It’s not that we have a Federal health insurance program for the poor that’s the problem. But how it’s setup and run that is the problem because Medicaid was never setup to be run affordably and efficiently. The idea of Medicaid is that "we are going to have free health insurance for the people who are on Medicaid. With the states, doctors, hospitals and clinics having to figure out how to pay for most of it with the Feds not chipping in much".
And what the states, doctors, hospitals and clinics are saying is that "we can’t afford that we need to be compensated for the healthcare that we deliver. Otherwise we are not going to be able to deliver it because we have our own bills to pay". Medicaid along with Medicare were setup in 1965, the difference being that Medicare was setup with a direct revenue source and increase in the payroll tax. Medicaid has never had that, it’s had to come out of general revenue from the Feds and states and what the Feds have basically said is that. "We do have the money for it" and have past the costs down to the states, hospitals, clinics and doctors.
So the way to fix Medicaid is to make self-financed with it’s own revenue source. And we could do that by having Medicaid be paid for by its customers like all other health insurance plans. Including Medicare so workers would pay for a portion of their Medicaid insurance, along with their employers. With these low-income workers being eligible for a tax credit at the end of the year. And people who are unemployed would get an additional payment to pay for their Medicaid.
As well as giving Medicaid patients an option to choose another health insurance plan with their Medicaid dollars, but they wouldn’t be forced to and we would see less people taking Medicaid for another plan. And then I would do what’s called in Washington, block-grant Medicaid to the states for them to run under a couple conditions. That anyone eligible for Medicaid would have the option of taking Medicaid and getting that health insurance. And that their Medicaid dollars could only be used to pay for Medicaid.
The concept of Medicaid is sound so that even low-income workers can have access to health insurance and health care in America. But the way it was setup and run has created a hole for the states, hospitals, clinics and doctors to fill. And what they are saying is that "we can no longer afford to fill that hole" and as a result Medicaid patients are now getting stuck without having health insurance. Something by law they are eligible to have.