The Times clears up the difference between Ryan’s current proposal and a previous proposal which had been criticized by Democrats (our emphasis):
Recognizing the political risk of significant changes in Medicare and Medicaid, the health care program for poor Americans, Mr. Ryan emphasized that such spending would continue to rise under the Republican budget plan, just not as sharply as it would have otherwise.
He also sought to clarify that any Medicare changes, which would include requiring more affluent Americans to pay a larger share of their Medicare costs, would not amount to a voucher program — an approach that has been heavily criticized by Democrats.
Mr. Ryan said his plan was more like the Medicare prescription drug program and would allow patients to pick from a menu of insurance plans. The federal government would direct the subsidy to the plan, not to the consumer.
“It doesn’t go to the person, into the marketplace,” Mr. Ryan said. “It goes to the plan. More for the poor, more for people who get sick, and we don’t give as much money to people who are wealthy.”
And if you’re confused on how block grants will impact Medicaid money—or, if you’re like me and need a refresher on how they work—Ethan Rome at the Huffington Post has a quick explanation:
Ryan and the Republicans want to turn Medicaid into a block-grant program. In the existing system, state Medicaid programs receive federal matching funds based on the number of people in need and the costs of care in that state. But recently GOP governors have been agitating to convert those federal Medicaid billions into state block grants—lump sums set in advance and capped.
CNN reporter Jeanne Sahadi makes an important point that many others do not this morning, and warns against making direct comparisons between what Ryan is proposing and what the president has proposed:
A budget resolution and a presidential budget request, however, are very different documents, and comparing them is not as telling as those doing the comparing will claim.
For one thing, the Congressional Budget Office has already offered an independent analysis of the costs and savings included in the president’s budget, which is far more detailed than a budget resolution.
The CBO, however, will not be scoring the House budget resolution, so any costs or savings claimed by Republicans will only reflect the calculations of the House budget and tax committees.
Still, despite those differences, the previewed proposal has set the pundits off as budget negotiations continue and Friday’s shutdown deadline looms. The Huffington Post’s Rome has a post up that is pretty representative of the left’s response. The block grants he describes will be most problematic.
In most instances the Republicans will impose deep cuts to the program—fewer people will be covered and their benefits will be scaled back. As usual, this means the Republicans would balance their budgets on the backs of the people who can least afford it - the elderly, the blind, the disabled, working families and the poor - while letting corporations and the very rich off the hook. That is immoral.
Caring for the Medicaid population with capped funding under the discretionary control of Republican ideologues in state capitals will harm the health of millions, create even larger financial shortfalls in states and force cuts in other core areas, like transportation, education and law enforcement.