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Paul Ryan’s “Warning” About Medicaid Is Actually a Threat

Now that Republicans have failed to repeal the Affordable Care Act in the short term many are still working to make the implementation even more problematic. One of the latest efforts comes from Paul Ryan (R-WI) “warning governors” that they shouldn’t count on generous matching funds for Medicaid expansion. From Chicago Tribune:

The chairman of the U.S. House Budget Committee said Monday he has been warning governors not to count on high federal reimbursement rates for expanding Medicaid coverage to low-income families under President Barack Obama’s health-care reform. […]

“The fastest thing that’s going to go when we’re cutting spending in Washington is a 100 or 90 percent match rate for Medicaid. There’s no way. It doesn’t matter if Republicans are running Congress or Democrats are running Congress. There’s no way we’re going to keep those match rates like that,” said Ryan, who added that he has spread the warning to Republican governors and the National Conference of State Legislatures.

Let’s be clear. This is not a warning, this is a threat.

For better or worse the Democratic brand is now closely tied to the Affordable Care Act, so they are invested in making sure the Medicaid expansion works. The Medicaid expansion is one of the most popular, best designed and important aspects of the law. It is also now optional so Democrats need to keep it generous to make sure states take part. Democrats would be stupid to mess with Medicaid expansion in the near term.

The only reason states might not be able to count on Medicaid’s matching funds is because Republicans, like Paul Ryan, want to cut them. Ryan is not providing a “warning” based on a dispassionate analysis of Washington. As a person in power he is making a threat to help advance his political and policy agenda.

Photo by Gage Skidmore released under Creative Commons License 

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Jon Walker

Jon Walker

Jonathan Walker grew up in New Jersey. He graduated from Wesleyan University in 2006. He is an expert on politics, health care and drug policy. He is also the author of After Legalization and Cobalt Slave, and a Futurist writer at