Posted on 02/22/2020 5:14:12 AM PST by Kaslin
Little remains of former President Barack Obamas signature healthcare legislation, Obamacare. Donald Trump has made sure of that. Through his executive branchs authority, the president has managed to do what Congress hasnt and chip away at the legislation, piece by piece. Indeed, the Trump administrations expansion of skinny health insurance plans, as well as its move to end cost-sharing reduction payments, should absolutely be commended. And the president is not done yet. According to an analysis from The Hill, President Trumps recently-proposed budget calls for additional massive cuts to Obamacare $844 billion over the next ten years.
Without a doubt, the presidents executive actions have helped to shore up our nations tenuous healthcare situation. However, rather than implement positive change, one new proposal from the Trump administration, called the Medicaid Fiscal Accountability Regulation (MFAR), will instead unintentionally empower the enforcers of Obamacare themselves.
Currently, under Medicaid, the federal government promises an agreed-upon match percentage to the states, tied to how much they each put into Medicaid. But ever since Obamacares Medicaid expansion, the system has begun to fall apart. Obamacare essentially forced states to expand Medicaid and spend more money on the entitlement program, regardless of their individual financial circumstances or the solvency of the healthcare system at large. Predictably, this led to the states engaging in creative bookkeeping with their state coffers in hopes of receiving more funds from the federal match to save the day. As a result, federal Medicaid liabilities have ballooned out of control.
The Trump administrations MFAR would tighten federal requirements for how states can provide reimbursements for Medicaid. The hope is that it would alleviate the state funding transparency problem.
Make no mistake: Medicaid expansion is the most significant piece of Obamacare remaining, so the Trump administration clearly has the right idea in wanting to address the added transparency and funding issues it brought to the nations third-largest entitlement program. However, in this instance, the proposed cure is worse than the disease. It would breathe new life into the Department of Health and Human Services (HHS) the very entity responsible for Obamacares troubled implementation in the first place.
When it comes to Obamacare, the HHS has an unfortunate history of incompetence. Perhaps most famously, the department bungled the rollout of the Obamacare websitea mistake costing millions of taxpayer dollars. Whats more, in 2015, they issued more than 800,000 Obamacare tax forms filled with incorrect information. The HHS isnt an entity with a record of success on this issue, yet its the department MFAR relies upon to micromanage and audit the states Medicaid programs. Clearly, this shouldnt be the case. If the past is any indication, growing the authority of the HHS will only result in more waste, inefficiency, and overreach, not less.
In this case, rather than eliminating the problematic federal Medicaid match, HHS will be approving all of the states' Medicaid budgets and telling them how they can and cannot fund the program. HHS doesnt get much right within its own federal responsibilities, let alone with issues pertaining to Obamacare. So, how is it going to understand and grasp the economic landscape of 50 different states to determinate how each once should be funding such a complex entitlement program?
Beyond that, if a future Democrat is elected, they will almost certainly use MFARs authority to have HHS cram down their leftist agenda. With Obamacare, for example, HHS attempted to force the Little Sisters of the Poor to pay for religiously and politically controversial products like the Morning-After pill a strong-arm tactic that the Supreme Court struck down. The lesson is simple once we empower HHS in health care, its incredibly hard to rein it in. Using the power to approve/disapprove state Medicaid budgets under MFAR, the HHS could push for anything from further Medicaid expansion to forced funding for abortions. Given the increasing radicalism of the Democratic Party, is that a risk the Trump administration should be willing to take?
To reduce the many side effects of Obamacares Medicaid expansion, the Trump administration doesnt need to expand the power of the federal government. Instead, it can eliminate transparency and budgetary concerns by repealing the federal match and implementing block granting instead. This would take the federal government out of health care and give more authority back to the states.
Block grants proportioned, predetermined federal funds given to each of the states maintain a distinct advantage over MFAR; they allow each state to determine where best to spend the money. Rather than relying upon a bevy of new federal rules and restrictions to dictate how the states can and cannot fund Medicaid, block grants encourage states to find creative solutions to their own problems. More importantly, they decrease the national governments influence over the healthcare industry.
The president has doubtlessly made incredible progress in saving American healthcare from the brink of collapse. However, trusting HHS the same troubled Department that caused most of the Obamacare headaches to begin with to implement further reforms will amount to a disaster, not yet another win for the White House.
Any policy attempts to implement new conservative regulations rather than eliminate/reform the federal Medicaid match will only amount to a guessing game thats destined for failure. Thats precisely what MFAR would do, which is why the policy change must be rejected.
Pure wind
Dunno - the best way to get rid of a crappy law is to strictly enforce it.
Drive a stake through its heart, Mr. Pres.
FTA: calls for additional massive cuts to Obamacare $844 billion over the next ten years.
Zero it out now!
Let free enterprise take over!
“Dunno - the best way to get rid of a crappy law is to strictly enforce it.”
And they don’t come much crappier than the Patient Endangerment and Unaffordable Health Destruction Act. Expecting good results from that monster was like fencing in a hundred acres of corn, turning a thousand wild hogs loose in it for a month and expecting to come back and find Augusta National golf course. Only someone unconnected to reality thought it would be anything but a disaster.
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