Mitt Romney has argued that he could lower federal spending on Medicaid by transferring control of the program to the states and transforming the current matching-rate funding structure into block grants that would pay states pre-determined funding amounts. The so-called “blocks” would not reflect actual costs of the program or automatically increase during economic downturns.

“I’ve laid out a plan that balances our budget,” Romney told Sean Hannity last month by taking “Medicaid and giving it back to the states and growing it only 1 to 2 percent a year.” Accepting Romney at his word, ThinkProgress concluded that the former governor’s cuts to Medicaid could be even more draconian than the reductions outlined in Paul Ryan’s budget, which aims to grow the federal contribution by approximately 3 percent annually (as compared to the estimated 6.5 percent to 7 percent annual growth* in federal expenditures that would occur under current law). Yesterday, during an appearance in Dubuque, Iowa, Romney brought his growth rate in line with Ryan’s proposal, promising to increase the federal block grants to the states by inflation plus 1 percent:

ROMNEY: Medicaid alone, by being sent back to the states, and growing the funding by inflation — CPI — plus 1 percent a year, will save a $100 billion.

Watch it:

The Congressional Budget Office (CBO) estimates CPI at 2.3 percent, meaning that CPI + 1 percent, would boost Romney’s growth rate to 3.3 percent. Comparatively, Ryan’s annual inflator — population growth plus CPI — stands at about 3 percent each year. Thus, Romney’s Medicaid plan appears more generous than he has previously suggested, but as the CBO’s analysis of Ryan’s proposal has indicated, it would significantly strain the program.

Under Ryan, federal spending for Medicaid would be “35 percent lower in 2022 and 49 percent lower in 2030 than current projected federal spending” and as a result “states would face significant challenges in achieving sufficient cost savings through efficiencies to mitigate the loss of federal funding.” “To maintain current service levels in the Medicaid program, states would probably need to consider additional changes, such as reducing their spending on other programs or raising additional revenues. Alternatively, states could reduce the size of their Medicaid programs by cutting payment rates for doctors, hospitals or nursing homes; reducing the scope of benefits covered; or limiting eligibility,” the budget office concluded. As a result, enrollees could “face more limited access to care,” higher out-of-pocket costs, and “providers could face more uncompensated care as beneficiaries lost coverage for certain benefits or lost coverage altogether.”

* Via Center on Budget and Policy Priorities (CBPP), this percentage normalizes the growth rate to take out the effects of 2014.

Secretary of State Hillary Clinton called on the United States and her allies to scale up their funding for HIV/AIDS prevention and treatment to “change the course of this pandemic and usher in an AIDS-free generation,” during a speech at the NIH this morning. “I want the American people to understand the irreplaceable role the U.S. has played in the fight against HIV/AIDS, it is their tax dollars, our tax dollars that have made this possible and we need to keep going,” she said before announcing, “creating an HIV-free population has never been a government priority until today. Today it is possible because of scientific advances largely funded by the United States.” Watch a compilation of the speech:

Clinton said she envisioned a world in which virtually no children are born with the virus, face far lower risk of becoming infected, and have access to treatments that prevent the development of AIDS and reduce spreading the infection. “HIV may be there in the future, but the disease that it causes may not be,” she said, laying out three “combination prevention” measures that would help meet the new goal:

1) Preventing mother to child transmission: 1 in 7 occurs when a mother passes the virus to her child, Clinton noted and joked: “We can get that number to zero. I keep saying zero, my speech writer keeps saying virtually zero.” She set the goal of eliminating new infections among children by 2015.

2) Voluntary male circumcision: Clinton described this option as a low-cost procedure that reduces the risk of female to male transmission by more than 60 percent. Since 2007, some 1 million have been circumcised for HIV prevention, with 3/4 of the procedures having been funded by PEPFAR.

3) Treating with anti-retro viral drugs:“If you treat a person living with HIV effectively, you reduce the risk of transmission to a partner by 96 percent,” Clinton said and pledged to “scale-up” funding that will have a profound impact on the fight against AIDS.

“Scaling up combination prevention would drive down new infections by at lest 40-60 percent,” Clinton predicted, “on top of 25 percent drop” that has occurred due to existing efforts. As a result, the number of new infections will decrease, making it possible to treat new infections each ear. “And so instead of falling behind, we will for the first time get ahead of the prevention,” Clinton explained. “We will be on the path of an AIDS-free generation.”

Clinton took a veiled shot at Republicans, referring to “some who wish us to live in an evidence free zone.” “It’s imperative that we stand up for evidence and for science. Facts are stubborn things, even though they might in the short term be dismissed. Eventually we will prevail,” she promised. The Secretary of State also announced $60 million in additional funding to determine how best to implement combination prevention strategies.

Rick Perry routinely overstates the success of his tort reform initiative in bringing more doctors to Texas, an Associated Press analysis has found. For instance, the governor claims that before his 2003 law — which caps non-economic damages in malpractice lawsuits to $250,000, limits time for filing a cause of action, toughens the standard of proof and raises the bar on qualifying expert witnesses — skyrocketing insurances costs were chasing doctors out of the state. The reform lowered malpractice insurance costs and “licensed more than 23,000 new doctors,” Perry says on the stump. During a recent speech to the Georgia Public Policy Foundation he added, “Pregnant women have better access to OB-GYNs. People in need of trauma care have better access to neurosurgeons and other specialists.”

But Perry’s 23,000 estimate includes 10,000 “who sought licenses in Texas but took jobs elsewhere” and overall, “the increase in physicians in Texas roughly tracked the state’s population growth”:

And the bulk of that influx has come in larger cities where health care was already abundant, leaving large rural swaths of Texas still without doctors…. [M]edical records in Texas show that of the state’s 254 counties, only 106 have an obstetrician/gynecologist — just six more than in 2003. In Presidio County, which has 8,000 residents and is growing, some of Parsons’ patients move 240 miles away to live with relatives in Odessa or Midland when they become pregnant. [...]

Medical rolls increased by 24 percent since 2003, while Texas’ population was soaring by 20 percent during the decade. Texas also saw rapid growth of physicians per capita before tort reform, according to the Texas Department of State Health Services.

Part of the challenge Texas faces in recruiting more doctors is its low Medicaid reimbursement rates and state cuts to medical education. This year, lawmakers cut $805 million from doctors serving Medicaid patients and postponed $4 billion in Medicaid costs for payment in the next budget cycle. The latest state budget also included an 8 percent cut in reimbursement rates to hospitals and reduced state support to graduate medical education by almost 40 percent. As a result, more than 5.2 million Texans already live in areas designated as official health professional shortage areas. In fact, Texas ranks 48th out of 50 states in the number of physicians per 100,000 residents.