaid expenditures by transferring more of the responsibility for the program to the states, telling Rep. Michael Burgess’ (R-TX) Congressional Health Care Caucus, “there is zero doubt in my mind that the Lyndon Johnson experiment of a nationally managed bureaucracy for the poor is a total failure. ” During a question an answer session following the speech, Gingrich was asked by CNN reporter Peter Hamby how he would respond to criticism that block grants would lead states to “throw people off the books.” The former speaker conceded that some would, saying “I think different states will do different things”:

GINGRICH: Well, I think different states would have different solutions and different states will do different things. Different states will organize care in different ways. But I find it fascinating that there are people in Washington DC, who believe that their depth of care is greater than the people in those states and they somehow should trust a bureaucrat in Washington who has never been in Idaho or North Dakota or Arizona to be more concerned about the health of people in those states than a company who lives down the street, is part of the process, and actually sees it on a daily basis. And I think different states will do different things.

Watch it:

As the Congressional Budget Office has predicted in analyzing a block-grant proposal offered by Rep. Paul Ryan (R-WI), some of those “different things” include providing “less extensive coverage” to their beneficiaries. In fact, an analysis of Gingrich’s 1995 block grant proposal concluded that 48 states would have experienced a reduction in federal dollars, while federal Medicaid spending would have fallen by 15 percent in FY 2002 — less than Gingrich predicted at the time. But, if this loss of federal funding “had been absorbed through eligibility restrictions, then more than 6 million people would have lost Medicaid coverage in 2002,” the study found. It added that “the states could have responded to these reductions in federal funding by increasing their own spending in order to maintain services for their Medicaid enrollees. However, the amount required to do so would have been equivalent to a 40 percent increase in the $40 billion shortfall that was estimated for 2002.”

Gingrich’s suggestion that “Washington bureaucrats” believe that they know more about a state’s health care program than local residents is also misleading, since Medicaid is a jointly funded program by the states and the federal government. In today’s Concord Monitor, Jim Roche, who is also the president of New Hampshire’s Business and Industry Association, and is “part of the process” wrote an editorial arguing that reducing spending on Medicaid would actually shift costs to businesses.

House Republicans are preparing to unveil their much-anticipated budget next Tuesday and early reports suggest that the party is ready to embrace Rep. Paul Ryan’s (R-WI) Roadmap proposal, which would slash billions of dollars out of the Medicare and Medicaid programs and transfer the risk and burden of health insurance from the federal government to the individuals and the states.

“Ryan’s budget will propose that the federal share of Medicaid be converted into a block grant,” the Hill’s Erik Wasson reports. “This would save the federal government money because the share of costs would be converted to a fixed dollar amount that rises according to inflation, rather than automatically to match healthcare costs.” Politico reports that the cuts could total up to $1 trillion over 10 years:

HUDDLE THEFT: MEDICAID CUTS OF $1 TRILLION- PULSE’s cousin, Huddle’s Jon Allen, is reporting that the House GOP’s fiscal 2012 budget will likely contain Medicaid cuts of about $1 trillion over 10 years, according to GOP insiders. Medicare cuts are also certain to be assumed by the budget, though the figures for that are still more in flux. Medicaid would generally be changed to cut overall federal dollars while giving greater flexibility to states to spend the money they get.

To put this number into some perspective, the current Medicaid baseline is about $4 trillion over the next 10 years, so Republicans are proposing cutting Medicaid by one-quarter with changes that would repeal the Medicaid expansion found in the Affordable Care Act (saving about $438 billion) and giving states fixed block grants that are below projected federal expenditures. As a result, states would either have to make up the difference by increasing spending for the program or “provide less extensive coverage” to their beneficiaries. An analysis of the consequences of a block grant proposal from 1995 found that giving states a fixed amount of funds would have reduced national federal Medicaid funding for FY 2002 by 15 percent and could have led some 6 million Americans to lose their health coverage.

Keep in mind that Medicaid pays for 40 percent of all births and that children comprise half its beneficiaries. But the real cost drivers are older Americans. Medicaid provides financing for 60 percent of nursing-home residents and pays 43 percent of America’s long-term care bill. Ryan’s reform would stick states with the bill and would likely leave many of the most vulnerable without coverage.

Republicans, who attacked the AARP for their support of the Affordable Care Act, are lashing out against the organization for allegedly profiting from the law and are hauling representatives of the group to testify before a Congressional committee tomorrow. In a report released yesterday by the House Ways and Means Committee, the GOP accuses AARP of profiting from the law’s cuts to Medicare Advantage, arguing that reductions in the program would “lead seniors to seek supplemental insurance, including Medigap, which AARP endorses and which, the congressmen said, would provide AARP with a bigger take than Medicare Advantage plans it endorses.” Republicans claim that AARP stands to gain $1 billion in fees from the Medicaid Advantage reductions.

But the GOP hasn’t always been so down on the organization. In fact, in 2003, when AARP endorsed the Republican-backed Medicare Part D prescription drug benefit, Republicans praised the organization without accusing it of potentially profiting from the effort:

REP. PETE SESSIONS (R-TX): “What is surprising to hear the Democrat Party lambaste AARP. The AARP is that organization for senior citizens all across the country who I think has made a very wise and careful decision to look at his prescription drug plan and have clearly said GOP is right on the policy and right on what will give long-term success to this nation.” [2003]

REP. BILL THOMAS (R-CA): “[I]f we are trying to destroy Medicare, why is the American Association of Retired People supporting this proposal? Why is the AARP in favor of this bill?…AARP has chosen to be with seniors, and they have chosen to be with us.” [2003]

REP. JOE WILSON (R-SC): “Additionally, I’m happy to be here because of the support of the AARP of the plan which is before us at this time. I’m a member of the AARP and I’m proud of their promotion of the best health plan that they feel can be produced and that’s the bill before of us this week.” [11/21/2003]

REP. PHIL GRINGEY (R-GA): “Thirty-five million senior members of AARP, 330,000 physician members of American Medical Association who are providing care to hundreds of millions of Americans and 40 million Medicare beneficiaries…Mr. Speaker with so many for prescription drug and Medicare modernization benefit for our beloved seniors who could be against it and why?” [11/21/2003]

In fact, the Republican’s own report reveals that AARP began began selling Medicare Part D drug plans after 2003 and saw its revenues nearly triple. The organization maintains that it keeps its insurance subsidiary’s activities separate from its nonprofit work.

ThinkProgress intern Kevin Donohue contributed significant research for this post.