Waking Up Too Late on Medicaid Expansion and "Fixing" Obamacare

Megan McCardle has a great revelation, now that Obamacare is in serious trouble:

Here’s my radical plan: If the Obamacare exchanges are going to result in, at best, people being able to buy Medicaid-style plans with limited choices and benefits, then why not just eliminate the middleman and give them … Medicaid?

Where was she six years ago, in the middle of “debate” on Obamacare, when I wrote this:

Here’s a suggestion: nationalise (or more accurately federalise) Medicaid.  Currently a joint venture of the states and the Feds, making it an entirely Federal program would have many possibilities:

  1. It would relieve the states of their largest running budget headache.  That would insure the support of all fifty governors, Republican and Democrat alike.
  2. It would enable the Feds to set a uniform standard for eligibility, etc.   That problem has bedevilled the current process, and led to the more egregious payoffs (LA, NE, etc.) we saw in the Senate process.
  3. It’s already a government program, so this (in principle) doesn’t “expand the role of government.”  That would put the small-government Republicans in a box.
  4. It addresses the medical insurance issues of the portion of the population least able to afford it.  Isn’t that what social welfare is all about?
  5. It would end the “health insurance shopping” that helped turn TennCare into the disaster it became before the state pared down the eligibility requirements.

I’ll also pass this along from three years ago.

Obamacare is the result of a political system–really, a life system in the U.S.–that puts “leadership” and “doing good” ahead of common sense and doing things that actually work.

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