My favorite part of Bill Clinton’s speech last night was his choice to play offense on Medicaid. Lots of Democratic campaign people don’t like to talk about Medicaid as much as they like talking about Medicare, because Medicaid is seen as a program for the poors, and *everybody knows* Democrats can’t talk about the poors – only the olds and the “middle class.”
But my man Bill Clinton wasn’t afraid to go there, and reminded America that a plurality of Medicaid’s budget goes to helping seniors afford long-term care, as well as children with disabilities and other groups that don’t make Democratic campaign staffers squeamish:
Now, folks, this is serious, because it gets worse. And you wont be laughing when I finish telling you this. They also want to block grant Medicaid and cut it by a third over the coming 10 years. Of course, thats going to really hurt a lot of poor kids.
But thats not all. A lot of folks dont know it, but nearly two-thirds of Medicaid is spent on nursing home care for Medicare seniors who are eligible for Medicaid.Its going to end Medicare as we know it. And a lot of that money is also spent to help people with disabilities, includinga lot of middle-class families whose kids have Downs syndrome or autism or other severe conditions.
And, honestly, just think about it. If that happens, I dont know what those families are going to do. So I know what Im going to do: Im going to do everything I can to see that it doesnt happen. We cant let it happen. We cant.
Medicaid is really the biggest difference between the Obama and Romney tickets. Whereas Paul Ryan’s Medicare voucher plan is phased in over time by future Congresses, his Medicaid cuts start pretty much immediately, and the block granting gives states even more leeway to cut Medicaid.
This is why the Medicaid expansion is so politically important. Obamacare opens up Medicaid to everybody who earns up to 133% of the poverty line. The program will begin insuring a lot of people in the lower middle class, and thus will eventually be seen as not just a program for the poors. Voters will end up knowing a lot more family and friends who use Medicaid, and this will serve to make the program as politically untouchable as Medicare. Over time, Democrats should be trying to expand Medicaid (and Medicare!) to more and more groups, making them more and more politically untouchable, and bargaining down service provider’s prices through monopsony power.