After the Senate released its own version of the ObamaCare repeal bill, now known as the Better Care Reconciliation Act, the media quickly pounced with a now-routine talking point: the Republican bill will slash Medicaid! People will die from deep cuts to Medicaid! Medicaid as we know it will be destroyed!
These attacks are misleading at best, and deliberate fear-mongering at worst. The GOP healthcare bill does not cut, destroy, slash, or 'any-other-scary-verb' Medicaid. Just look for yourself. The top line numbers from the CBO don't lie.
Under current law - that is, ObamaCare - Medicaid spending is expected to spiral from $393 billion this year to $624 billion in 2026. That's nearly a 50% increase for a program that is already a budget-buster and is growing far faster than the U.S. economy and our national debt can manage.
In contrast, under the GOP's healthcare bill, Medicaid spending is still expected to increase from $393 billion this year to $464 billion in 2026. That's an 18% increase, but it's more in line with regular economic growth and inflation. The below chart from the CBO comparing the two laws makes the trend pretty clear.
The BCRA actually increases Medicaid spending relative to today, while curbing the projected unsustainable growth line in the future - that is, dollars that have not yet been spent.
Only to Democrats is increased spending on a federal program considered a cut.
The reduced cost curve in the GOP plan - remember, spending is still increasing - would come from significant changes in how the federal government reimburses the states for their Medicaid spending, as well as more flexibility in how states can manage their programs. The bill also phases out the Medicaid expansion that ObamaCare exclusively funded - which means that the CBO's estimates on decreased Medicaid enrollment compared to current law consider Americans who might have someday in the future been covered by Medicaid.
One government study found that the majority of Medicaid recipients stay on the program for less than 36 months. A third stay enrolled for less than a year. Keeping Medicaid's funding structure sustainable - not simply creating more open-ended financial commitments while enrolling millions of new otherwise able-bodied patients - is crucial to guaranteeing the safety net is there for those who are most vulnerable.
Medicaid reform is long overdue (these ideas were popular among Democrats in the 1990s) and the GOP bill takes steps to actually address the program's flaws while keeping it on a fiscally sound growth path. Medicaid spending will still be increasing.
But that won't stop the left from talking about “cuts.”