Arlene Wohlgemuth and I have an op-ed in this weekend’s edition of the Houston Chronicle on why federal block grants are the right way forward for Medicaid reform in Texas.
On both the acute and long-term care side of Medicaid, the program suffers from the same problems as the broader health system. Third-party insurance – in this case public insurance, poorly managed by the federal and state governments – creates distance between those providing care and those receiving it.
With the freedom that a block grant would afford, the state could use Medicaid funds to offer a version of “premium support,” and subsidize the purchase of private insurance for non-disabled, non-elderly enrollees, who could choose an insurance plan from a competitive field. It is through this kind of competition that costs can be held in check.