U.S. Representative Paul Ryan (R-Wis.), chair of the House Budget Committee, released a plan on March 12 calling for repeal of the Patient Protection and Affordable Care Act (ACA), supplanting it with another version of healthcare reform.
Ryan's plan would give states flexibility when it comes to Medicaid -- and do away with both Medicaid expansion and health insurance exchange subsidies altogether.
“Our budget repeals the president's healthcare law and replaces it with patient-centered reforms,” Ryan wrote in a Wall Street Journal op-ed published March 12.
In his proposal, The path to prosperity: A responsible, balanced budget, Ryan envisions that as baby boomers retire, social welfare programs “will start to burst at the seams.” In the coming decade, Social Security will grow 5.8 percent annually and Medicare 6.2 percent, while the overall economy expands at a slower 4.8 percent average.
“Medicaid – thanks in part to its expansion under the healthcare law – will grow at an astounding 9.9 percent,” Ryan wrote in his budget plan. “Without reform, entitlement programs will overwhelm all other items in the federal budget. And the resulting national debt will overwhelm our economy.”
In the section "Safety nets strengthened," Ryan touches on giving states more flexibility on Medicaid. “The budget resolution proposes to transform Medicaid from an open-ended entitlement into a block-granted program like State Children’s Health Insurance Program. These programs would be unified under the proposal and grown together for population growth and inflation.”
The second part of his healthcare plan calls for repealing ACA's Medicaid expansion and "removing the law’s burdensome programmatic mandates on state governments.”
On the matter of health insurance exchanges, the plan again aims to repeal a provision in ACA: “Instead of putting healthcare decisions into the hands of bureaucrats, Congress should pursue patient-centered healthcare reforms that actually bring down the cost of care by empowering consumers.”
Much the way Ryan maintained, as a vice presidential candidate, that his goal is to preserve the so-called entitlement programs rather than do away with them, he reiterated the point in his plan.
“I want Medicare to be there for my kids – just as it's there for my mom today. But Medicare is going broke. Under our proposal, those in or near retirement will see no changes, and future beneficiaries will inherit a program they can count on,” Ryan wrote in his op-ed. “Starting in 2024, we'll offer eligible seniors a range of insurance plans from which they can choose – including traditional Medicare – and help them pay the premiums.”
Photo attributed to Gage Skidmore via Creative Commons license.