As Congress attempts to reform our health-care system yet again, discussions about how to manage and pay for Medicaid are on the front burner. With one in four Americans enrolled in what’s now the largest “unearned” public-welfare program in history, curbing the program’s growth is a fiscal imperative.
But that doesn’t mean cutting back Medicaid has to hurt the poor as liberals claim; Medicaid spending can go down while patient care improves and the number of patients covered goes up. I know this is true because I helped my state achieve it.
In 2009, as secretary of health and human services for Governor Donald Carcieri of Rhode Island, I was charged with running a novel experiment. With exploding Medicaid costs in our state crowding out education, infrastructure, and other vital needs, we plainly saw what most current governors see today: an out-of-control entitlement growing 7 percent each year and eating 30 percent of our budget, yet frustrating patients with its complexities and subpar outcomes.
