Walker’s Medicaid Plan Puts a New Twist on Republican Reform

Republicans have wanted for decades to turn Medicaid into a block-grant program. If they win the presidency and hold onto the Senate in 2016, they might have a chance to do it as part of their pledge to repeal and replace Obamacare.

Scott Walker’s Medicaid plan could point the path forward.

The Wisconsin governor last week outlined his plan for health care reform. It was no surprise that he endorsed the concept of a Medicaid block grant, which would give states a capped amount of money and more flexibility in how they spend it. But his proposal was one of the most detailed to be released by a candidate for office, and it added a twist: He would actually turn Medicaid into three different funding streams for three different populations.

One would be a block grant for states to cover children, their parents, and other adults—the part of Medicaid that looks the most like regular health insurance. Another would be a separate block grant to cover long-term care for poor seniors and disabled people. The third stream would be open-ended grants to cover acute-care events for the disabled and elderly.