I really like the three principles that Charles Blahous lays out as a framework for “forging a consensus” on the reform of Medicaid in his post at e21:
- Distinguish between problems created by the ACA and those that existed before.
- Distinguish between the ACA’s Medicaid eligibility expansion and its elevated federal match rate.
- Recognize that the ACA’s elevated match rate is a problem warranting correction.
Read the whole thing for the explanation and significance of those three bullet points.
Of course, to those I would add that the basic underlying problems are that health care costs are rising faster than incomes and that we’re importing workers at the same or higher rate than the rate at which we’re creating jobs. As long as those are the case we’re going to need to subsidize somebody’s health care and the proportion of those somebodies to the population will increase over time.