Sorry State Of Medicaid

The WSJ notes with dozens of states facing nasty budget shortfalls, many are looking for any way out, including dropping Medicaid.

Medicaid, begun in 1965 and jointly funded by federal and state dollars, is the nexus of care for the neediest Americans, and a huge payer to hospitals, nursing homes and doctors. Medicaid enrollment totaled 62 million nationwide in 2007, the most recent data available.

But Medicaid has become one of the biggest items on state budgets, and states complain they don't have enough flexibility to pare it without losing their federal matching funds. The federal government, on average, covers 57% of the cost of the program for states. In exchange, states must keep Medicaid open to all who qualify.

Some states, in particular those led by Republicans, are calculating whether they'd be better off giving up the federal funding and replacing Medicaid with a narrower program of their own. Texas Gov. Rick Perry has proposed that his state get out of Medicaid in favor of a state-run system unburdened by federal mandates—including the one that prohibits states from reducing eligibility for the program if they want to qualify for the federal matching funds.

"We feel very comfortable that we could come up with a more equitable, a more efficient, and obviously a more cost-effective way to deliver health care," he said.

And if you can do that and cover all the people on the program now, then congratulations.  I'm betting however that this isn't going to happen, and that the rolls of any state program that would replace Medicaid would have far fewer benefits and cover far fewer people.

What does Gov. Perry propose then happens to the people that would be removed from the rolls?  Nobody apparently has an answer for this, and the WSJ article doesn't bother to ask the question.

But I guess that's somebody else's problem.

[UPDATE] And Gov. Perry believes he'll be more powerful than the President soon.  Take that as you will.